REGIONAL DIFFERENCES IN POSITIVE SEXUAL BEHAVIOUR AMONG YOUTH IN SUB-SAHARAN AFRICA

Contextual determinants of multiple sexual partnerships amongst young people in South Africa: a multilevel analysis

BACKGROUND

Risky sexual behaviour (RSB), particularly multiple sexual partnerships (MSP) continues to be a major public health concern and has been linked to the increasing STIs, including HIV/AIDS in many parts of sub-Saharan Africa (SSA), suggesting that there is an association between contextual factors and multiple sexual partnering. However, in South Africa, this association is not well established in recent literature. Hence, this study examined the contextual factors contributing to multiple sexual partnerships among young people in South Africa.

MATERIALS AND METHODS

Data was extracted from the 2016 South Africa Demographics and Health Survey (2016 SADHS). A cross-sectional study of 3889 never-married young people. Descriptive and inferential statistics as well as multilevel logistic regression were used to analyse the data on never-married young people aged 15 to 24 years.

RESULTS

The results indicated that at the individual level, young males (61.7%) were significantly more likely than their female counterparts (56.1%) to engage in multiple sexual partners, although, the difference was not as significant as expected. At the community level clustering, the likelihood of exposure to multiple sexual partnerships significantly increased among females (OR = 1.47; 95% CI: 1.25-1.73) but decreased among their male counterparts (OR = 0.73; 95% CI: 0.58-0.92), in particular, family disruption, residential instability, and ethnic diversity led young people to engage in multiple sexual partnerships.

CONCLUSIONS

There is a need to intensify programmes aimed at considering appropriate policy options to reduce the prevalence of multiple sexual partnerships. Adopting the implications of these findings is essential for a developmental strategy towards achieving the sustainable development goal of ending STIs among young people in South Africa.

Regional and Country Prevalence Estimates of Unsafe Sex Among Adolescents in 68 Low-Income and Middle-Income Countries

Prioritizing adolescent health is a public health priority to achieve the sustainable development goals, including reducing the risk of unsafe sex. Data on unsafe sex have remained scarce among adolescents in low-and middle-income countries (LMICs). To estimate the prevalence of unsafe sex in LMICs, we conducted secondary data analysis on the Global School-based Student Health Surveys among 244,863 students aged 13-17 years from 68 countries across five World Health Organization regions. The overall prevalence of ever had sex was 16.2%. The highest to lowest regional prevalence estimation of ever had sex was 30.5% (28.9-32.1) in the Americas, 28.6% (26.8-30.4) in Africa, 10.9% (9.2-12.6) in the Eastern Mediterranean, 9.6% (8.8-10.5) in South-East Asia, and 8.0% (6.8-9.1) in the Western Pacific. The highest prevalence of sexual intercourse before age 14 and practicing sexual intercourse without condom use were 36.5% (34.5-38.5) and 32.2% (30.1-34.3) in Africa, respectively. Findings suggest that current interventions are inadequate in promoting the uptake of safe sexual behaviors and an urgent intervention is needed.

[Factors Influencing Sexual Experiences in Adolescents Using a Random Forest Model: Secondary Data Analysis of the 2019~2021 Korea Youth Risk Behavior Web-based Survey Data]

PURPOSE

The objective of this study was to develop a predictive model for the sexual experiences of adolescents using the random forest method and to identify the "variable importance."

METHODS

The study utilized data from the 2019 to 2021 Korea Youth Risk Behavior Web-based Survey, which included 86,595 man and 80,504 woman participants. The number of independent variables stood at 44. SPSS was used to conduct Rao-Scott χ² tests and complex sample t-tests. Modeling was performed using the random forest algorithm in Python. Performance evaluation of each model included assessments of precision, recall, F1-score, receiver operating characteristics curve, and area under the curve calculations derived from the confusion matrix.

RESULTS

The prevalence of sexual experiences initially decreased during the COVID-19 pandemic, but later increased. "Variable importance" for predicting sexual experiences, ranked in the top six, included week and weekday sedentary time and internet usage time, followed by ease of cigarette purchase, age at first alcohol consumption, smoking initiation, breakfast consumption, and difficulty purchasing alcohol.

