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Youth violence in Latin America is an important public health problem. However, the evidence from preventive programs within the region to address this problem is limited. Identifying context-specific factors that facilitate or hinder the success of interventions is necessary to guarantee the successful implementation of new preventive strategies. We present a systematic review and synthesis of qualitative studies to identify factors affecting the implementation of programs to prevent youth violence in Latin America. We searched 10 electronic databases and websites of international institutions. The quality of the studies was assessed using the critical appraisal skills program checklist, while the certainty of the findings of the synthesis was assessed using the certainty of the qualitative evidence approach. We included eight papers describing five programs in Argentina, Venezuela, Peru, El Salvador, and Mexico. Most of the factors affecting the implementation of programs were aspects related to features of the programs and social/political constraints. The synthesis suggests that future programs can benefit from having a multidisciplinary and/or multisectoral approach involving different key players. At the same time, potential strategies for avoiding problems related to such active engagement should be planned via promoting effective channels for communication and supervision. The review also suggests the importance of increasing awareness and motivation toward the problem of youth violence among relevant agencies and stakeholders. While the limited volume and quality of the literature impact on the ability to draw conclusions, the results could be useful for new programs being designed and the ones seeking to be adapted from other contexts.

Objective. To explore the opinions of Mexican male adolescents regarding teenage pregnancy and analyze its association with sexual behavior. Materials and methods. This is a cross-sectional study using a self-administered questionnaire among a conventional sample of male students (15-19 years old) in eight public schools in Morelos and Mexico City. Analyses include multivariate models to identify the association between opinions and sexual behaviors. Results. Overall, 68% agree that a teenage pregnancy is a negative event. In a hypothetical case, if a girlfriend got pregnant in this moment 56% would continue in the school whereas 18% would definitely abandon it. Those who affirm that a teenage pregnancy is something very bad have greater odds of using condoms (OR=1.8; p menor que 0.05). Conclusions. Male adolescents’ views about teenage pregnancy are associated with some sexual behaviors; however their opinions reflect several contradictions. The design of surveys directed exclusively to explore male adolescents’ opinions about reproductive health is urgent.

Background: Most studies on parent-adolescent sexual health communication come from developed countries and are based on either parents’ or children’s reports. In developing countries, there is little evidence about the agreement among reports of all parties involved in parent-adolescent sexual health communication. Objective: The objective of this study is to explore the congruence (agreement) between adolescents and their parents about how frequently they discuss on selected sexual health topics. Subjects: A total of 1606 parent-adolescent dyads of adolescents attending the first year in public high schools and their parents, in Morelos, Mexico were sampled in this study. Methods: The participants completed a self-administered questionnaire that included the frequency of parent-adolescent communication about eight sexual health topics. An ordinal logistic threshold model was used to estimate intra-class correlation coefficients within parent-adolescent dyads (as a measure of congruence) and to test if thresholds were equal between parents and adolescents. Results: Congruence in reported frequency of parent-adolescent sexual health communication ranged from 0.205 (menstruation) to 0.307 (condoms) for mother-adolescent dyads, and from 0.103 (ejaculation) to 0.380 (condoms) for father-adolescent dyads. The thresholds (i.e., the cutoff points that define the categories in the observed ordinal variable) differed between parents and adolescents for each of the sexual health topics explored (p Conclusion: Our findings suggest a low congruence between parents’ and adolescents’ reports on parent-adolescent sexual health communication. This might be due to interpretation of frequency and intensity of sexual health communication which differs between parents and adolescents.

Background Little is known about abortion practice in Mexico postlegalization of abortion in Mexico City in 2007. Study Design In 2009, we anonymously surveyed 418 Mexican health care providers at the Colegio Mexicano de Especialistas en Ginecologia y Obstetricia meeting using audio computer-assisted self-interview technology. Results The majority of respondents were obstetrician gynecologists (376, 90%), Catholic (341, 82%), 35–60 years old (332, 79%) and male (222, 53%) and worked with trainees (307, 74%). Prior to 2007, 11% (46) and 17% (71) provided medical and surgical abortions; now, 15% (62) and 21% (86) provide these services, respectively. Practitioners from Mexico City were more likely to provide services than those from other areas. Most medical abortion providers (50, 81%) used ineffective protocols. Surgical abortion providers mainly used either manual vacuum aspiration (39, 45%) or sharp curettage (27, 32%). Most abortion providers were trained in residency and wanted more training in medical (54, 87%) and surgical (59, 69%) abortion. Among nonproviders, 49% (175) and 27% (89) expressed interest in learning to perform medical and surgical abortion, respectively. Conclusion Given the interest in learning to provide safe abortion services and the prevalent use of ineffective medical abortion regimens and sharp curettage, abortion training in Mexico should be strengthened.

