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Luwedde M, Sserwanja Q, Katantazi N. Determinants of age at first sex inequality between women and men youth in Uganda: A decomposition analysis. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000303. [PMID: 36962531 PMCID: PMC10021423 DOI: 10.1371/journal.pgph.0000303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 08/12/2022] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Teenage pregnancies and sexually transmitted diseases are major public health problems in Uganda. Early sexual debut is one of the main routes of these public health problems. This study aimed to identify factors that explain age at first sex inequality between men and women Ugandan youth. METHODS This study used secondary data from a cross-sectional Uganda demographic health survey (2016). Participants were 10 189 sexually experienced youth. Using Stata 14, intermediary analysis was done to assess the statistical association between explanatory variables and age at first sex in a multiple logistic regression analysis. Oaxaca decomposition was used to decompose factors that explain inequalities in age at first sex between men and women youth. RESULTS Intermediary results showed Islam, many household members, residing in the eastern region, and being divorced/widowed were predictors of early age at first sex. While secondary education, higher education, blue-collar jobs, and being 20 to 30 years old were protective factors against early age at first sex. Material, behavior/cultural, psychosocial, and demographic explanatory factors jointly explained a statistically significant portion of the observed gap in early age at first sex between women and men youth. More women were at a disadvantage at an early age at first sex compared to men youth. About 96.37% of this gap was explained by unequal distribution of material, behavior/cultural, psychosocial, and demographic factors between men and women youth. Relationship to household head (49%), education (16.87%), occupation (8,94%), number of household members (8.57%), using the internet (7.99%), and reading newspapers or magazines (4.39%) made a significant contribution to the explanation of early age at first sex inequality between men and women youth. CONCLUSIONS Results showed early age at first sex inequality between women and men youth that favored men. Programs designed to address early age at first sex and related health outcomes must combat inequities in education, employment opportunities, access to sexual reproductive information through internet, and newspapers or magazines between men and women youth. They should also foster household relationships and monitor girls.
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Affiliation(s)
- Mary Luwedde
- Heart for Girls Initiative Uganda, Kayunga, Uganda
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Murenzi G, Shumbusho F, Hansen N, Munyaneza A, Gage JC, Muhoza B, Kanyabwisha F, Pierz A, Tuyisenge P, Anastos K, Castle PE. Long-term human papillomavirus vaccination effectiveness and immunity in Rwandan women living with and without HIV: a study protocol. BMJ Open 2022; 12:e061650. [PMID: 36008069 PMCID: PMC9422845 DOI: 10.1136/bmjopen-2022-061650] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Prophylactic human papillomavirus (HPV) vaccines have been shown to be highly effective in protecting women against cervical infections, high-grade abnormalities and cancer caused by the targeted HPV types. However, the evidence for their effectiveness in women living with HIV (WLWH) is less clear. METHODS WLWH and HIV-negative women who likely did (birth cohorts 1996 and later) and WLWH and HIV(-) negative who likely did not (birth cohorts before 1996) receive HPV vaccination (n=3028; 757 participants for each of the four groups). Between groups, we will compare cervicovaginal, anal and oral prevalent and 6-12 month persistent HPV6/11/16/18 infections as measured using a modified AmpFire HPV genotyping assay that tests for 15 high-risk or intermediate-risk HPV genotypes, HPV6 and HPV11. We will also compare the HPV immune response in HPV-vaccinated WLWH to HPV-vaccinated HIV-negative women using an anti-HPV16 and anti-HPV18 ELISA. Vaccination status will be confirmed through national vaccination records. ANALYSIS We will calculate point prevalence and prevalence of 6-12 month persisting infections by individual HPV-type specific infections and groups of infections for each anatomic site and for each group of women. Results will be stratified by age at vaccination, age at enrolment and the number of doses (3 vs 2) as well as other factors possibly associated with HPV prevalence. Differences in endpoints between groups, overall and between subgroups, will be tested for statistical significance (p<0.05) using Fisher's exact or Pearson χ2 test. Differences in geometric mean titres and seropositivity will be tested for statistical significance using the Mann-Whitney and Fisher's exact tests, respectively. ETHICS AND DISSEMINATION The study was approved by the Albert Einstein College of Medicine Institutional Review Board and the Rwanda National Ethics Committee. Results will be disseminated through publication in peer-reviewed journals.