CONCLUSION

Education and support programs for promoting adolescent sexual health, based on the top-ranking important variables, should be integrated with health behavior intervention programs addressing internet usage, smoking, and alcohol consumption. We recommend active utilization of the random forest analysis method to develop high-performance predictive models for effective disease prevention, treatment, and nursing care.

Prevalence and predictors of premarital sexual intercourse among young women in sub-Saharan Africa

INTRODUCTION

Premarital sexual intercourse (PSI) without adequate information and/or appropriate application of the relevant knowledge about sex before marriage, potentially has adverse effects on the sexual and reproductive health outcomes of vulnerable young women in sub-Saharan Africa (SSA). This study sought to examine the prevalence and predictors of PSI among young women aged 15-24 in SSA.

METHODS

Nationally representative cross-sectional data from 29 countries in SSA were extracted for the study. A weighted sample size of 87,924 never married young women was used to estimate the prevalence of PSI in each country. A multilevel binary logistic regression modelling approach was used to examine the predictors of PSI at p < 0.05.

RESULTS

The prevalence of PSI among young women in SSA was 39.4%. Young women aged 20-24 (aOR = 4.49, 95% CI = 4.34, 4.65) and those who had secondary/higher educational level (aOR = 1.63, 95% CI = 1.54, 1.72) were more likely to engage in PSI compared to those aged 15-19 and those with no formal education. However, young women who belonged to the Islamic religion (aOR = 0.66, 95% CI = 0.56, 0.78); those who were working (aOR = 0.75, 95% CI = 0.73, 0.78); belonged to the richest wealth index (aOR = 0.55, 95% CI = 0.52, 0.58); were not exposed to radio at all (aOR = 0.90, 95% CI = 0.81, 0.99); were not exposed to television at all (aOR = 0.50, 95% CI = 0.46, 0.53); resided in rural areas (aOR = 0.73, 95% CI = 0.70, 0.76); and those who were living in the East African sub-region (aOR = 0.32, 95% CI = 0.29, 0.35) were less likely to engage in PSI compared to those who were traditionalist, unemployed, belonged to the poorest wealth index, exposed to radio frequently, exposed to television frequently, resided in urban areas, and lived in the Southern Africa sub-region, respectively.

CONCLUSION

Sub-regional variations in the prevalence of PSI exist amidst multiple risk factors among young women in SSA. Concerted efforts are required to empower young women financially, including education on sexual and reproductive health behaviors such as the detrimental effects of sexual experimentation and encouraging abstinence and/or condom use through regular youth-risk communication advocacy.

Prevalence and associated factors of early sexual initiation among youth female in sub-Saharan Africa: a multilevel analysis of recent demographic and health surveys

Background

Early sexual initiation is a major public health concern globally, specifically in Sub-Saharan African (SSA) countries where reproductive health care services are limited. It is strongly related to increased risk of HIV/AIDS, sexually transmitted diseases, unwanted pregnancy, adverse birth outcomes, and psychosocial problems. However, there is limited evidence on the prevalence and associated factors of early sexual initiation among youth females in SSA.

Methods

A secondary data analysis was employed based on the recent DHSs of sub-Saharan African countries. A total weighted sample of 184,942 youth females was considered for analysis. Given the hierarchical nature of DHS data, a multilevel binary logistic regression model was fitted. The Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), and Likelihood Ratio (LR) test were used to assess the presence of clustering. Four nested models were fitted and the model with the lowest deviance (-2LLR0 was selected as the best-fitted model. Variables with p-value < 0.2 in the bivariable multilevel binary logistic regression analysis were considered for the multivariable analysis. In the multivariable multilevel binary logistic regression analysis, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) was reported to declare the strength and statistical significance of the association.

Results

The prevalence of early sexual initiation among youth females in sub-Saharan Africa was 46.39% [95%CI: 41.23%, 51.5%] ranging from 16.66% in Rwanda to 71.70% in Liberia. In the final model, having primary level education [AOR = 0.82, 95% CI; 0.79, 0.85], and [AOR = 0.50, 95%CI; 0.48, 0.52], being rural [AOR = 1.05, 95%CI: 1.03, 1.07], having media exposure [AOR = 0.91, 95%CI: 0.89, 0.94], and belonged to a community with high media exposure [AOR = 0.92, 95%CI: 0.89,0.96] were found significantly associated with early sexual initiation.

