<![CDATA[Background: Many adolescents engage in sexual risk behaviors (SRBs). Purpose: This study aimed to assess the prevalence of SRBs that lead to unintended sexually transmitted diseases (STDs) and teen pregnancy. Method: The cross-sectional ‘Global School-Based Health Survey (GSHS)’ was conducted in 2018, with 6,940 Bolivian students aged 11–18 years or older responding to a questionnaire. The GSHS measure used in this survey included topics ranging from demographic information to sexual risk behaviors (SRB). Almost one-third of the students had ever had sex (33.7%), and nearly half of those who had sex had also consumed alcohol. Findings: In adjusted ordinal logistic regression analysis, ever drinking alcohol (AOR = 1.55, 95% CI [1.22, 1.98]) and heavy alcohol use (AOR = 1.34, 95% CI [1.04, 1.74]) were positively associated with SRB. Conclusion: This study highlights the contribution of alcohol and substance use to the increasing prevalence of SRB among Bolivian adolescents. Additionally, 1 out of 3 students engage in SRB, reflecting a lack of sexual health education among adolescents. Implication: The study shows that nearly one in three adolescents in Bolivia engage in SRB, influenced by alcohol and substance use, school truancy, and lack of parental support. This highlights the urgent need for more comprehensive sexual education programs that address these interconnected issues. Stakeholders are encouraged to develop deeper, integrated approaches that focus on substance use prevention, improving school engagement, and fostering stronger family support to reduce SRB and promote healthier outcomes for adolescents.]]>