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Affiliation(s)
- Gad Murenzi
- Einstein-Rwanda Research and Capacity Building Program, Rwanda Military Hospital, Kigali, Rwanda
- Einstein-Rwanda Research and Capacity Building Program, Research for Development (RD Rwanda), Kigali, Rwanda
| | - Fabienne Shumbusho
- Einstein-Rwanda Research and Capacity Building Program, Rwanda Military Hospital, Kigali, Rwanda
- Einstein-Rwanda Research and Capacity Building Program, Research for Development (RD Rwanda), Kigali, Rwanda
| | - Natasha Hansen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Athanase Munyaneza
- Einstein-Rwanda Research and Capacity Building Program, Rwanda Military Hospital, Kigali, Rwanda
- Einstein-Rwanda Research and Capacity Building Program, Research for Development (RD Rwanda), Kigali, Rwanda
| | - Julia C Gage
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Benjamin Muhoza
- Einstein-Rwanda Research and Capacity Building Program, Rwanda Military Hospital, Kigali, Rwanda
- Einstein-Rwanda Research and Capacity Building Program, Research for Development (RD Rwanda), Kigali, Rwanda
| | - Faustin Kanyabwisha
- Einstein-Rwanda Research and Capacity Building Program, Rwanda Military Hospital, Kigali, Rwanda
- Einstein-Rwanda Research and Capacity Building Program, Research for Development (RD Rwanda), Kigali, Rwanda
| | - Amanda Pierz
- Department of Community Health and Health Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Patrick Tuyisenge
- Einstein-Rwanda Research and Capacity Building Program, Rwanda Military Hospital, Kigali, Rwanda
- Einstein-Rwanda Research and Capacity Building Program, Research for Development (RD Rwanda), Kigali, Rwanda
| | - Kathryn Anastos
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Philip E Castle
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland, USA
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Youth health risk behavior: effects of early sexual debut on HIV incidence among Rwandan youth. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01617-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Liang M, Simelane S, Fortuny Fillo G, Chalasani S, Weny K, Salazar Canelos P, Jenkins L, Moller AB, Chandra-Mouli V, Say L, Michielsen K, Engel DMC, Snow R. The State of Adolescent Sexual and Reproductive Health. J Adolesc Health 2019; 65:S3-S15. [PMID: 31761002 DOI: 10.1016/j.jadohealth.2019.09.015] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
Abstract
In the 25 years since the 1994 International Conference on Population and Development, significant progress has been made in adolescent sexual and reproductive health and rights (ASRHR). Trend analysis of key ASRHR indicators at global, national, and subnational levels indicates that adolescent girls today are more likely to marry later, delay their first sexual experience, and delay their first childbirth, compared with 25 years ago; they are also more likely to use contraceptives. Despite overall progress, however, unequal progress in many ASRHR outcomes is evident both within and between countries, and in some locations, the state of adolescents' lives has worsened. Population growth in countries with some of the worst shortfalls in ASRHR mean that declining rates, of child marriage, for example, coexist with higher absolute numbers of girls affected, compared with 25 years ago. Emerging trends that warrant closer attention include increasing rates of ovarian and breast cancer among adolescent girls and sharp increases in the proportion of adolescents who are overweight or obese, which has long-term health implications.
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Affiliation(s)
| | | | | | | | | | | | - Lorna Jenkins
- Latin America and Caribbean Regional Office, UNFPA, Panama City, Panama
| | - Ann-Beth Moller
- Department of Reproductive Health and Research (RHR) and UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Venkatraman Chandra-Mouli
- Department of Reproductive Health and Research (RHR), Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Lale Say
- Department of Reproductive Health and Research (RHR), Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Kristien Michielsen
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | | | - Rachel Snow
- Technical Division, UNFPA, New York, New York.
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KRINDGES CA, HABIGZANG LF. Regulação emocional, satisfação sexual e comportamento sexual de risco em mulheres vítimas de abuso sexual na infância. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2018. [DOI: 10.1590/1982-02752018000300010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Resumo Buscou-se investigar questões relacionadas à regulação emocional, à satisfação sexual e ao comportamento sexual de risco em mulheres adultas com histórico de abuso sexual na infância. Participaram desta pesquisa oito mulheres, com média de idade 38 anos, que responderam aos instrumentos de autorrelato sobre regulação emocional e satisfação sexual e a uma entrevista em profundidade, que avaliou aspectos do contexto familiar, emocional, relacionamentos amorosos e também sexuais, abordando questões sobre comportamento sexual de risco. O delineamento utilizado foi exploratório, descritivo com abordagem mista. Os resultados demonstraram que todas as participantes avaliadas possuíam difi culdades de regulação emocional, em menores ou maiores níveis. Em relação à satisfação sexual, seis das participantes obtiveram índices positivos de satisfação, e algumas delas relataram desejo e satisfação sexual preservados. No entanto, outras participantes relataram difi culdades, como aversão sexual e comportamento hipersexualizado. Comportamentos sexuais de risco foram identifi cados em duas das participantes e vinculados a comportamentos do passado.
