Gathering Insights About Sexual Health Promotion From Adolescents' Adoption of COVID-19-Protective Behaviors

This study aimed to understand how adolescent adoption of behaviors protective against different health risks relate to each other, as well as the role family and friends might play in the adoption of protective behaviors. We used data from adolescents (N = 1,803; age 13-17 years) who were recruited between April 2022 and June 2023 for the QuaranTeen Health study, an online, longitudinal survey assessing the impact of the COVID-19 pandemic on adolescent sexual health. We used data from the baseline questionnaire to calculate weighted correlations between friend and family norms about masking and vaccination and adolescents' COVID-19 protective behaviors, defined as 1) participant masking in the past two weeks and 2) receiving at least one COVID-19 vaccination shot. We used weighted logistic regression models to estimate associations between COVID-19-protective behaviors and sexual health-protective behaviors (i.e., condom use and hormonal contraception use at the most recent sex). We found that increased friend and family norms for COVID-19-protective behaviors were associated with participant masking (friends: ρ = .40, p < .01; family: ρ = .34, p < .01) and vaccine uptake (friends: ρ = .40, p < .01; family: ρ = .56, p < .01). Both behaviors were positively associated with condom use (masking: OR = 1.63, 95% CI = [1.05, 2.52]; vaccination: OR = 2.20, 95% CI = [1.32, 3.69]). Neither was associated with hormonal contraception use. Our findings suggest that family and friend norms for health-protective behaviors appear to be associated with health-protective behaviors among adolescents, at least when examining COVID-19-protective behaviors. Integrating friend and family norms may increase the effectiveness of future sexual health interventions designed to increase sexual health-protective behaviors among adolescents.