Gender differences in exposure to SRH information and risky sexual debut among poor Myanmar youths

Socioeconomic inequality in early sexual initiation among female youths in sub-Saharan African countries: a decomposition analysis

INTRODUCTION

Youths are defined as individuals within the age group 15-24 years. It is the transitional stage from childhood to adulthood with biological, social, and psychological change, so it is a time of risk and opportunity for their future life. Early sexual initiation exposes young people to various social, economic, sexual, and reproductive health issues, such as unwanted adolescent pregnancies, sexually transmitted infections, unsafe abortion, cervical cancer, and early marriages. Therefore, this study aimed to assess the presence of socioeconomic inequality in early sexual initiation and contributing factors in sub-Saharan African countries.

METHODS

A total of 118,932 weighted female youths from SSA countries' DHS data were included in the study. Socioeconomic inequality of Early sexual initiation was evaluated using the Erreygers znormalized concentration index and associated concentration curve. Decomposition analysis was performed to determine those factors causing socioeconomic-related inequality.

RESULTS

The weighted Erreygers normalized concentration index of wealth-related inequality of early sexual initiation was - 0.157 with a Standard error = 0.0046 (P value < 0.0001); this indicated that early sexual initiation was disproportionately concentrated among the poor (pro-poor). Moreover, the weighted Erreygers normalized concentration index (ECI) of educational status-related inequality of early sexual initiation was - 0.205 with a Standard error = 0.0043 (P value < 0.0001). This indicated that early sexual initiation was disproportionately concentrated among youths with no formal education. The decomposition analysis revealed that mass media exposure, wealth index, place of residency, religion, marital status, educational status, and age were significant contributors to the pro-poor socioeconomic inequalities in early sexual initiation.

CONCLUSION AND RECOMMENDATION

This study has revealed pro-poor inequality in early sexual initiation. Therefore, priority must be given to modifiable factors such as promoting the accessibility of media exposure in the household, improving the educational opportunity of female youths, and improving their country's economy to a higher economic level to improve the wealth status of the population.

Examining the relationship between risky sexual behavior and suicidal thoughts among unmarried adolescents in India

Addressing the problem of suicidal thoughts in adolescents requires understanding the associated risk factors. Multiple studies have shown that risky sexual behavior affected the adolescents' psychological health that leads to their suicidal thoughts, behaviors and attempts. This study aimed to identify the association between various risky sexual behaviours and suicidal thoughts among unmarried adolescents in India. We used data collected from 4221 unmarried adolescent boys and 5987 unmarried adolescent girls aged 10-19 years, from the two rounds of the Understanding the Lives of Adolescents and Young Adults (UDAYA) survey. Descriptive analysis was done to observe changes in the selected variables from wave-1 to wave-2. Random effect regression analysis was used to estimate the association of suicidal thoughts among unmarried adolescents with their risky sexual behaviours. The percentage of adolescent boys having suicidal thoughts increased from 1.35% in wave 1 to 2.19% in wave 2. Among adolescent girls, the percentage increased from 2.92% in wave 1 to 5.05% in wave 2. A proportion of 3.26% adolescent boys had more than one sexual partner during wave 1 whereas in wave 2, it rose to 8.71%, while in case of adolescent girls, the estimates only increased from 0.26% at wave 1 to 0.78% at wave 2. Nearly 4.55% boys and 1.37% girls had early sexual debut. Almost five percentage boys were sexually active at wave 1 whereas in wave 2, it rose to 13.56%, while among adolescent girls, the estimates decreased from 1.54% at wave 1 to 1.51% at wave 2. Contraceptive use increased over time among both adolescent boy and girls. Also, a large proportion of adolescent boys reported watching pornography (27.08% at waive 1 and 49.39% at wave 2) compared to adolescent girls (4.46% at wave 1 and 13.10% at wave 2). Adolescents who had more than one sexual partner [Coef: 0.04; p < 0.001], exposed to early sexual debut [Coef; 0.019; p < 0.01], sexually active [Coef: 0.058; p < 0.001] and reported watching pornography [Coef: 0.017; p < 0.001] were more likely to have suicidal thoughts. Adolescent boys and girls with risky sexual behaviors are likely to be at a higher risk of suicidal ideation, and thus, they should be treated with special care and attention by local healthcare practitioners.

Knowledge, and practices on sexual and reproductive health among youth trainees attached to youth training centers in Sri Lanka

BACKGROUND

Sexual and reproductive health is a major concern among adolescents and youth in Sri Lanka. The study was carried out to assess the knowledge, and practices of the youth trainees attached to youth training institutes in Sri Lanka.