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Regassa T, Chala D, Adeba E. Premarital Sex in the Last Twelve Months and Its Predictors among Students of Wollega University, Ethiopia. Ethiop J Health Sci 2017; 26:351-8. [PMID: 27587933 PMCID: PMC4992775 DOI: 10.4314/ejhs.v26i4.7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Premarital sex increases the risk of unintended pregnancy and sexually transmitted infections including HIV if unprotected and contraception is not used. Thus, the objective of this study was to assess premarital sex in the last twelve months and its predictors among regular undergraduate students of Wollega University. METHODS A cross-sectional survey using pretested, structured questionnaire was conducted on a total of 704 regular undergraduate students of Wollega University from February to March, 2014. We used multistage sampling technique to recruit study participants. Binary and multivariable logistic regressions were performed using SPSS version 20 to assess predictors of premarital sex. Statistical significance was determined through a 95% confidence level. RESULTS Wollega University youths who had premarital sex in the last twelve months were 28.4%; 55.5% of them did not use condom during last sex while 31.3% engaged in multiple sex. Being male [Adjusted Odds Ratio (AOR)(95% Confidence Interval(CI))=2.7(1.58-4.75)], age 20-24 years [AOR(95%CI)=2.8(1.13-7.20)], training on how to use condom [AOR(95%CI)=1.7(1.17-2.46)], being tested for HIV [AOR(95%CI)=2.3(1.48-3.53)], using social media frequently [AOR(95%CI)=1.8(1.14-2.88)], having comprehensive knowledge of HIV [AOR(95% CI)=1.5(1.01-2.10)], alcohol use [AOR (95%CI)=2.2(1.31-3.56)] were associated with increased odds of premarital sex in the last twelve months. CONCLUSION Nearly one-third of regular undergraduate students of the university were engaged in premarital sex in the last twelve months. Being male, using social media frequently and alcohol use were associated with increased odds of premarital sex in the stated period. Thus, higher institutions have to deliver abstinence messages alongside information about self-protection.
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Affiliation(s)
| | - Dereje Chala
- Department of Nursing, Wollega University, Ethiopia
| | - Emiru Adeba
- Department of Public Health, Wollega University, Ethiopia
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Abstract
There are several studies that showed the high prevalence of high-risk sexual behaviors among youths, but little is known how significant the proportion of higher risk sex is when the male and female youths are compared. A meta-analysis was done using 26 countries' Demographic and Health Survey data from and outside Africa to make comparisons of higher risk sex among the most vulnerable group of male and female youths. Random effects analytic model was applied and the pooled odds ratios were determined using Mantel-Haenszel statistical method. In this meta-analysis, 19,148 male and 65,094 female youths who reported to have sexual intercourse in a 12-month period were included. The overall OR demonstrated that higher risk sex was ten times more prevalent in male youths than in female youths. The practice of higher risk sex by male youths aged 15-19 years was more than 27-fold higher than that of their female counterparts. Similarly, male youths in urban areas, belonged to a family with middle to highest wealth index, and educated to secondary and above were more than ninefold, eightfold and sixfold at risk of practicing higher risk sex than their female counterparts, respectively. In conclusion, this meta-analysis demonstrated that the practice of risky sexual intercourse by male youths was incomparably higher than female youths. Future risky sex protective interventions should be tailored to secondary and above educated male youths in urban areas.
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Affiliation(s)
- Yifru Berhan
- a MD, is a Professor in Hawassa University College of Medicine and Health Sciences , P.O. Box 1560, Hawassa , Ethiopia
| | - Asres Berhan
- b MSC, Hawassa University College of Medicine and Health Sciences , P.O. Box 1560, Hawassa , Ethiopia
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Tarkang EE. Sexual risk behaviours of high school female learners in Mbonge subdivision of rural Cameroon. Pan Afr Med J 2015; 20:49. [PMID: 26090007 PMCID: PMC4449985 DOI: 10.11604/pamj.2015.20.49.2938] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 01/31/2014] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Since female learners in high schools in Cameroon fall within the age group hardest hit by HIV/AIDS, it is assumed that these learners might be exposed to sexual risk behaviours. However, little has been explored on the sexual risk behaviours of high school female learners in Cameroon. This study aimed at examining the sexual risk behaviours of high school female learners in Mbonge subdivision of rural Cameroon. METHODS A cross sectional design was adopted, using a self-administered questionnaire for data collection. Respondents were selected through disproportional stratified simple random sampling resulting in 210 female grade 10 to grade 12 learners from three participating high schools in Mbonge subdivision, Cameroon. Descriptive and inferential statistics were calculated using SPSS version 20 software program. RESULTS Majority of the respondents, 54.0% reported being sexually active, of whom only 39.8% used condoms during first sex; 49.5% used condoms during last sex and 29.6% used condoms consistently. Up to 32% of the sexually active respondents had multiple sexual partners in the past one year before the study, while 9.3% had multiple sexual partners during the study period. The mean age of first sex was 15.6 years. Lack of parental control, religion, academic profile, poverty, place of residence and perception of risk of HIV infection were the main factors significantly associated with sexual risk behaviours. CONCLUSION The findings indicate that sexual risk behaviours exist among high school female learners in Mbonge, Cameroon. There is need for campaigns and interventions to bring about sexual behaviour change.