Conclusion

The prevalence of early sexual initiation among youth females in SSA was high. Educational status, wealth index, residence, media exposure, and community media exposure have a significant association with early sexual initiation. These findings highlight those policymakers and other stakeholders had better give prior attention to empowering women, enhancing household wealth status, and media exposure to increase early sexual in the region.

Prevalence and associated factors of early sexual initiation among female youth in East Africa: further analysis of recent demographic and health survey

Background

Early sexual initiation is one of the risky sexual practices. Early sexual beginning is associated with an increased risk of HIV/AIDS, sexually transmitted infections (STIs), unexpected pregnancies, unsafe abortion, premature deliveries, and psychosocial issues. However, there is still a lack of evidence, particularly in East Africa, where community-level factors are not investigated. Therefore, this study aimed to estimate the pooled prevalence and to identify associated factors of early sexual initiation among female youth in Eastern Africa.

Methods

A total weighted sample of 49,716 female youth was included in this analysis. STATA version 14 software was used for data extraction, recoding, and analysis. A multilevel binary logistic regression model was fitted to identify determinants of early sexual initiation in the region. Finally, Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was reported to declare the factors that are significantly associated with early sexual initiation.

Result

The prevalence of early sexual initiation in East Africa was 21.14% [95% CI: 20.00%, 21.50%]. In the multivariable multilevel analysis; being age 20–24 years [AOR = 0.65: 95% CI; 0.61, 0.69], primary [AOR = 0.73: 95% CI; 0.67, 0.78], secondary &above education [AOR = 0.30: 95% CI; 0.27,0.33], married [AOR = 1.85: 95% CI; 1.73,1.97], middle wealth [AOR = 0.78: 95% CI; 0.72,0.84], richest [AOR = 0.74: 95% CI; 0.68,0.80], and reading newspaper [AOR 0.77: 95% CI;0.71,0.83] were significantly associated with early sexual initiation.

Conclusion

The study revealed that early sexual initiation among female youth was high in East Africa. Educational status, respondent age, marital status, wealth index, age at first cohabitation, contraceptive use, reading newspaper, and place of residence were associated with early sexual initiation. Therefore, the survey findings will help policymakers, as well as governmental and non-governmental organizations, design the most effective interventions. Moreover, strengthening information, education, and wealth status are important intervention areas to delay the age of early sexual debut.

Prevalence of unprotected sexual activity in the Brazilian population and associated factors: National Health Survey, 2019

OBJECTIVE

To estimate prevalence of unprotected sexual activity and associated factors in the Brazilian population.

METHODS

This was a cross-sectional study with 61,523 adults aged 18 years or older who took part in the 2019 National Health Survey. We estimated prevalence of unprotected sexual activity in the last year. We analyzed association of socioeconomic and demographic variables with the outcome using Poisson regression, estimating prevalence ratios (PR) and 95% confidence intervals (95%CI).

RESULTS

Prevalence of unprotected sexual activity was 76.9% (95%CI 76.3;77.6), being higher in all the country's regions in comparison to the Northern region, as well as being higher among people living in rural areas (PR = 1.04; 95%CI 1.03;1.06), females (PR = 1.06; 95%CI 1.05;1.08), participants aged 60 years or older (PR = 1.33; 95%CI 1.27;1.38), married individuals (PR = 1.25; 95%CI 1.23;1.27) and those with less education (PR = 1.05; 95%CI 1.03;1.06).

CONCLUSION

Strategies aimed at groups with higher prevalence of unprotected sexual activity are necessary.

Contexts, beliefs and health behaviour: Are individuals who engage in risky sexual behaviour likely to wear facemasks against COVID-19?