METHODOLOGY

A descriptive, cross-sectional study was carried out among randomly selected 425 youth trainees attached to youth training centers in Sri Lanka using a pre-tested self-administered questionnaire. Statistical analysis was conducted using SPSS-21. Categorical variables were presented as numbers and percentages. A comparison of categorical variables was conducted using the Chi-Square test and Fisher's exact test as applicable. The bivariate logistic regression model was used to determine the independent association of the selected demographic factors with youth trainees' sexual and reproductive health knowledge.

RESULTS

Study group consisted of 51.8% (n = 220) males and 48.2% (n = 205) females with a mean age of 18.6 years (SD = 1.8). Youth trainees' knowledge of the physiology of the reproductive tract was not at a satisfactory level, where Only 49% (n = 211) knew that nocturnal emission is normal in young men. The trainee's knowledge of contraception was also at a poor level. Only 47.5% (n = 202) had ever heard of condoms, and 13.2% (n = 56) knew about the emergency contraceptive pill. Nearly 8% (n = 33) of the youth had engaged in sexual intercourse at least once in their lifetime. Male gender (AOR = 2.3, p < 0.001), and age above 20 years (AOR = 1.9, P = 0.005) were positively associated with SRH knowledge.

CONCLUSIONS AND RECOMMENDATIONS

Knowledge and practices on sexual and reproductive health among youth trainees were sub-standard. The study recommends strengthening sexual and reproductive health education at youth training centers.

Prevalence and Factors Associated with Risky Sexual Behaviors Among Sexually Active Female Adolescents in Zambia

Despite decades long commitment to women's reproductive health rights, sexually transmitted diseases and unintended pregnancies continue to be major public health concerns in sub-Saharan Africa. In order to provide an evidence base for future policy and services, this study aims to explore the prevalence and factors associated with risky sexual behaviors (RSB) among sexually active Zambian female adolescents using a nationally representative sample. Data on females, aged 15-19 (n = 3000), were obtained from the 2018 Zambia Demographic and Health Survey, an interviewer-administered, nationally representative survey that used multistage sampling. The study conducted multiple logistic regression to explore the correlates of RSB. Of the 3000 respondents, 49.7% (1490) reported ever having sexual intercourse of which 71.1% reported engaging in RSB. Among sexually active female adolescents, the following RSB percentage were reported: intercourse before age 16 (50.6%), nonuse of condoms at last intercourse (37.8%), engaging in transactional sex (6.2%), alcohol use at last intercourse (4.6%), and multiple sexual partners (1.9%). Educational attainment and household wealth showed strong inverse trends with RSB risk and there were notably large geographic differences in RSB within Zambia (22.1% in Lusaka region vs. 62.4% in Western province). The multiple logistic regression results revealed that those who were younger, unmarried, with less than secondary education, without access to Internet, and residents of Western Zambia were significantly more likely to have engaged in RSB (AOR: 1.74-7.69, p < 0.05). Given the negative health outcomes associated with RSB, Zambian adolescent health care programs may strategically target limited resources to the identified risk groups.

Access to mass media and teenage pregnancy among adolescents in Zambia: a national cross-sectional survey

OBJECTIVE

Teenage pregnancies and childbirths are associated with negative health outcomes. Access to health information enables adolescents to make appropriate decisions. However, the relationship between access to health information through mass media and teenage pregnancy has not received much attention in existing literature. We therefore examined the association between access to mass media and teenage pregnancy in Zambia.

DESIGN

Cross-sectional.

SETTING

Zambia.

PARTICIPANTS

Weighted sample of 3000 adolescents aged 15-19 years.

OUTCOME MEASURE

Teenage pregnancy that included adolescents who were currently pregnant or had had an abortion or had given birth in the last 5 years preceding the survey.

RESULTS

Out of 3000 adolescents, 897 (29.9%, 95% CI: 28.1% to 31.3%) were pregnant or had ever been pregnant. Majority of the adolescents resided in rural areas (55.9%) and had secondary education (53.6%). Adolescents who had exposure to internet, newspapers or magazines, radio and television were 10.5%, 22.6%, 43.1% and 43.1%, respectively. Adolescents who had daily access to newspapers or magazines (adjusted OR (AOR): 0.33, 95% CI: 0.13 to 0.82) or using internet (AOR: 0.54, 95% CI: 0.30 to 0.95) were less likely to be pregnant or to have had a pregnancy compared with those with no access to newspapers and internet, respectively.

