Predictors of primary and secondary sexual abstinence among never-married youth in urban poor Accra, Ghana

Trends, and patterns, of premarital sexual intercourse and its associated factors among never-married young women aged 15-24 in Sierra Leone

BACKGROUND

Premarital sexual intercourse has essential implications for the sexual and reproductive health and rights of young women. These include increased sexual pleasure and satisfaction as well as exposure to the risks of unintended pregnancy and sexually transmitted infections, including HIV/AIDS. This study examined the trends, patterns, and associations of premarital sexual intercourse among young women aged 15-24 in Sierra Leone.

METHODS

Nationally representative cross-sectional data from the 2008, 2013, and 2019 Demographic and Health Surveys in Sierra Leone were used for the study. A weighted sample of 9,675 never-married young women was used to estimate the pooled prevalence of premarital sexual intercourse in Sierra Leone. Percentages were used to present the results of the trends and patterns of premarital sexual intercourse. We employed a multilevel binary logistic regression modelling technique to examine the associations of premarital sexual intercourse. The results were presented using adjusted odds ratio with their respective 95% confidence interval.

RESULTS

The pooled prevalence of premarital sexual intercourse among the young women in Sierra Leone was 62.9%. Over the survey years, premarital sexual intercourse increased from 59.8% in 2008 to 65.1% in 2013. However, it declined by 3.5% to 61.6% in 2019. Young women aged 20-24 (aOR = 12.47, 95% CI = 10.54-14.76) had higher odds of engaging in premarital sexual intercourse than those aged 15-19. Young women with higher educational levels (aOR = 1.87, 95% CI = 1.17-2.99), those who were working (aOR = 1.60, 95% CI = 1.44-1.78), those who listened to the radio (aOR = 1.33, 95% CI = 1.29-1.60), and those who lived in the Northwestern (aOR = 2.19, 95% CI = 1.68-2.84), Eastern (aOR = 1.47, 95% CI = 1.23-1.760, Northern (aOR = 1.48, 95% CI = 1.25 -, 1.76), and Southern (aOR = 1.63, 95% CI = 1.36-1.94) regions were more likely to engage in premarital sexual intercourse compared to those with no formal education, those not working, those who did not listen to the radio, and those who lived in the Western region, respectively. Young women in the richest wealth category (aOR = 0.62, 95% CI = 0.49-0.78), and residing in rural areas (aOR = 0.84, 95% CI = 0.72-0.98) had lower odds of engaging in premarital sexual intercourse relative to those from the poorest wealth quintile and those living in urban areas.

CONCLUSION

Our study found a high prevalence of premarital sexual intercourse among young women in Sierra Leone. Premarital sexual intercourse was associated with age, educational level, wealth, employment, and region. This necessitates providing them with comprehensive information regarding sexual and reproductive health behaviours, specifically emphasising the benefits and adverse consequences of engaging in sexual experimentation. Additionally, it is crucial to promote the adoption of abstinence, injections, implants, and condom usage through consistent advocacy for youth-risk communication.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSION

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

Cultural Determinants and Parent-Child Communication as an Effective Tool to Prevent Child Sexual Abuse: A Quick Qualitative Study

The current study's sole specific goal was to use a qualitative approach, from the parents' emic perspective, to investigate the cultural determinants that influence using parent-child communication as an instrument to protect children from sexual abuse in the six electoral wards of Ife-East Local Government that covered the rural settlement of Ile-Ife. The study adopted a simple random sampling method to select a village from each ward and a convenient sampling method to select six parents from each village, making a total sample size of 36. The study utilized in-depth face-to-face interviews to garner the primary data and content analysis for data analysis. This study found and concluded that parents' economic activities, religious beliefs, fear of stigmatization or mockery, belief that giving a child sex education via parent-child communication promotes waywardness in the behavior of such a child, belief that sex education should be best confined to formal education, and overconfidence of the parents in their wards were among the cultural determinants influencing the efficacy of parent-child communication as a device to shield young ones from being victims of sexual abuse in the study location. The study recommended public enlightenment via various social institutions on dealing with these cultural determinants.

