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Mpofu E, Ntinda K, Levers LL, van Rensberg A, Nkomazana F. Pathways to sexual decision making by Pentecostal church youths in Botswana. BMC Public Health 2021; 21:659. [PMID: 33823835 PMCID: PMC8025555 DOI: 10.1186/s12889-021-10645-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/17/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The ways church youth make sexual decisions are incompletely understood and yet important for public health interventions. This study aimed to examine personal religiosity influences on the sexual decisions by church youth from the country of Botswana, taking into account their sense of personal agency. METHOD Participants were 235 Botswana Pentecostal faith church youth (females = 67.2%, male = 32.8%; age range 12-23 years). They completed measures of personal religiosity, personal agency, sexual abstinence, and contraception use predisposition. We analysed the data applying Structural Equation Modelling to test five paths - personal religiosity to personal agency, personal agency to abstinence, personal religiosity to abstinence, personal agency to contraceptive use, and personal religiosity to contraceptive use. RESULTS Results suggest that personal religiosity influences the youth in their sexual abstinence and contraception decisions through personal agency. High personal agency, but not personal religiosity, was associated with pro-sexual abstinence, and contraception use was associated with religiosity. Personal agency augmented the likelihood of both abstinence and contraception use decisions among the older church youth and with church youth with higher levels of formal education. CONCLUSION Church youth likely adopt discretionary sexual behaviours over the developmental period from early to older adolescents, which would make them more receptive to public sexual health messages. Personal agency appears to be an important resource for public health interventions aimed at influencing church youth's sexual decisions.
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Affiliation(s)
- Elias Mpofu
- Rehabilitation and Health Services Department, College of Health and Public Services, University of North Texas, 1151 Union Circle #, Denton, TX, 311456, USA.
- University of Sydney, Australia, Camperdown, Australia.
- University of Johannesburg, South Africa, Johannesburg, South Africa.
| | - Kayi Ntinda
- University of Eswatini, Kwaluseni, Eswatini
- University of Botswana, Gaborone, Botswana
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Irfan M, Hussain NHN, Noor NM, Mohamed M, Ismail SB. Sexual Abstinence and Associated Factors Among Young and Middle-Aged Men: A Systematic Review. J Sex Med 2020; 17:412-430. [PMID: 31955912 DOI: 10.1016/j.jsxm.2019.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/30/2019] [Accepted: 12/04/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Sexual activity is an essential human need and an important predictor of other aspects of human life. A literature review was conducted to investigate whether sexual abstinence in young and middle-aged men is generally considered a deliberate, healthy behavior and whether it has other causes and consequences. AIM To review the prevalence and factors associated with sexual abstinence in young (10-24 years) and middle-aged (25-59 years) men. METHODS Studies were retrieved from Science Direct, PubMed, and EBSCOhost published from 2008 to 2019. The selection criteria were original population- or community-based articles, published in the English language, on sexual abstinence, and in young and middle-aged men. MAIN OUTCOME MEASURE This article reviewed the literature on the proportions of and factors associated with sexual abstinence in young and middle-aged men. RESULTS A total of 13,154 studies were retrieved, from which data were extracted for 37 population- or community-based studies. The prevalence of sexual abstinence varied from 0% to 83.6% in men younger than 60 years. The prevalence of primary sexual abstinence was 3.4%-83.3% for young men and 12.5%-15.5% for middle-aged men. The prevalence of secondary abstinence for young men ranged from 1.3% to 83.6%, while for middle-aged men, it was from 1.2% to 67.7%. The prevalence of sexual abstinence decreased with increasing age in young men but increased with increasing age in middle-aged men. The significant factors reported were age, single status, poor relationships, low socioeconomic status, sex education, religious practices, caring and monitoring parents, and not using alcohol, cigarettes, or drugs. Although the variations in findings from different studies can be explained by different regions and cultures, the information cannot be generalized worldwide because of a lack of studies in Asian and Australian populations. CLINICAL IMPLICATIONS The studies on sexual abstinence in the future should use a consistent and standard definition, cover all sexual behaviors, and investigate all related factors. STRENGTH & LIMITATIONS The restricted timeframe (2008-2019), English language, availability of full text, and variability in definition and time duration may be the sources of bias. CONCLUSION Young men had higher proportions of sexual abstinence than middle-aged men, and age, unavailability of a partner, lower educational levels, low socioeconomic status, conservative and religious conditions, and no or less knowledge about sexually transmitted infections were common predictors of sexual abstinence in most of the men. Although determinants of sexual abstinence were identified, further investigation of biological factors in men younger than 60 years is needed. Irfan M, Hussain NHN, Noor NM, et al. Sexual Abstinence and Associated Factors Among Young and Middle-Aged Men: A Systematic Review. J Sex Med 2020;17:412-430.