Beside age, underlying comorbidities and availability of sanitation facilities, individual health beliefs and behaviour are critical in combating the sustained prevalence of Covid-19. Behaviour has, however, been shown to be consistent but could be context- dependent based on the individual’s beliefs. To investigate whether or not individuals’ protective behaviour against coronavirus is associated with their behaviour in a previous health context. Facemask usage and engagement in risky sexual behaviour (RSB) were employed as corollaries of Covid-19 protective behaviour and a previous health context respectively. Data on them and other sociodemographic correlates of health behaviour were collected on 522 Nigerians via a web-based survey. The data were analyzed using frequency, Chi Square and Binary Logistics Regression. About 31% of the population wore facemasks in public, 48.1% believed Covid existed and was severe, and 31.6% had engaged in RSB. Individuals who engaged in RSB had lower odds of wearing facemasks in public in both the general population and across the rural-urban divide. The relationship was, however, only statistically significant (OR:0.642, p<0.05) in the adjusted regression model. Other significant determinants of facemask use were gender, place of residence, employment status and beliefs about Covid. The similarity of individual beliefs and behaviours in different health contexts provides an opportunity to model behaviour change communication policies for preventing and combating the spread of coronavirus and other infectious diseases.

Predictors of Multiple Sexual Partners among Men in Ethiopia: A Multilevel Analysis

Background

Multiple sexual partnerships were one of the public health issues in the spread of high rates of sexually transmitted infections in sub-Saharan regions. An increase in the number of non-marital sexual partners can lead to a loss of satisfaction as well as other mental health repercussions such as greater rates of anxiety, depression, etc. This study examined the predictors of multiple sexual partners among men in Ethiopia.

Methods

This study used 2016 nationally representative data which was conducted using a multistage stratified cluster sampling method. Multilevel binary logistic regression models were employed to estimate the predictors of multiple sexual partners among men in Ethiopia with the assistance of the STATA software.

Results

In this study 6778 participants were considered with an overall prevalence rate of multiple sexual partners of 6.5% during the 12 months preceding the survey. The findings showed that older-age, urban-resident, inconsistent use of a condom, exposure to any media, abuse of alcohol, early-time first-sex, and religion were predictors of multiple sexual partners among men in Ethiopia.

Conclusions

The findings revealed that the prevalence rate of men's multiple sexual partners in Ethiopia was very high. Therefore, the country needs to re-examine the behavioral change strategies periodically to adapt to the contextual realities and engage relevant stakeholders. Specifically, health sectors and religious organizations should develop strategies to create awareness in society on the risk of having multiple sexual partnerships. In addition, we highly recommend stakeholders prepare risk reduction interventions that take the significant predictors of multiple sexual partners.

A multilevel mixed effect analysis of neighbourhood and individual level determinants of risky sexual behaviour among young people in South Africa

BACKGROUND

Despite national and international commitments and efforts to prevent risky sexual behaviours, a high proportion of young people in South Africa are engaged in risky sexual behaviour. However, most efforts are currently directed toward addressing individual-level factors at the expense of not addressing neighbourhood-level determinants such as social disorganisation, contributing to risky sexual behaviour among young people in South Africa. This study investigated the multilevel factors of risky sexual behaviours among young people by gender in South Africa, using the lens of socio-ecological and social disorganisation frameworks.

METHODS

Data from a nationally representative sample of 1268 males and 2621 females aged 15-24 years, giving a total of, 3889 never-married youths, were drawn from the 2016 South Africa Demographic and Health Survey. Analysis was conducted using multilevel mixed-effect logistic regressions with random community-level effects.

RESULTS

Findings show that youth who were from a heterogeneous ethnic group (AOR = 0.49, CI: 0.35-0.67), household size of 5 + members (AOR = 0.78, CI: 0.54-1.15), community education (AOR = 0.97, CI: 0.72-1.32) were associated with low engagement in multiple sexual partnerships. Youths who were employed (AOR = 0.84, CI: 0.59-1.18), and from high-level community poverty (AOR = 0.76, CI: 0.58-1.00) were also associated with reduced odds of unprotected sex. In addition, older youth aged 20-24 years (AOR = 12.6, CI: 9.93-16.00); secondary education attainment (AOR = 1.01, CI 0.58-1.77); family structure (AOR = 1.37, CI: 0.75-1.15); Gauteng province (AOR = 1.45 CI: 0.92-2.28); residential mobility (AOR = 1.25, CI: 1.02-1.53), community media exposure to contraceptives (unprotected sex) (AOR = 1.38, CI: 1.09-1.76) were more likely to engage in risky sexual behaviour.