Influences of parental monitoring and school connectedness on age at first sexual debut among unmarried female youth in Bedele town, Ethiopia: A survival analysis of timing using accelerated failure time model

Background

The age of first sexual debut among youth continues to attract interest as it marks the start of their exposure to a variety of sexual and reproductive health problems. Parental monitoring (PM) and school connectedness (SC) has been found to have an effect on this problem. Despite this fact, there is a dearth of literature on implications of PM and SC on age at first sexual debut in Ethiopia. Therefore, this paper examined the influences of PM and SC age at first sexual debut among female youth.

Methods

A retrospective follow-up study was conducted on 470 randomly selected female youth in Bedele town, Oromia regional state, southwest Ethiopia from February 1 to March 30, 2021. The age at first sexual debut was asked in full years for respondents who ever engaged in sexual debut at a time of data collection. Data were entered using Epi-Data version 4.6 and analyzed using Stata version 14. All variables at P-values less than 0.2 in bivariable analysis were exported to multivariable analysis. Multivariable Accelerated Failure Time (AFT) regression analyses using Weibull distribution were used to examine the association of age at first sexual debut with PM and SC at 5% level of significance.

Results

Overall, 132(28.1%) youths were begun sexual activities of which 79.54% was an early (vaginal penetrative sex before 18 years old). The incidence rate was 15.58/1000 PY with 95% CI of [13.14, 18.47]. The result shows that, female youth start first sexual debut as early as 10 year and mean age was 16.89±2.82. Only 27.97% of those who began sexual debut used contraception during first sex. Multivariable Weibull AFT regression analyses adjusted for different variables showed that high PM (Adjusted Time Ratio (ATR) 1.13: 95%CI; [1.04, 1.21]) and good SC (ATR: 1.14: 95% CI; [1.06, 1.22] significantly delays the age at first sexual debut.

Conclusions

Overall, four out of every five premarital sexual activities were early sexual debuts. High PM and high SC significantly decrease early sexual debut by delaying the age of sexual initiation. Therefore, family and school involvement focused on PM and SC of the youth is recommended as an important mechanism for preventing youths’ risky sexual behaviour, including early sexual debut.

Determinants of communication on sexual issues between adolescents and their parents in the Adaklu district of the Volta region, Ghana: a multinomial logistic regression analysis

BACKGROUND

Poor communication on sexual issues between adolescents and their parents results in high rates of negative sexual practices such as teenage pregnancy. Contributing factors to this poor communication on sexual issues between adolescents and their parents in a high teenage pregnancy setting have not been adequately explored. We sought to fill this gap by examining the factors that predict communication on sexual issues between adolescents and their parents in the Adaklu district of the Volta region of Ghana.

METHODS

A baseline cross-sectional household survey of 221 adolescents aged 10-19 years in 30 randomly selected communities was used. A well-structured questionnaire was developed. A multinomial logistic regression analysis was used to examine factors that significantly influenced communication between adolescents and their parents regarding sex.

RESULTS

Only 11.3% of adolescents had discussions on sexual issues with both parents while 27.6% of communicated sexual issues with only one parent in Adaklu district. Adolescent males (AOR = 0.21, CI = 0.06-0.75), those aged 10-14 years (AOR = 0.41, CI = 0.04-0.57), non-members of adolescent health clubs (AOR = 0.46, CI = 0.21-1.00), and those living with only a father (AOR = 0.19, CI = 0.06-0.61) had lower odds of communicating with their parents on sexual issues.

CONCLUSIONS

Adolescent-parental communication on sexual issues in Adaklu district is very low. This situation requires more empowerment of adolescents to enable them to discuss sexual issues with their parents through increased engagement with adolescent health club activities and capacity building capacity of parents with the right information on sexual and reproductive health by health staff within the district. Additionally, parents need to be equipped with communication skills to enable them to communicate effectively with their children.