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Affiliation(s)
- Muhammad Irfan
- Women's Health Development Unit, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia; Department of Zoology, Pir Mehr Ali Shah, Arid Agriculture University, Rawalpindi, Pakistan
| | - Nik Hazlina Nik Hussain
- Women's Health Development Unit, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
| | - Norhayati Mohd Noor
- Department of Family Medicine, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Mahaneem Mohamed
- Department of Physiology School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Shaiful Bahari Ismail
- Department of Family Medicine, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
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Harper GW, Muthigani A, Neubauer LC, Simiyu D, Murphy AG, Ruto J, Suleta K, Muthiani P. The Development and Evaluation of a National School-based HIV Prevention Intervention for Primary School Children in Kenya. JOURNAL OF HIV AND AIDS 2019; 4. [PMID: 30733998 DOI: 10.16966/2380-5536.150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Primary schools in Kenya provide a promising venue for widespread delivery of HIV prevention interventions. This article describes the development and evaluation of Making Life's Responsible Choices (MLRC), a school-based HIV prevention intervention for primary school children developed through a collaborative global partnership involving multiple community stakeholders. Intervention development was informed by extensive reviews of youth-focused evidence-based HIV prevention interventions, and was rooted in both the Theory of Planned Behavior and Social Cognitive Theory. MLRC includes six modules: 1) self-awareness, 2) human sexuality, 3) healthy relationships, 4) drug/alcohol abuse, 5) HIV/AIDS and other sexually transmitted infections, and 6) behavior change. Class 5 pupils (N=1846; 52.1% girls, 47.9% boys; mean age = 12) attending 46 different Catholic-sponsored public and private primary schools throughout Kenya participated in the evaluation of the intervention program which was delivered in the classroom and occurred over the course of 40 weeks (one academic term). Changes in knowledge and behavioral intentions were assessed using a one-group pre-test post-test experimental design. Pupils completed module-specific assessment measures, and paired samples t-tests were used to compare changes in knowledge and behavioral intentions at the classroom level. Gender-specific analyses were also conducted. All six modules displayed statistically significant positive changes in the mean percentage of knowledge items answered correctly for the full sample, with marginal gender differences revealed. Statistically significant health-promoting changes were seen in 11 of the 18 behavioral intention items (3 per module), with gender differences also revealed. Findings suggest that implementing interventions such as MLRC has the potential to thwart the spread of HIV among youth in Kenya, and equip youth with health-promoting skills. In addition, school-based programs have the potential to become institutionalized in school settings in order to maintain their long-term sustainability.
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Affiliation(s)
| | - Augusta Muthigani
- Commission for Education and Religious Education at the Kenya Conference of Catholic Bishops
| | | | - David Simiyu
- Commission for Education and Religious Education at the Kenya Conference of Catholic Bishops
| | | | - Julius Ruto
- Commission for Education and Religious Education at the Kenya Conference of Catholic Bishops
| | | | - Paul Muthiani
- Commission for Education and Religious Education at the Kenya Conference of Catholic Bishops
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Okigbo CC, Speizer IS. Determinants of Sexual Activity and Pregnancy among Unmarried Young Women in Urban Kenya: A Cross-Sectional Study. PLoS One 2015; 10:e0129286. [PMID: 26047505 PMCID: PMC4457813 DOI: 10.1371/journal.pone.0129286] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 05/06/2015] [Indexed: 12/01/2022] Open
Abstract
Objectives With age of marriage rising in Kenya, the period between onset of puberty and first marriage has increased, resulting in higher rates of premarital sexual activity and pregnancy. We assessed the determinants of sexual activity and pregnancy among young unmarried women in urban Kenya. Methods Baseline data from five urban areas in Kenya (Nairobi, Mombasa, Kisumu, Machakos, and Kakamega) collected in 2010 by the Measurement, Learning & Evaluation project were used. Women aged 15-24 years, who had never been married, and were not living with a male partner at the time of survey (weighted n=2020) were included. Using weighted, multivariate Cox proportional hazard regression and logistic regression analyses, we assessed factors associated with three outcome measures: time to first sex, time to first pregnancy, and teenage pregnancy. Results One-half of our sample had ever had sex; the mean age at first sex among the sexually-experienced was 17.7 (± 2.6) years. About 15% had ever been pregnant; mean age at first pregnancy was 18.3 (±2.2) years. Approximately 11% had a teenage pregnancy. Three-quarters (76%) of those who had ever been pregnant (weighted n=306) reported the pregnancy was unwanted at the time. Having secondary education was associated with a later time to first sex and first pregnancy. In addition, religion, religiosity, and employment status were associated with time to first sex while city of residence, household size, characteristics of household head, family planning knowledge and misconceptions, and early sexual debut were significantly associated with time to first pregnancy. Education, city of residence, household wealth, early sexual debut, and contraceptive use at sexual debut were associated with teenage pregnancy for those 20-24 years. Conclusion Understanding risk and protective factors of youth sexual and reproductive health can inform programs to improve young people’s long-term potential by avoiding early and unintended pregnancies.