CONCLUSION

The study revealed that neighbourhood and individual-level factors were important in explaining the factors associated with risky sexual behaviour among young people in South Africa. In addition, engagement in risky sexual behaviour was high, with minimal variation among young females and males in South Africa. It specifies that the practice of risky sexual behaviour is significantly associated with multilevel factors of social disorganisation that cut across gender. These results imply that there is a need to review policies of sexual risks reduction for each gender, which might help mitigate the adverse effects of social disorganisation for women and men youths in South Africa.

HIV testing and ethnicity among adolescent girls and young women aged 15-24 years in Ghana: what really matters?

Despite the high prevalence of HIV among adolescent girls and young women (AGYW) aged 15-24 years in Ghana, HIV testing remains low among this population. The objective of this study was to examine the relationship between ethnicity and HIV testing among AGYW in Ghana. The 2014 Ghana Demographic and Health Survey data were used and analyses were restricted to 3325 female participants aged 15-24 years. Chi-squared tests and a logistic regression model were used to assess the association between ethnicity and HIV testing. Furthermore, the PEN-3 cultural model informed the conceptual framework that explained the relationship between ethnicity and HIV testing behaviour. Results from the bivariate analysis showed an association between ethnicity and HIV testing among AGYW (p<0.05). However, when controlling for other behavioural and socioeconomic determinants of HIV testing in the logistic regression, there was no association between ethnicity and HIV testing. The significant predictors of HIV testing were marital status, having multiple sexual partners, and condom use. The AGYW who were married (adjusted odds ratio [aOR] = 4.56, CI: 3.46-6.08) or previously married (aOR = 4.30, CI: 2.00-9.23) were more likely to test for HIV compared with those who were never married. Having multiple sexual partners (aOR = 0.41, CI: 0.20-0.85) and condom use (aOR = 0.56, CI: 0.38-0.84) were associated with lower odds of HIV testing. The results provide evidence that ethnicity is not associated with HIV testing among AGYW in Ghana, as the bivariate association was attenuated when other behavioural and socioeconomic determinants of HIV testing were accounted for. These findings highlight the importance of considering individual-level factors, community-level factors, and other socio-cultural factors as they really matter in the development of HIV prevention programmes for adolescent girls and young women in Ghana.

Socioeconomic variations in risky sexual behavior among adolescents in 14 sub-Saharan Africa countries who report ever having had sex

BACKGROUND

Equity is a guiding principle of the Global Strategy for Women, Children and Adolescents' Health (2016-2030) aimed at improving adolescent health and responding more effectively to adolescents' needs. We investigated the socioeconomic differentials in having multiple sexual partners and condom use among unmarried adolescents who reported ever having had sex aged 15-19 years in 14 sub-Saharan countries.

METHODS

Using the most recent publicly available Demographic and Health Surveys conducted between 2011 and 2018, we calculated survey- and sex-specific proportions of two or more partners and condomless sex, both overall and by selected socioeconomic characteristics and we fitted logistic regression models to estimate the survey- and sex-specific adjusted odds ratios. The pooled adjusted odds ratios were estimated using multilevel logistic regression.

RESULTS

In most countries, higher percentages of male adolescents than female adolescents reported having more than one partner in the last 12 months. Conversely, a lower percentage of young male reported having condomless sex when compared to young female: from 19.8% in Gabon to 84.5% in Sierra Leone among male adolescents and from 32.6% in Gabon to 93.2% in Sierra Leone among female adolescents. In the multilevel analyses, condomless sex was associated with place of residence, wealth and schooling for both female and male adolescents, while among male adolescents multiple partnerships was significantly associated with place of residence.

CONCLUSION

Our findings on disparities in condomless sex associated with socioeconomic characteristics might reflect constraint choice and decision making. Results also suggest the need for educational programming and services and better access to barrier methods.

