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Chandra R, Paul P, Srivastava S. Prevalence and Predictors of Risky Sexual Behavior Among Young Men in India: Evidence From National Family Health Survey. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2023; 36:32-45. [PMID: 38600902 PMCID: PMC10903700 DOI: 10.1080/19317611.2023.2286984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 11/15/2023] [Indexed: 04/12/2024]
Abstract
Objective The study examines the prevalence and factors associated with high-risk sexual behavior among sexually active young Indian men. Methods This study used samples of 14,584 men aged 15 to 29 from the National Family Health Survey (NFHS-5), 2019-21. Results 14% of men engaged in early sexual debut (<18 years), 68% had unprotected sex, and 4% had multiple sexual partners in the past 12 months. Age, marital status, educational attainment, occupation, wealth quintile, alcohol consumption, internet use, media exposure, and region were significant predictors of risky sexual behavior. Conclusions We suggest a tailored approach for effective policy design considering risk factors of risky sexual behavior.
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Affiliation(s)
- Rakesh Chandra
- School of Health Systems Studies, Tata Institute of Social Science, Mumbai, India
| | - Pintu Paul
- Centre for the Study of Regional Development, Jawaharlal Nehru University, New Delhi, India
- Research and Data Officer, Aspire (A Society for Promotion of Inclusive and Relevant Education), New Delhi, India
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Abstract
This study examines family context and sexual debut among young people in China. Using data from the 2018 Panel Study of Chinese University Students (PSCUS), it explores how the family is correlated with sexual debut among young people in China aged 18-24 years. The Kaplan-Meier method was adopted to detect a survival function for different family factors and related demographic variables. Cox proportional hazard regression analysis was adopted to calculate hazard ratios for the timing of sexual debut. The average age of sexual debut among the college students was 18.39 years. The Kaplan-Meier analysis showed that sexual intercourse initiation was earlier for female students who had no siblings, and those who had a mother with senior high school (including technical school) education or higher family income, but this correlation was insignificant among male students. The multivariate hazard regression analysis revealed that living in a family with a higher level of fathers' education, having a lower level of family income and having siblings had positive correlations with later sexual debut among the college students. Moreover, family factors showed gender differences in their associations with the timing of sexual debut, typically parent's education level, family income and left-behind experience. This study provides a comprehensive perspective on the role of family influences in timing of sexual debut among youth in China.
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Muhammad T, Srivastava S, Kumar P, Patel SK. What predicts the early sexual debut among unmarried adolescents (10-19 years)? Evidence from UDAYA survey, 2015-16. PLoS One 2021; 16:e0252940. [PMID: 34111205 PMCID: PMC8192016 DOI: 10.1371/journal.pone.0252940] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/25/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The societal norm in India is such that adolescents are expected to respect and follow traditional values and view early sexual debut as undesirable and deviant from the social mores. However, a dramatic shift in attitudes towards sex before marriage has been observed in India. We in this study, aim to study the factors associated with early sexual debut among unmarried adolescents. MATERIALS AND METHODS The study used data from the Understanding the lives of adolescents and young adults (UDAYA) survey conducted in 2016 with 15,388 adolescents aged 10-19 years from two Indian states. Bivariate and logistic regression analyses were performed to determine the associated factors. RESULTS Adolescent boys (9%) were more prone to early sexual debut compared to girls (4%). Both boys (17.2%) and girls (6%) who were school dropouts had significantly higher chances of early sexual debut. Boys who had rare [OR: 2.28; CI: 1.12-4.64] or frequent media exposure [OR: 2.70; CI: 1.36-5.32] were significantly more likely to report early sexual debut than those who had no media exposure. Further, the likelihood of early sexual debut was significantly higher among boys [OR: 3.01; CI: 2.34-3.87] and girls [OR: 1.87; CI: 1.12-3.12] who had exposure to pornography compared to their counterparts. The odds of early sexual debut were higher among boys [OR: 1.89; CI: 1.19-3.01] and girls [OR: 1.77; CI: 1.30-2.41] who had moderately-severe/severe depressive symptoms compared to their counterparts. CONCLUSIONS The results highlight that Indian unmarried adolescents demand the appropriate knowledge to promote safer sexual behavior and lead a responsible and healthy lifestyle. The preventive efforts must be multifaceted with involvement at the individual and parental levels. Especially, interventions appear advantageous to be parents-focused emphasizing family life education that can prevent risky sexual behaviors among adolescent boys and girls. And the public programs should focus on sexual health promotion considering the physical and psychosocial changes during early ages of sex life.