CONCLUSION

Our study suggests that internet use and reading of newspapers or magazines may trigger behavioural change as an effective approach to reducing teenage pregnancy. Behavioural change communicators can implement mass media campaigns using newspapers, magazines and the internet to publicise adolescent health messages that can encourage adolescents to adopt healthy behaviours and prevent teenage pregnancies.

Usability of a mobile health application in tuberculosis screening and compliance to perform chest x-ray examination among presumptive cases detected by the app in Myanmar (Preprint)

Background

In Myanmar, the use of a mobile app for tuberculosis (TB) screening and its operational effect on seeking TB health care have not been evaluated yet.

Objective

This study aims to report the usability of a simple mobile app to screen TB and comply with chest X-ray (CXR) examination of presumptive cases detected by the app.

Methods

A new “TB-screen” app was developed from a Google Sheet based on a previously published algorithm. The app calculates a TB risk propensity score from an individual’s sociodemographic characteristics and TB clinical history and suggests whether the individual should undergo a CXR. The screening program was launched in urban slum areas soon after the COVID-19 outbreak subsided. A standard questionnaire was used to assess the app’s usability rated by presumptive cases. Compliance to undergo CXR was confirmed by scanning the referral quick response (QR) code via the app.

Results

Raters were 453 presumptive cases detected by the app. The mean usability rating score was 4.1 out of 5. Compliance to undergo CXR examination was 71.1% (n=322). Active TB case detection among CXR compliances was 7.5% (n=24). One standard deviation (SD) increase in the app usability score was significantly associated with a 59% increase in the odds to comply with CXR (β=.464) after adjusting for other variables (P<.001).

Conclusions

This simple mobile app got a high usability score rated by 453 users. The mobile app usability score successfully predicted compliance to undergo CXR examination. Eventually, 24 (7.5%) of 322 users who were suspected of having TB by the mobile app were detected as active TB cases by CXR. The system should be upscaled for a large trial.

Internet Usage and Risky Sexual Behavior among High School Students in a Suburban Area of Indonesia

BACKGROUND: Internet has been of great benefit to human life, however, it has some disadvantages which exist particularly among young people. AIM: Therefore, this study aims to investigate the internet usage and risky sexual behavior among high school students in a suburban area in Indonesia. METHODS: This was a cross-sectional study carried out using stratified random sampling in a high school located in a suburban area in West Java, Indonesia. Furthermore, self-administered Modified Internet Sex Screening Test (ISST) questionnaire was applied to measure the risky sexual behavior among the students. RESULTS: The results showed that based on the overall risky sexual behavior from internet usage, 35 (12.9%), 211 (77.6%), and 26 (9.6%) subjects were at low, medium, and high risk, respectively. Furthermore, the male gender and browsing for sexual content video were discovered to be the significant risk factors associated with risky sexual behavior with an adjusted odds ratio (AOR) of 5.79 (95% CI: 1.15-29.14) and 3.11 (95% CI: 1.03-9.39), respectively. CONCLUSIONS: From the results obtained, it was concluded that the prevalence of risky sexual behavior based on internet usage is high among students. Furthermore, it was discovered that male students need more attention by being involved in healthy sexual education. In addition, the role of policy-maker in filtering the accessible content for students is required.

Changing Trends in Sexual Debut Age in the Korean Internet Sexuality Survey

Purpose

To evaluate changing trends in relation to the sexual debut age and socioeconomic status (SES) in Korea.

Materials and Methods

The Korean Internet Sexuality Survey (KISS) was conducted for in 2004, 2006, 2014, and 2016. We sent emails and surveyed people registered at an Internet survey agency. To determine the changing trends in sexual debut age, we collected and compared the responses of females in their 20s in 2004 (n=253) and 2014 (n=131) and collected and compared the responses of males in their 20s in 2006 (n=87) and 2016 (n=200).

Results

In females, SES factors such as occupation, income, and academic background were not related to early sexual debut age. In the 2006 male study, early sexual debut age was associated with occupation, income, and academic background. However, in the 2016 male study, participants' academic background was the only significant factor about early sexual debut age. In both the male and female studies, early sexual debut age was related to a higher number of sexual partners in life. Also, in both female cohorts (2004 and 2014), the number of pregnancies and the incidents of sexual abuse experienced were higher in the early sexual debut groups.

Conclusions

Factors influencing early sexual debut were different in time and between men and women. And there was no significant association between SES factors and early sexual debut age in women. However, early sexual debut caused multiple problems, especially in young women. Thus, we need to create some suitable strategies to address these problems.