Using Social Ecological Theory to Identify Factors Associated With Risky Sexual Behavior in Cambodian Adolescent Girls and Young Women Aged 10 to 24 Years: A Systematic Review

There is an increase in risky sexual behavior (RSB) in Cambodian female youth aged 10 to 24 years, which can contribute to detrimental sexual and reproductive health due to the increased risk of acquiring sexually transmitted infections, unintended pregnancies, or abortions. Bronfenbrenner’s social ecological model was used to identify factors at personal, microenvironment, and macroenvironment levels potentially associated with RSB. A systematic literature review employing PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was conducted to search 8 databases for articles published between 1994 and 2019. A risk of bias tool was applied for methodological quality of the 4 included studies. RSB is associated with multiple factors including sexual debut at young age, alcohol and substance abuse, multiple partners, living away from parents or orphan status, peer delinquency, non-use of condoms by partners, transactional sex, low education and socioeconomic status, and no access to sexual and reproductive health services. Multipronged preventive strategies operating at different levels are recommended in terms of including sex education and increasing reproductive health literacy programs at the schools and community programs for safe sex, condom use and sexual negotiation skills, and access to modern contraceptive methods.

Consistent Provisions Mitigate Exposure to Sexual Risk and HIV Among Young Adolescents in South Africa

Exposure to sexual risk in early adolescence strongly predicts HIV infection, yet evidence for prevention in young adolescents is limited. We pooled data from two longitudinal South African surveys, with adolescents unexposed to sexual risk at baseline (n = 3662). Multivariable logistic regression tested associations between intermittent/consistent access to eight provisions and reduced sexual risk exposure. Participants were on average 12.8 years, 56% female at baseline. Between baseline and follow-up, 8.6% reported sexual risk exposure. Consistent access to caregiver supervision (OR 0.53 95%CI 0.35-0.80 p = 0.002), abuse-free homes (OR 0.55 95%CI 0.37-0.81 p = 0.002), school feeding (OR 0.55 95%CI 0.35-0.88 p = 0.012), and HIV prevention knowledge (OR 0.43, 95%CI 0.21-0.88 p = 0.021) was strongly associated with preventing early sexual risk exposure. While individual factors reduced the odds of sexual risk exposure, a combination of all four resulted in a greater reduction, from 12.9% (95%CI 7.2-18.7) to 1.0% (95%CI 0.2-1.8). Consistent access to provisions in early adolescence may prevent sexual risk exposure among younger adolescents.

HIV voluntary counselling and testing and behaviour changes among youths in Nigeria

Voluntary counselling and testing (VCT) for HIV has been promoted as a strategy to prevent HIV pandemics by changing sexual behaviour. Despite the provision of VCT in countries with generalized or high-burden epidemics, including Nigeria, the extent of its influence on behavioural change remains a conjecture. The main objective of this study was to examine the influence of HIV VCT on sexual behaviour changes among youths in Nigeria. The study utilized 2013 Nigeria Demographic and Health Survey (NDHS) data. Data were analysed from a nationally representative sample drawn from 8046 females and 6031 males aged 15-24 giving a total sample of 14,077 never-married youths. Descriptive and analytical analyses were carried out, including multivariate logistic regression. The study found a low uptake of HIV VCT and regional variation in behavioural changes between female and male youths. Voluntary HIV counselling and testing was found to be a protective factor for condom use at last sex for female youths, but significantly reduced the likelihood of primary sexual abstinence for both females and males, as well as having a single sexual partner for female youths. After controlling HIV VCT with other variables, certain socioeconomic factors were found to be significantly associated with behavioural changes. Thus, the attitudes of most Nigerian youths towards voluntary HIV counselling and testing needs to be improved through socioeconomic factors for healthy sexual activity. To achieve this, government and non-governmental organizations, as well as religious leaders and policymakers, should engage in appropriate and long-term activities directed at the sexual health needs of never-married youths, through voluntary HIV counselling and testing, to encourage them to change their sexual behaviour.

Protective sexual behaviours among young adults in Nigeria: influence of family support and living with both parents

Background

Many studies have focused on risky sexual behaviour among adolescents and young adults; however, literature on protective sexual practices among this age cohort is still evolving. Since young adults are disproportionately burdened by sexually transmissible infections, including HIV, understanding factors that influence protective sexual behaviour among the age group is crucial in developing age-appropriate interventions. Drawing from a cross-sectional survey conducted among adolescents and young adults in two Nigerian universities, we examined gender differences in protective sexual behaviours and the influence of family support and living with both parents on these behaviours.