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Affiliation(s)
- Chinelo C. Okigbo
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Measurement, Learning, and Evaluation Project, Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
- * E-mail:
| | - Ilene S. Speizer
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
- Measurement, Learning, and Evaluation Project, Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, United States of America
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Dlamini BN, Chiao C. Closing the health gap in a generation: exploring the association between household characteristics and schooling status among orphans and vulnerable children in Swaziland. AIDS Care 2015; 27:1069-78. [PMID: 25830786 DOI: 10.1080/09540121.2015.1026306] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Swaziland has one of the highest HIV/AIDS prevalences in the world, which has contributed to many Swazi children being left as "orphans and vulnerable children" (OVC). In 2010, there were 78,000 AIDS orphans in the country and the number is expected to increase given the current HIV prevalence. The WHO aims to close the gap in a generation and eliminate health inequality; as a result the Swazi Government began in 2005 to provide financial support to the education of OVC. Prior research has indicated that household characteristics are some of the major determinants with respect to schooling status among children. We have examined the association between household characteristics and schooling status of OVC. Schooling status may vary by gender and by age, as well as by other sociodemographic factors, in sub-Saharan African societies, and therefore we have also included a comprehensive set of appropriate variables in all of our multivariate analyses. Using existing data from the Swaziland Multiple Indicator Cluster Survey 2010, a total of 5890 children aged 7-18 years old were analyzed. The results from the multivariate logistic regressions showed that non-OVC were more likely than OVC to be in school (OR = 2.18, p < 0.001), even after taking other variables into considerations. The OVC in socioeconomically disadvantaged households, such as those with lower levels of household wealt, and those who resided in an urban area, were less likely to be in school. These findings suggest that education programs for OVC need to be household-appropriate.
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Affiliation(s)
- Bongiwe N Dlamini
- a College of Medicine, Institute of Public Health, International Health Program , National Yang Ming University , Taipei , Taiwan , Republic of China
| | - Chi Chiao
- b College of Medicine, Institute of Health and Welfare Policy, Institute of Public Health , National Yang-Ming University , Taipei , Taiwan , Republic of China
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Sangowawa AO, Adebiyi AO. Factors associated with sexual abstinence among out-of-school females in a transitional town in Oyo State, South-Western Nigeria. Health Care Women Int 2013; 34:917-32. [PMID: 23638653 DOI: 10.1080/07399332.2013.769998] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
One hundred and forty-three respondents participated in this cross-sectional study and 42 (29.4%) of them had never had sex. About 92% engaged in at least one leisure activity. Factors significantly associated with abstinence follow: living arrangement, type of occupation, mode of earning, self-esteem, alcohol use, and some leisure activities (p < .05). Factors predictive of abstinence were living with parents or other relatives, earning weekly and monthly wages as opposed to daily wages, high self-esteem, and reading of novels during leisure time. Intensified efforts are necessary to enhance the identified protective factors in order to promote abstinence among out-of-school females.
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Affiliation(s)
- Adesola O Sangowawa
- Institute of Child Health, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Oyo State, Nigeria.
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Chiao C, Yi CC, Ksobiech K. Exploring the relationship between premarital sex and cigarette/alcohol use among college students in Taiwan: a cohort study. BMC Public Health 2012; 12:527. [PMID: 22809432 PMCID: PMC3490780 DOI: 10.1186/1471-2458-12-527] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2012] [Accepted: 06/29/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cigarette/alcohol use and premarital sex, and their subsequent consequences on the well-being of college students, are international health promotion issues. However, little is known about the temporal relationship of these risk behaviors among Taiwanese college students. METHODS This study utilizes data from the Taiwan Youth Project, a cohort sample of 20-year-olds (N = 2,119) with a 2-year follow-up, to explore the relationship between adolescent cigarette/alcohol use, and subsequent premarital sex. To incorporate the Taiwanese context where the normative value of abstinence until marriage remains strong, multivariate logistic regression models included data on premarital sex attitudes, stressful life events, peer influence, as well as family and individual factors which might influence this relationship. RESULTS The sample consists of 49% male and 51% female college students. About 16% of the sample report having had premarital sex by age 20. After excluding sexually active youth, 20% of males and 13% of females report engaging in premarital sex in the 2-year follow-up interview. Multivariate logistic regression analyses reveal adolescent alcohol use is significantly associated with a higher likelihood of engaging in premarital sex for both genders; adolescent smoking is significantly associated with premarital sexual activity among males, but not females. Our results indicate liberal premarital sexual attitudes and stressful personal events are also significantly associated with premarital sexual activity. CONCLUSIONS These findings suggest health promotion programs for college students need to take developmental and gender perspectives into account. Future research to incorporate a broader, multi-cultural context into risk reduction materials is recommended.