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Affiliation(s)
- T. Muhammad
- Department of Population Policies and Programs, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Shobhit Srivastava
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Pradeep Kumar
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Brahme R, Mamulwar M, Rahane G, Jadhav S, Panchal N, Yadav R, Gangakhedkar R. A Qualitative Exploration to Understand the Sexual Behavior and Needs of Young Adults: A Study Among College Students of Pune, India. Indian J Pediatr 2020; 87:275-280. [PMID: 31942679 DOI: 10.1007/s12098-019-03160-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 12/17/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Youth and adolescents are the priority population to target the interventions as risky behaviors persist and they contribute to almost half of the new Human immunodeficiency virus (HIV) infections. The youth in India have a unique and diverse need of sex health education. The present study was conducted with the objective to understand their sexual behavior and requirements of sexual health. METHODS Focus group discussions were conducted among 74 college students, separately for boys and girls. The participant students were from different streams of education. The domains of enquiry were related to the relationships, risk behaviors, sources of information and use of technology for sex health education. The qualitative data was analyzed based on the themes and subthemes derived from these discussions. RESULTS A majority of the youth favoured active involvement of parents, school teachers in sex health education. They suggested that better-informed parents lead to better-informed adolescents. Open discussion with experts was also desired by the students. The use of mobile/web based application for sex health education and awareness about HIV and sexually transmitted infections (STIs) was preferred, however, they suggested that based on personal requirements, individual need based counseling and guidance is important. CONCLUSIONS Active parental involvement and open discussions on sexuality were the preferred options by the student to seek the knowledge and guidance. Innovative mobile application for sex health education will be useful for the young adults for information and communication. The study highlighted a need to develop a holistic approach to generate a culturally-sensitive sex health education and life skills model.
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Affiliation(s)
- Radhika Brahme
- ICMR-National AIDS Research Institute, 73-G Block, MIDC, Bhosari, Pune, Maharashtra, 411026, India.
| | - Megha Mamulwar
- ICMR-National AIDS Research Institute, 73-G Block, MIDC, Bhosari, Pune, Maharashtra, 411026, India
| | - Girish Rahane
- ICMR-National AIDS Research Institute, 73-G Block, MIDC, Bhosari, Pune, Maharashtra, 411026, India
| | - Sachin Jadhav
- ICMR-National AIDS Research Institute, 73-G Block, MIDC, Bhosari, Pune, Maharashtra, 411026, India
| | - Narayan Panchal
- ICMR-National AIDS Research Institute, 73-G Block, MIDC, Bhosari, Pune, Maharashtra, 411026, India
| | - Rajesh Yadav
- ICMR-National AIDS Research Institute, 73-G Block, MIDC, Bhosari, Pune, Maharashtra, 411026, India
| | - Raman Gangakhedkar
- ICMR-National AIDS Research Institute, 73-G Block, MIDC, Bhosari, Pune, Maharashtra, 411026, India
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Kamara JK, Namugambe BM, Egessa R, Kamanga G, Renzaho AMN. The Socioeconomic and Sexual Health Status of Young People Living in Urban Slum Areas of Kampala, Uganda. J Urban Health 2019; 96:616-631. [PMID: 30790124 PMCID: PMC6890897 DOI: 10.1007/s11524-019-00347-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Slum dweller youth in Kampala, Uganda, face social economic exclusion and a plethora of health risks, and their needs are poorly understood. The aim of the current study was to analyze their needs and to suggest contextual evidence-based solutions to improve their well-being sustainably. We conducted a qualitative study involving 10 focus group discussions (FGDs; N = 113) and 20 key informant (KII) interviews. Emerging themes and sub-themes were identified, defined, reviewed, and organized and narrated following the structuration theoretical framework, which enabled the examination of the inherent capacity of slum dweller youth to make choices independently and the recurrent rules and resources that influence or limit the choices and opportunities available to them. The findings suggest that the slum dweller youth's ability to reach and fulfil their potential remains constrained by a confluence of individual and societal-level factors. The individual factors were poor quality of and dissatisfaction with life, and poor sexual and reproductive health practices. The societal-level factors were poor sexual and reproductive health services, and an extremely weak labor market. The needs of slum dweller youth in Kampala, Uganda, remain unaddressed, and leaving such a large population economically unproductive and dissatisfied with life is a recipe for political instability and insecurity. Interventions to address their needs need to adopt a whole-community approach in order to engage and empower all parts of the slum community and strengthen community structures that improve livelihoods and harness the opportunities that engender income fortification and socio-civic transformation for the youth.
