This research investigates the principal factors that influence youth sexuality, exploring the multi-faceted forces that shape young people's sexual knowledge, attitudes, and practices. Seeking to shed light on the diverse social, cultural, and structural forces that contribute to youth sexual risk-taking, I conducted a quantitative study of 1686 high school students between the ages of 18 and 24 who live in the Mesoamerican region of southern Mexico, Belize, and Guatemala. My survey includes 95 multiple choice and open-ended questions that explore a broad range of factors, including: personal relationships and plans; knowledge and sources of information about sex, contraception, and HIV prevention; sexual experience and contraceptive use; attitudes and beliefs concerning sexuality; perceived risk and experiences with HIV; and social and demographic variables.

Conducted between May 2007 and July 2009, this study is informed by the 2008 Mexico City Ministerial Declaration `Prevenir Con Educacion' (Preventing Through Education), a regional policy initiative that seeks to expand youth access to comprehensive sexuality education and services throughout Latin America. Within this policy context, I explore the ways in which school-based sexuality education influences young people's sexual knowledge, attitudes, and practices, in addition to examining how social norms shape youth sexuality across diverse cultural contexts in Latin America.

To contextualize this research, I integrate sociological theories of gender and sexuality that are framed within the context of economic development and globalization. Further, I incorporate empirical findings from public health research and programmatic models concerning the connections between knowledge, behavior, risk-taking, and policy interventions. Using multivariate analysis, I begin by separately examining the study results from Mexico, Belize, and Guatemala, analyzing the influence of the most salient independent variables within each national context. To best understand the ways in which these influences remain constant or diverge throughout the region, I then compare and contrast the results across the three countries.

These study findings demonstrate that four principal factors influence youth sexual behavior in Mesoamerica - school-based sexuality education, relationships and communication with parents and peers, church attendance, and ethnicity. My findings validate the efforts of the Mexico City Ministerial Declaration by highlighting the need to provide Mesoamerican youth with comprehensive school-based sexuality education and services in order to reduce high rates of unwanted pregnancy, adolescent childbearing, and HIV/AIDS throughout the region. I conclude with recommendations concerning how the Ministerial Declaration could more effectively achieve its principal goals of improving adolescent sexual and reproductive health outcomes in Latin America.