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Affiliation(s)
- Chi Chiao
- Insitute of Health and Welfare Policy, Research Center for Health and Welfare Policy, School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.
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Chiao C, Yi CC. Adolescent premarital sex and health outcomes among Taiwanese youth: perception of best friends' sexual behavior and the contextual effect. AIDS Care 2011; 23:1083-92. [DOI: 10.1080/09540121.2011.555737] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Chi Chiao
- a Institute of Health and Welfare Policy, College of Medicine , National Yang-Ming University , Taipei , Taiwan
| | - Chin-Chun Yi
- b Institute of Sociology , Academia Sinica , Taipei , Taiwan
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Cho H, Hallfors DD, Mbai II, Itindi J, Milimo BW, Halpern CT, Iritani BJ. Keeping adolescent orphans in school to prevent human immunodeficiency virus infection: evidence from a randomized controlled trial in Kenya. J Adolesc Health 2011; 48:523-6. [PMID: 21501814 PMCID: PMC3079907 DOI: 10.1016/j.jadohealth.2010.08.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Revised: 08/10/2010] [Accepted: 08/10/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE We report the findings from a pilot study in western Kenya, using an experimental design to test whether comprehensive support used to keep adolescent orphans in school can reduce risk factors associated with infection with human immunodeficiency virus. METHODS Adolescent orphans aged 12-14 years (N = 105) in Nyanza Province were randomized to condition, after stratifying by household, gender, and baseline survey report of sexual behavior. The intervention comprised school fees, uniforms, and a "community visitor" who monitored school attendance and helped to resolve problems that would lead to absence or dropout. Data were analyzed using generalized estimating equations over two time points, controlling for gender and age. RESULTS Compared with the control group, intervention students were less likely to drop out of school, commence sexual intercourse, or report attitudes supporting early sex. School support also increased prosocial bonding and gender equity attitudes. CONCLUSIONS After 1 year of exposure to the intervention, we found evidence suggesting that comprehensive school support can prevent school dropout, delay sexual debut, and reduce risk factors associated with infection with human immunodeficiency virus. Further research, with much larger samples, is needed to better understand factors that mediate the association between educational support and delayed sexual debut, and how gender might moderate these relationships.
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Affiliation(s)
- Hyunsan Cho
- Pacific Institute for Research and Evaluation, 1516 E. Franklin Street, Chapel Hill, NC 27514, USA.
| | | | | | | | | | - Carolyn T. Halpern
- Department of Maternal and Child Health, University of North Carolina, Chapel Hill, NC, USA
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Hallfors D, Cho H, Rusakaniko S, Iritani B, Mapfumo J, Halpern C. Supporting adolescent orphan girls to stay in school as HIV risk prevention: evidence from a randomized controlled trial in Zimbabwe. Am J Public Health 2011; 101:1082-8. [PMID: 21493943 DOI: 10.2105/ajph.2010.300042] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Using a randomized controlled trial in rural eastern Zimbabwe, we tested whether comprehensive support to keep orphan adolescent girls in school could reduce HIV risk. METHODS All orphan girls in grade 6 in 25 primary schools were invited to participate in the study in fall 2007 (n = 329). Primary schools were randomized to condition. All primary schools received a universal daily feeding program; intervention participants received fees, uniforms, and a school-based helper to monitor attendance and resolve problems. We conducted annual surveys and collected additional information on school dropout, marriage, and pregnancy rates. We analyzed data using generalized estimating equations over 3 time points, controlling for school and age at baseline. RESULTS The intervention reduced school dropout by 82% and marriage by 63% after 2 years. Compared with control participants, the intervention group reported greater school bonding, better future expectations, more equitable gender attitudes, and more concerns about the consequences of sex. CONCLUSIONS We found promising evidence that comprehensive school support may reduce HIV risk for orphan girls. Further study, including assessment of dose response, cost benefit, and HIV and herpes simplex virus 2 biomarker measurement, is warranted.
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Affiliation(s)
- Denise Hallfors
- Pacific Institute for Research and Evaluation, 1516 E Franklin St, Suite 200, Chapel Hill, NC 27514, USA.
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