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Affiliation(s)
- Joseph Kihika Kamara
- School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Sydney, Penrith, NSW 2751, Australia.,Australia & World Vision International, 693 Somhlolo Road, Mbabane, Australia
| | | | - Robert Egessa
- World Vision Uganda, 15B Nakasero Road, Nakasero, Kampala, 5319, Uganda
| | - Gilbert Kamanga
- World Vision Uganda, 15B Nakasero Road, Nakasero, Kampala, 5319, Uganda
| | - Andre M N Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Sydney, Penrith, NSW 2751, Australia.
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Asamoah BO, Agardh A. Individual- and Family-Level Determinants of Risky Sexual Behavior Among Swedish- and Foreign-Born Young Adults 18-30 Years of Age, Residing in Skåne, Sweden. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:517-528. [PMID: 28560591 PMCID: PMC5775364 DOI: 10.1007/s10508-017-0978-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 12/07/2016] [Accepted: 03/18/2017] [Indexed: 05/26/2023]
Abstract
In Sweden, various public health interventions have been performed to reduce risky sexual behaviors among young people and promote safer and positive approaches to sexuality, while attempting to bridge the gap between the less privileged or more vulnerable young people and their more privileged peers. This study aimed to compare the individual- and familial-level determinants of risky sexual behavior among foreign-born and Swedish-born young adults 18-30 years of age residing in Skåne, the south of Sweden. This was a cross-sectional study that used a questionnaire to collect data from 2968 randomly selected respondents between 18 and 30 years between January and March 2013. The associations were analyzed using chi-square tests, and simple and multiple logistic regression analyses. Younger age, i.e., individual-level factor, and living with only one parent or another person while growing up, i.e., familial-level factor, increased the risk of engaging in sexual risk taking for both Swedish- and foreign-born youth. Male gender was related to a higher risk of engaging in sexual risk-taking behaviors among foreign-born youth but was not as important as influence on sexual risk taking among Swedish-born youth. Parental education level, on the other hand, was significantly associated with sexual intercourse on the "first night" and early sexual debut solely among Swedish-born youth. Condom use was not associated with any family-level factor among both Swedish-born and foreign-born youth. The design of sexual reproductive health and rights messages and interventions to target risky sexual behavior among Swedish youth should take into consideration immigration status (for example, being Swedish-born or foreign-born), individual- and family-level characteristics, as well as the type of behavioral change or outcome desired.
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Affiliation(s)
- Benedict Oppong Asamoah
- Social Medicine and Global Health, Department of Clinical Sciences, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, House 28, Floor 12, 205 02 Malmö, Sweden
| | - Anette Agardh
- Social Medicine and Global Health, Department of Clinical Sciences, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, House 28, Floor 12, 205 02 Malmö, Sweden
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Abstract
En España los jóvenes debutan sexualmente antes que en otros países; sin embargo, poco se sabe de la relación entre la edad de debut sexual y el comportamiento sexual en esta población. Se analizan las prácticas sexuales y el uso del preservativo según la edad de debut sexual en adolescentes españoles sexualmente experimentados (N = 351); la edad media fue 15.9 años (DT = .75, rango: 14-18). Se establecieron tres grupos a partir de la edad de debut sexual informada: debut sexual temprano (anterior a los 15 años), promedio (15 años) y tardío (posterior a los 15 años). El grupo con debut sexual temprano practicó en mayor medida masturbación mutua, coito vaginal y sexo oral, con un número de parejas sexuales superior al resto. El uso del preservativo en la primera relación sexual, el porcentaje de uso y el uso consistente del preservativo fue inferior en el grupo debut sexual temprano respecto a los otros dos. El debut sexual anterior a los 15 años se asoció con mayor riesgo de contraer infecciones sexuales por déficit en el uso del preservativo y mayor exposición sexual. Los hallazgos de este estudio sugieren que la edad de debut sexual tiene implicaciones en la salud sexual de los jóvenes.