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Farid NDN, Rus SC, Dahlui M, Al-Sadat N, Aziz NA. Predictors of sexual risk behaviour among adolescents from welfare institutions in Malaysia: a cross sectional study. BMC Public Health 2014; 14 Suppl 3:S9. [PMID: 25437631 PMCID: PMC4251141 DOI: 10.1186/1471-2458-14-s3-s9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND In welfare institutions, it is essential to address the health-related needs of adolescent populations who often engage in sexual activities. This study examines the association between individual and interpersonal factors concerning sexual risk behaviour (SRB) among adolescents in welfare institutions in Malaysia. METHODS Data were derived from a cross-sectional study of 1082 adolescents in 22 welfare institutions located across Peninsular Malaysia in 2009. Using supervised self-administered questionnaires, adolescents were asked to assess their self-esteem and to complete questions on pubertal onset, substance use, family structure, family connectedness, parental monitoring, and peer pressure. SRB was measured through scoring of five items: sexual initiation, age of sexual debut, number of sexual partners, condom use, and sex with high-risk partners. Multivariate logistic regression analysis was used to examine the various predictors of sexual risk behaviour. RESULTS The study showed that 55.1% (95%CI = 52.0-58.2) of the total sample was observed to practice sexual risk behaviours. Smoking was the strongest predictor of SRB among male adolescents (OR = 10.3, 95%CI = 1.25-83.9). Among females, high family connectedness (OR = 3.13, 95%CI = 1.64-5.95) seemed to predict the behaviour. CONCLUSION There were clear gender differences in predicting SRB. Thus, a gender-specific sexual and reproductive health intervention for institutionalised adolescents is recommended.
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Affiliation(s)
- Nik Daliana Nik Farid
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Centre for Population Health, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Sulaiman Che' Rus
- Institute for Health Behavioural Research, Ministry of Health Malaysia, Jalan Rumah Sakit Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Maznah Dahlui
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Centre for Population Health, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Nabilla Al-Sadat
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Centre for Population Health, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Norlaili Abdul Aziz
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Centre for Population Health, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
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High-risk human papillomavirus infection in HIV-positive African women living in Europe. J Int AIDS Soc 2013; 16:18023. [PMID: 23406965 PMCID: PMC3574170 DOI: 10.7448/ias.16.1.18023] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 12/12/2012] [Accepted: 01/10/2013] [Indexed: 11/21/2022] Open
Abstract
Introduction Cervical infection with high-risk human papillomavirus (HRHPV) induces cervical cancer and is present in 14% of women in Europe. We assessed the prevalence and incidence of cervical HRHPV in a cohort of HIV-positive women living in Belgium. Methods Prospective observational program of screening and follow up of HRHPV cervical infection performed by Hybrid Capture in 825 HIV-positive women between 2002 and 2011. Women without normal cervix at baseline were excluded. Results The final analysis included 652 women: median age 38 years, African origin (81%), median HIV follow-up (66 months), median CD4 count (426 cells/μL) and 79% on antiretroviral therapy (cART). At baseline, HRHPV prevalence was 43% and decreased significantly as both age and CD4 cell count increased: highest prevalence (100%) in women <30 years and <200 CD4/μL and lowest (19%) in women >40 years and >500 CD4/μL (p<0.0001, multivariate analysis). The relative risk (RR) to carry HRHPV at baseline decreases proportionally by 11% for each 5 years-age increase and by 11% for each 100 CD4 cells/μL rise (RR=0.89, 95% CI: 0.85-0.93; p<0.0001, Poisson regression for both). During follow-up, incidence rate of HRHPV was 13.4 per 100 women-years. Conclusions We found a high HRHPV prevalence of 43% and an incidence rate of 13 per 100 women-years in this cohort of HIV-positive women living in Europe and on cART. Women under 40 years-age had the highest prevalence even with CD4 count >350 cells/μL. The magnitude of HRHPV epidemiology should prompt to evaluate the clinical efficacy of vaccines against HPV in HIV-infected women.
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