In this article reporting on our qualitative study, we describe changes in parent—adolescent sexual health communication following an intervention for parents of 10th graders in Mexico. The intervention was aimed to sensitize and develop skills for appropriate parent—child communication about the prevention of sexually transmitted infections (STIs), unplanned pregnancy, and birth control, and focused on encouraging condom use with emergency contraception backup. We conducted 66 in-depth interviews with adolescents and parents after the intervention. Following the principals of grounded theory, we carried out inductive analysis to create codes and organize central themes. Our findings identify previously undefined critical steps or movements important for parent—child communication about sex. When parents are sensitized to the risks their adolescent children face, it is easier to initiate communication about prevention. These initial movements are essential to achieve substantive conversation, and must be considered in future strategies that aim to promote parent—adolescent communication about sexuality and the prevention of STIs and unplanned pregnancy.

OBJETIVO: Evaluar el conocimiento y uso de anticoncepción de emergencia (AE), y factores asociados en estudiantes de escuelas públicas en Morelos, México. MATERIAL Y MÉTODOS: Estudio transversal realizado entre 2003-2004 con 1550 estudiantes de 14-24 años. Se utilizó regresión logística para identificar factores asociados al conocimiento correcto sobre AE. RESULTADOS: El 40% fueron hombres y 60% mujeres con edad promedio de 19 años. El 60% ha escuchado sobre AE pero únicamente 45% tiene conocimiento correcto; 3% de los estudiantes sexualmente activos la ha usado. Factores asociados al conocimiento correcto: ser mujer (RM=1.66; IC 1.33, 2.06), haber tenido relaciones sexuales (RM=1.77; IC 1.43, 2.18), nivel socioeconómico medio (RM=1.87; IC 1.04, 3.37), vivir en zona semi-urbana (RM=1.34; IC 1.02, 1.77), tomar alcohol (RM=1.78; IC 1.42, 2.22). CONCLUSIONES: En Morelos, el conocimiento de los adolescentes sobre la AE es escaso. La transmisión de mensajes claros sobre su forma precisa de uso resulta necesaria.

Objective To evaluate the effectiveness of an educational intervention for parents of first year high school students in the State of Morelos, Mexico, whose aim was to impact adolescents’ sexual behavior, knowledge and access to contraception. Material and methods Quasi-experimental prospective study with eleven control and eleven intervention schools using self-administered questionnaires for parents and adolescents pre- and post-intervention. Parent–child dyads in the control and intervention schools were matched according to parents’ propensity score; the average treatment effect (ATE) was estimated for adolescent’s outcome variables. Results At follow-up, we found significant differences for adolescents in the intervention schools: 6.8% delayed initiation of sexual intercourse, 14.4% had correct knowledge about emergency contraception (EC), and 164% reported having received condoms from their parents, when comparing with students in control schools. Conclusions Our results suggest that parent-focused interventions could be an innovative and effective strategy to promote adolescents sexual health.

To evaluate emergency contraception (EC) knowledge and use as well as identify factors associated to correct EC knowledge among public schools students in Morelos, Mexico.Cross-sectional study conducted in 2003-2004 in a sample of 1,550 students (ages 14-24). Logistic regression was used to identify factors associated to EC correct knowledge.Among all, 40% were men and 60% women with an average age of 19 years. Sixty percent have heard about EC, nevertheless, only 45% have correct knowledge about it; 3% of sexually active students (43%) reported its use. Factors associated to EC correct knowledge are: being a woman (OR=1.66; CI 1,33, 2,06), being sexually active (OR=1.77; CI 1,43, 2,18), middle income (OR=1.87; CI 1,04, 3,37), living in a semi-urban zone (OR=1.34; CI 1,02, 1,77), drinking alcohol (OR=1.78; CI 1,42, 2,22).In Morelos, adolescents' knowledge of EC is scarce. Specific messages regarding its correct use are necessary.