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Sahay S, Nirmalkar A, Sane S, Verma A, Reddy S, Mehendale S. Correlates of sex initiation among school going adolescents in Pune, India. Indian J Pediatr 2013; 80:814-20. [PMID: 23604612 DOI: 10.1007/s12098-013-1025-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 03/25/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To identify the correlates of sex initiation among school going adolescents in Pune, India. METHODS A study among 910 school going adolescents was conducted in five schools and one junior college in and around Pune, Maharashtra (India) between 2003-2006. Case control analysis (n = 205) was performed among 41 cases who reported ever having sex and 164 controls matched for gender, location and type of school. Correlates of sex initiation were identified using conditional logistic regression. RESULTS Adolescents studying in vernacular schools, accessing pornography and having unfriendly relationship with parents had higher likelihood of sex initiation. Adolescents who reported sexual abuse, Sexually Transmitted Diseases (STDs) symptoms, smoking habit and those who had not read scientific literature on reproductive and sexual health were more likely to have initiated sex early. In the multivariate model, unfriendly relationship with parents and reported symptoms of STDs were found to be independently associated with 'early initiation of sex' among school going adolescents in this study. CONCLUSIONS Premarital sexual activity, both consensual and non-consensual, was reported indicating a need for school based adolescent reproductive and sexual health education (ARSHE) programs in Maharashtra, India. The program in India should focus on specialized interventions for young adolescents. Routine health check-ups and probing on symptoms of STDs, non-consensual sex and other risky practices should be implemented in schools.
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Affiliation(s)
- Seema Sahay
- Division of Social & Behavioural Research, National AIDS Research Institute, Plot No. 73, 'G' Block, MIDC, Bhosari, Pune, 411026, India,
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DiStefano AS, Gill JK, Hubach RD, Cayetano RT, Hilbert CJ. HIV testing in an ethnically diverse sample of American university students: associations with violence/abuse and covariates. J Behav Med 2013; 37:1030-46. [DOI: 10.1007/s10865-013-9540-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Accepted: 09/07/2013] [Indexed: 10/26/2022]
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Ernst KC, Phillips BS, Duncan BD. Slums are not places for children to live: vulnerabilities, health outcomes, and possible interventions. Adv Pediatr 2013; 60:53-87. [PMID: 24007840 PMCID: PMC7112084 DOI: 10.1016/j.yapd.2013.04.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Kacey C Ernst
- Epidemiology, College of Public Health, University of Arizona, Tucson, AZ 85724, USA.
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Swahn MH, Palmier JB, Kasirye R, Yao H. Correlates of suicide ideation and attempt among youth living in the slums of Kampala. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:596-609. [PMID: 22470312 PMCID: PMC3315266 DOI: 10.3390/ijerph9020596] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 01/21/2012] [Accepted: 02/06/2012] [Indexed: 11/26/2022]
Abstract
While suicidal behavior is recognized as a growing public health problem world-wide, little is known about the prevalence and risk factors for suicidal behaviors among street and slum youth in Africa, and in Uganda, specifically. The number of youth who live on the streets and in the slums of Kampala appears to be growing rapidly, but their mental health needs have not been documented, which has hampered resource allocation and service implementation. This study of youth, ages 14-24, was conducted in May and June of 2011, to assess the prevalence and correlates of suicidal behavior. Participants (N = 457) were recruited for a 30-minute interviewer-administered survey through eight drop-in centers operated by the Uganda Youth Development Link for youth in need of services. Bivariate and multivariate logistic regression analyses were computed to determine associations between psychosocial correlates and suicide ideation and suicide attempt. Reporting both parents deceased Adj.OR = 2.36; 95% CI: 1.23-4.52), parental neglect due to alcohol use (Adj.OR = 2.09; 95% CI: 1.16-3.77), trading sex for food, shelter or money (Adj.OR = 1.95; 95% CI: 1.09-3.51), sadnesss (Adj.OR = 2.42; 95% CI: 1.20-4.89), loneliness (Adj.OR = 2.67; 95% CI: 1.12-6.40) and expectations of dying prior to age 30 (Adj.OR = 2.54; 95% CI: 1.53-4.23) were significantly associated with suicide ideation in multivariate analyses. Parental neglect due to alcohol use (Adj.OR = 2.04; 95% CI: 1.11-3.76), sadness (Adj.OR = 2.42; 95% CI: 1.30-7.87), and expectations of dying prior to age 30 (Adj.OR = 2.18; 95% CI: 1.25-3.79) were significantly associated with suicide attempt in multivariate analyses. Given the dire circumstances of this vulnerable population, increased services and primary prevention efforts to address the risk factors for suicidal behavior are urgently needed.
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Affiliation(s)
- Monica H. Swahn
- Institute of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA 30302, USA; (J.B.P.); (H.Y.)
| | - Jane B. Palmier
- Institute of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA 30302, USA; (J.B.P.); (H.Y.)
| | - Rogers Kasirye
- Uganda Youth Development Link, P.O. Box 12659, Kampala, Uganda;
| | - Huang Yao
- Institute of Public Health, Georgia State University, P.O. Box 3995, Atlanta, GA 30302, USA; (J.B.P.); (H.Y.)
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