Methods

A total of 800 male and female university students in two Nigerian universities were recruited using stratified random sampling between February and April 2018. Analysis was, however, based on 599 participants aged between 15 and 24 . Adjusted and unadjusted multinomial logistic regression models were used to examine the influence of family support, and living with both parents on protective sexual behaviours at a 95% confidence interval.

Results

Findings show that the largest proportion of our participants engaged in protective sexual behaviours. We found no gender differences in protective sexual behaviours, including sexual abstinence, consistent condom use, and sexual fidelity. Family support and living with both parents were positively associated with protective sexual behaviours among adolescents and young adults.

Conclusion

This study found that a majority of adolescents and young adults in Nigerian Universities engage in protective sexual behaviours. Adequate family support and living with both parents are positively associated with protective sexual behaviours. The study however revealed that about one-fifth of our participants engaged in high-risk sexual behaviour. This suggests a need for behavioural change interventions, provision of sexual health services and empowerment of students who receive inadequate family support.

Religiosity and sexual abstinence among Nigerian youths: does parent religion matter?

BACKGROUND

Religion plays an important role in youth behaviours, making it a significant factor in the discourse on youth sexuality in sub-Saharan Africa. Several studies have found that religion and religiosity play an important role in the sexual behaviours of young people. However, little research in Nigeria has examined the mechanisms through which religiosity influences youth sexual behaviour and if parents' religion moderates this relationship. Guided by the social control theory, this paper contributes to the existing literature by examining the relationship between religiosity and youth sexual behaviour.

METHODS

Data for the study came from 2399 male and female youth aged 16-24 years in four states purposively selected from four regions in Nigeria. Abstinence was the sexual behaviour of interest. Logistic regression was used to examine this relationship.

RESULTS

Results showed that 68% of the youth had never had sex. Religiosity was a protective factor for youth sexual behaviour and this positive association was still evident even after controlling for other covariates. Youth who were highly religious (OR - 1.81, CI- 1.13-2.88) had significantly higher odds of abstaining compared to their counterparts who were not religious.

CONCLUSION

Religiosity is a protective factor for sexual abstinence among youth in Nigeria. Policy makers can work around using religious institutions for behavioural change among youth in Nigeria.

Heterosexual oral and anal sex in Kinshasa (D.R.Congo): Data from OKAPI prospective cohort

BACKGROUND

Sexually transmitted infections can be spread through oral and anal heterosexual sex. There are few data on these practices in Sub-Saharan Africa. We analyzed the prevalence of heterosexual oral and anal sex among HIV Voluntary Counseling and Testing (VCT) attendees in Kinshasa and the associated sociodemographics, perceptions and behavioral factors.

METHODS

OKAPI (Observational Kinshasa AIDS Prevention Initiative) prospective cohort study. It evaluates the VCT impact on HIV-related knowledge and behaviors at 6 and 12-month follow-up. Since April 2016 until April 2018, 797 persons aged 15-59 years were HIV tested and replied to a baseline interview, including information about anal and oral sex. Descriptive, bi- and multivariate analyses were performed using baseline data.

RESULTS

Among 718 sexually active participants reporting heterosexual sex, 59% had had oral sex, 22% anal sex and 18% both practices. Among participants reporting "not" having had sex, 6% reported oral sex, 3% anal sex and 1% both. Oral sex was associated with a daily use of the Internet/mobile phone, perceiving low community HIV risk, reporting HIV-related behaviors (multiple partners, inconsistent condom use, anal, paid and forced sex) and having been pregnant. Being married-monogamous was inversely associated with oral sex. Anal sex was directly associated with having other risk sexual behaviors.

CONCLUSIONS

Oral and anal sex were common among people reporting heterosexual sex in Kinshasa. Perceiving a low community HIV risk and having other sexual risk behaviors are associated with these practices, which are commonly not considered as risky despite their strong association with HIV/STIs. They need to be considered when designing preventive strategies in Kinshasa.