Geospatial Distribution of Family Planning Services in Kira Municipality, Wakiso District, Uganda

Introduction: Access to family planning (FP) services remains a challenge, particularly in informal urban settlements. The unmet need for FP in these settings is high, with a correspondingly high prevalence of unintended pregnancies that may lead to unsafe abortions. However, there is a paucity of quality data on the distribution of FP services in such settings in Uganda. This paper described the geospatial distribution of FP services in Kira Municipality, Wakiso District, Uganda.

Methods: This was a cross-sectional study in which we determined the availability and distribution of FP services in Kira Municipality. Community mapping and analysis were conducted using ArcGIS (version 10.1) and ArcGIS Online. Stata version 13.1 was used for data analysis. Chi-square test was used to compare the contraceptive provision and availability among facilities from informal and formal settlements.

Results: Of the 176 healthcare facilities surveyed, only 42% (n = 74) offered contraceptives in informal settlements. The majority of the facilities were privately owned small clinics (95%). At least 80% of the facilities provided three or more modern contraceptive methods, with no difference (p = 0.107) between facilities in informal and formal settlements. Only 30.7% (p = 0.001) of the facilities provided at least one long-acting contraceptive. Similarly, 20 and 12% (p = 0.001) of the facilities had implants and intrauterine devices (IUDs) on the day of the survey. Almost 25% of the facilities did not offer contraceptive services (counseling and commodities) to unmarried adolescents.

Conclusions: Most facilities were small privately-owned clinics, offering at least three modern contraceptive methods. The unavailability of long-acting reversible methods in the informal settings may affect the quality of FP services due to limited choice. The inequity in service provision that disfavors the unmarried adolescent may increase unwanted/unintended pregnancies. We recommend that local governments and partners work toward filling the existing commodities gap and addressing the discrimination against unmarried adolescents in such settings.

An Exploratory Study of Current Sources of Adolescent Sexual and Reproductive Health Information in Kenya and Their Limitations: Are Mobile Phone Technologies the Answer?

Purpose The prevalence of pregnancy and sexually transmitted infections among adolescents in low and middle-income countries leads us to believe that sexual and reproductive health (SRH) information needs are still unmet. This paper investigates current sources and their limitations and then explores the role technology could play. Methods: In an exploratory qualitative study themes identified; (1) preferred sources of SRH information; (2) their limitations; (3) the role of technology in meeting their needs. Results: Mobile phone-based apps could improve awareness and provide information in a confidential way. Conclusions: Adolescents have an unmet need that vary by age and gender. Mobile phones could offer accessible, user-friendly platform.

Postpartum and post-abortion contraceptive use among unmarried young women in Ghana

Pregnancy outcomes impact subsequent contraceptive behaviour. The purpose of this study was to assess the relationship between previous pregnancy outcomes and subsequent contraceptive behaviours among unmarried young women intending to delay childbearing. Using data from the 2014 Ghana Demographic and Health Survey, among 1118 sexually experienced, fecund and non-pregnant unmarried women aged 15-24 years, the study assessed how childbirth and abortion are related to sexual abstinence and use of modern contraception. While about 70% of unmarried young women were nulligravid, approximately 11% had had an abortion and 18.2% were postpartum. The majority of respondents were sexually abstinent while 21% and 27% were using and not using contraception, respectively. Postpartum women were more likely than nulligravid and post-abortion women to use contraceptives. Post-abortion women were least likely to be sexually abstinent. Number of years since the respondent's sexual debut was positively associated with the likelihood of using modern contraception, particularly among postpartum women, and negatively associated with sexual abstinence among those who had aborted. The findings show that prior pregnancy outcomes have significant implications for secondary abstinence and contraceptive use among unmarried young women in Ghana. Post-abortion women are more likely than postpartum women to be sexually active but less likely to use contraceptives. Efforts must be strengthened towards increasing access to modern contraceptives for young women who present for abortion in Ghana.