Prevalence of first adolescent pregnancy and its associated factors in sub-Saharan Africa: A multi-country analysis

INTRODUCTION

In low-and middle-income countries, pregnancy-related complications are major causes of death for young women. This study aimed to determine the prevalence of first adolescent pregnancy and its associated factors in sub-Saharan Africa.

METHODS

We undertook a secondary analysis of cross-sectional data from Demographic and Health Surveys conducted in 32 sub-Saharan African countries between 2010 and 2018. We calculated the prevalence of first adolescent (aged 15 to 19 years) pregnancy in each country and examined associations between individual and contextual level factors and first adolescent pregnancy.

RESULTS

Among all adolescents, Congo experienced the highest prevalence of first adolescent pregnancy (44.3%) and Rwanda the lowest (7.2%). However, among adolescents who had ever had sex, the prevalence ranged from 36.5% in Rwanda to 75.6% in Chad. The odds of first adolescent pregnancy was higher with increasing age, working, being married/cohabiting, having primary education only, early sexual initiation, knowledge of contraceptives, no unmet need for contraception and poorest wealth quintile. By contrast, adolescents who lived in rural areas and in the West African sub-region had lower odds of first adolescent pregnancy.

CONCLUSION

The prevalence of adolescent pregnancy in sub-Saharan African countries is high. Understanding the predictors of first adolescent pregnancy can facilitate the development of effective social policies such as family planning and comprehensive sex and relationship education in sub-Saharan Africa and can help ensure healthy lives and promotion of well-being for adolescents and their families and communities.

Trends and birth outcomes in adolescent refugees and migrants on the Thailand-Myanmar border, 1986-2016: an observational study

Background: Currently there are more adolescents (10-19 years old) and young adults (20-24 years old) than ever. Reproductive health among this age group is often overlooked, although it can have a profound impact on the future. This is especially the case in conflict zones and refugee settings, where there is a heightened need for reproductive health care, and where both the resources and possibility for data collation are usually limited.

Methods: Here we report on pregnancies, birth outcomes and risk factors for repeat pregnancies among adolescent and young adult refugees and migrants from antenatal clinics on the Thailand-Myanmar border across a 30 year time span.

Results: Pregnancy and fertility rates were persistently high. Compared with 20-24-year-olds, 15-19-year-olds who reported being unable to read had 2.35 (CI: 1.97 – 2.81) times the odds for repeat pregnancy (gravidity >2). In primigravidae, the proportion of small for gestational age (SGA) and preterm births (PTB), and neonatal deaths (NND) decreased with increasing maternal age (all p <0.001). After adjustment, this association retained significance for PTB (cut-off point, ≤18 years) but not for SGA and NND.

Conclusions: There is considerable room for improvement in adolescent pregnancy rates in these border populations, and educational opportunities may play a key role in effective interventions.

Gender-based differences in the high-risk sexual behaviours of young people aged 15-29 in Melilla (Spain): a cross-sectional study

Background

Research confirms the existence of gender-based differences regarding the high-risk sexual behaviour (non-use of condoms and casual partners) of young men and women. The objectives were to provide evidence for this association; to analyse the reasons why both sexes have sexual relations with casual partners and to ascertain the motives for condom use or non-use during casual sex.

Methods

A cross-sectional study was performed on a sample of 900 participants, 524 males and 376 females. All participants were 15-29 (20.93 ± 4.071) years of age and came from four different centres (a university, two secondary schools, and a military base) in Melilla (Spain). The participants were given a socio-demographic survey as well as a psychometric text on high-risk sexual behaviour.

Results

The results found gender-based significant differences for sexual relations with penetration (p = 0.001), number of sexual partners (p = 0.001), and sexual relations with casual partners (p = 0.001). In all of these variables, male participants had higher percentages than female participants. Reasons for having casual sexual relations were also different for men and women, differences were found for the items, opportunity (p = 0.001), interest in knowing the other person (p = 0.015), physical excitement (p = 0.056) and drug consumption (p = 0.059). Regarding the reasons for consistent condom use with casual partners, there were differences for the item, my demand of a condom (p = 0.002). For the non-use of condoms with casual partners, differences were found for the items, I do not like to use condoms (p = 0.001) and condoms lessen sensitivity and reduce pleasure (p = 0.009).

Conclusions

Men and women were found to have different high-risk sexual behaviours and practices. Of the motives for having sexual relations with casual partners, male participants considered opportunity and interest in knowing the other person to be more important than the female participants. Regarding condom use, the female participants’ demand to use a condom was a significant gender-based difference. In contrast to the young women, the male participants mostly justified not using a condom because it lessened sensitivity and reduced pleasure.