To identify the prevalence of and factors associated with suicidal ideation and intent in adolescent students in Mexico.A cross-sectional study was conducted with a sample of 12,424 students from public schools in 2007. We used logistic regression to obtain odds ratios (OR) with 95% confidence intervals.A total of 47% of the students reported at least one suicidal ideation symptom and 9% reported an antecedent of suicidal intent. Factors associated with suicide ideation and intent include low confidence in communication with parents (OR=1.30; OR=1.54), sexual abuse (OR=1.92; OR=1.57), depressive symptoms (OR=5.36; OR=1.51), tobacco use (OR=1.30; OR=2.57), alcohol use (OR=1.60; OR=1.31) and, for women, having had sexual relations (OR=1.28; OR=1.65).Roughly 50% of high school students had at least one symptom of suicidal ideation. To lessen this problem, associated factors should be considered, including consumption of addictive substances, gender, history of sexual abuse and depression.

Background The relationship between urbanicity and adolescent health is a critical issue for which little empirical evidence has been reported. Although an association has been suggested, a dichotomous rural versus urban comparison may not succeed in identifying differences between adolescent contexts. This study aims to assess the influence of locality size on risk behaviors in a national sample of young Mexicans living in low-income households, while considering the moderating effect of socioeconomic status (SES). Methods This is a secondary analysis of three national surveys of low-income households in Mexico in different settings: rural, semi-urban and urban areas. We analyzed risk behaviors in 15-21-year-olds and their potential relation to urbanicity. The risk behaviors explored were: tobacco and alcohol consumption, sexual initiation and condom use. The adolescents' localities of residence were classified according to the number of inhabitants in each locality. We used a logistical model to identify an association between locality size and risk behaviors, including an interaction term with SES. Results The final sample included 17,974 adolescents from 704 localities in Mexico. Locality size was associated with tobacco and alcohol consumption, showing a similar effect throughout all SES levels: the larger the size of the locality, the lower the risk of consuming tobacco or alcohol compared with rural settings. The effect of locality size on sexual behavior was more complex. The odds of adolescent condom use were higher in larger localities only among adolescents in the lowest SES levels. We found no statically significant association between locality size and sexual initiation. Conclusions The results suggest that in this sample of adolescents from low-income areas in Mexico, risk behaviors are related to locality size (number of inhabitants). Furthermore, for condom use, this relation is moderated by SES. Such heterogeneity suggests the need for more detailed analyses of both the effects of urbanicity on behavior, and the responses--which are also heterogeneous--required to address this situation.

Objetivo. Identificar prevalencias y factores asociados a la ideación e intento suicida en estudiantes adolescentes de México. Material y métodos. Estudio transversal en 12424 adolescentes de escuelas públicas en 2007. Se utilizaron modelos de regresión logística para obtener razones de momios (RM) con intervalos de confianza de 95% (IC 95%). Resultados. 47% reportó al menos un síntoma de ideación; 9% refirieron antecedente de intento. Los factores asociados a la conducta suicida fueron: poca confianza en la comunicación hacia los padres (RM=1.30, RM=1.54); abuso sexual (RM=1.92, RM=1.57), sintomatología depresiva (RM=5.36, RM=1.51), consumo de tabaco (RM=1.30, RM=2.57), alcohol (RM=1.60, RM=1.31) y, para las mujeres, haber tenido relaciones sexuales (RM=1.28, RM=1.65). Conclusión. Casi la mitad de los(as) estudiantes del nivel medio superior presentaron al menos un síntoma de ideación. Para disminuir esta problemática se deben considerar los factores asociados: el consumo de sustancias adictivas, género, antecedentes de abuso sexual y depresión.Objective. To identify the prevalence of and factors associated with suicidal ideation and intent in adolescent students in Mexico. Material and Methods. A cross-sectional study was conducted with a sample of 12 424 students from public schools in 2007. We used logistic regression to obtain odds ratios (OR) with 95% confidence intervals. Results. A total of 47% of the students reported at least one suicidal ideation symptom and 9% reported an antecedent of suicidal intent. Factors associated with suicide ideation and intent include low confidence in communication with parents (OR=1.30; OR=1.54), sexual abuse (OR=1.92; OR=1.57), depressive symptoms (OR=5.36; OR=1.51), tobacco use (OR=1.30; OR=2.57), alcohol use (OR=1.60; OR=1.31) and, for women, having had sexual relations (OR=1.28; OR=1.65). Conclusions. Roughly 50% of high school students had at least one symptom of suicidal ideation. To lessen this problem, associated factors should be considered, including consumption of addictive substances, gender, history of sexual abuse and depression.