Analysing intersecting social resources in young people’s ability to suggest safer sex - results from a national population-based survey in Sweden

Background Safer sex is one of the most crucial areas in sexual and reproductive health and rights (SRHR). Drawingon the theory of health promotion where social life generates resources for health our hypothesis is that having controlover one’s life situation, affects the ability for safer sex and thereby sexual health. The aim is to explore the associationbetween having control over one’s life and the ability to suggest safer sex among young people aged 16–29, andhow this plays out in relation to membership of six constructed social groups based on: gender, transgender experience,sexual identity, economy, being foreign-born, and social welfare recipiency followed by an in-depth analysis ofthe intersection of gender and sexual identity. Methods The data set comprises cross-sectional survey responses from a stratified random sample of 7755 in thetotal Swedish population of young people. The SRHR-focused questionnaire was developed within the HIV-monitoringprogram at the Public Health Agency of Sweden. Data collection was conducted by Statistics Sweden betweenApril 15 and June 8 in 2015. The survey had a response rate of 26%, which was in line with the study design. Statisticalanalysis was used to explore the self-reported outcome variable ability for safer sex and the exposure variable controlover one’s life. The methods used comprise multivariate logistic regression and an intersecting multivariate regressionexploring 12 intersecting social positions by gender and sexual identity. Results The results show that young people’s control over their lives is associated with their ability for safer sex. Dueto this, control over one’s life can be seen as a resource for safer sex. The associations in the 12 intersecting social positionsshowed complex patterns.Conclusions: The intersections of resources show the complexity and that gender cannot account for all differencesin the resources for young people’s ability to suggest safer sex. Implications for policy and practitioners involve bothaddressing and strengthening the sexual rights of young people from sexual minorities and tailoring interventions ina way that takes the intersections between gender and sexual identity into consideration