Individual and contextual factors associated with sexual initiation among adolescents

Sexual behaviour among Kenyan adolescents enrolled in an efficacy trial of a smartphone game to prevent HIV: a cross-sectional analysis of baseline data

Sexual behaviour of adolescents is contextual, with various determinants affecting sexual activity and age of sexual debut. Insight into sexual activity among young adolescents has the potential to influence appropriate sexual and reproductive health interventions. For this analysis, adolescents were recruited as part of the Tumaini smartphone game efficacy trial. Data collection included a self-administered behavioural survey and blood test for HIV and HSV-2. Descriptive statistics were calculated for demographics and measures of sexual behaviour and behavioural intent based on gender and sexual experience, with associations assessed using chi-square tests, t-tests and Wilcoxon rank sum tests as appropriate. We enrolled 996 adolescents, mean age 14 years and 2.2% HSV-2 positivity. Overall, 15% of the adolescents were sexually experienced, this being associated with lower socio-economic status (p = 0.01), household food insecurity (p = 0.008), a living situation without both parents (p < 0.01), substance use (p = 0.02), no adult conversation about future goals (p = 0.003), conversations about condoms (p = 0.01), with some gender disparity within these factors. Among those sexually experienced, 21.7% reported unwilling sex; 17.5% had engaged in transactional sex; 57.8% had willing first sex, of whom 60.9% reported no condom use. Among those abstaining, female adolescents were less likely to contemplate condom use at first sex (p = 0.006). Our findings determine that young sexually active adolescents are likely engaging in unprotected sex and having unwilling sexual experiences. Socio-economic status, living situation and parental monitoring remain significant factors associated with sexual experience among young adolescents. In this context, early adolescence is an opportunity to provide age- and developmentally appropriate education about safer sex practices.Trial registration: ClinicalTrials.gov identifier: NCT04437667.

Association between early sexual initiation and sexually transmitted infections among Peruvian reproductive-age women

Background

Sexually transmitted infections (STIs) are a serious public health problem worldwide, especially among reproductive-age women. The early sexual onset of sexual intercourse (EOSI) has been suggested as a risk factor, although there is no data at the national level.

Objective

To evaluate the association between EOSI and STIs in Peruvian women of childbearing age.

Methods

Analytical cross-sectional study with secondary data analyzes of the Peruvian Demographic and Family Health Survey 2018. The outcome was the presence of STIs in the last 12 months and the exposure variable was EOSI (age < 15 years at the time of their first sexual experience). To evaluate the association of interest, crude and adjusted prevalence ratios (aPRs) were calculated using generalized linear models with Poisson family and logarithmic link function.

Results

We analyzed data from 31,028 women of childbearing age. The 11.3% reported having STIs in the last 12 months and 20.2% of the participants had an EOSI. After adjusting for potential confounders, we found that EOSI was associated with STIs (aPR: 1.27; 95% CI: 1.08-1.50; p = 0.005). When conducting stratified analysis by area of residence and number of sexual partners, this association was maintained in women living in urban areas (aPR: 1.36; 95% CI: 1.11-1.66; p = 0.003) those who did not report having a history of multiple sexual partners (aPR: 1.27; 95% CI: 1.08-1.51; p = 0.005), and those in the middle (aPR: 1.42; 95% CI: 1.03-1.97; p = 0.034) and highest (aPR: 2.12; 95% CI: 1.33-3.39; p = 0.002) wealth quintiles.

Conclusion

Among reproductive-age women from Peru, EOSI was associated with STIs, especially in women living in urban areas, with no history of multiple sexual partners, and belonging to the middle to higher wealth index. The implementation of measures to prevent EOSI and fostering appropriate sexual health counseling for women with EOSI is advised.

Diversities of Sexual Activities and Correlates of Safe Sex Practices Among Adolescents in Plateau State, Nigeria

Background: Unsafe sex, particularly, condomless sex exposes adolescents to sexual and reproductive health risks. This study aimed to assess the sexual experiences and to determine the most important covariates of sexual activity and consistent condom use among adolescents in Plateau State, Nigeria.

Methods: A cross sectional survey was conducted among 428 adolescents selected from 6 LGAs through a multistage sampling technique. The data was analyzed using the IBM Statistical package for Social Sciences (SPSS) version 23, multiple logistic regression was conducted to determine the covariates of sexual activity and condom use.

Results: About one third (38%) of the adolescents were sexually active, 5.7% had same sex partners, 70% had more than one sexual partner and majority (72.4%) were not consistently using condom during sex. Logistic regression results showed that older adolescents (OR = 5.73; CI = 3.72–8.12; p = 0.001) and out of school adolescents (OR = 2.68; CI = 1.79–4.00; p = 0.001) were more likely to be sexually active, while multivariable logistic regression analysis showed age (AOR = 0.33; CI = 0.12–0.90; p = 0.031) and gender as important covariates of being sexually active, (AOR = 6.29; CI = 3.18–12.44; p = 0.001). Inconsistent condom use was more likely among adolescents; with lower education, (OR = 2.14; CI = 1.19–3.85; p = 0.011), having sex with older partners (OR = 0.61; CI = 0.42–0.90; P = 0.013) and with low awareness of SRH issues (OR = 2.08; CI = 1.02–4.22; p = 0.044). The multivariable logistic regression however, showed gender, being male (AOR = 0.43; CI = 0.006–3.09; p = 0.023) as covariate of consistent condom use.

Conclusion: Most sexually active adolescents had multiple sexual partners, some had same sex partners and majority were not consistently using condom. Older adolescents and those out of school were more likely to be sexually active. Awareness of SRH issues significantly influenced condom use while gender, specifically being male, was the independent covariate for being sexually active and for consistent condom use. We recommend sexual health intervention targeted at adolescents. In addition, gender should be mainstreamed into adolescent sexual and reproductive health programmes.

Early Sexual Debut among Ghanaian Women: Correlates and Psychological Effect

Early sexual initiation is linked to an increased risk of HIV/AIDS and other STIs among teenagers, as well as having multiple partners, not using contraception, unintended pregnancy, and illegal abortions. Aim. To identify the correlates and psychological effects of early sexual debut among not-in-union women in Ghana. A descriptive cross-sectional survey was used for this study using data from Ghana Multiple Indicator Cluster Survey (MICS) for the year 2017/2018. SPSS software was used for data analysis, bivariate analysis for association was done using chi-square, and the prediction was done using a binary logistic regression model. The national prevalence of nonmarital early sexual initiation this current study recorded was 56.9%. Predictors variables were age, 15-24/≥35 years (AOR = 1.51, 1.28-1.78), ever educated (AOR = 0.50, 0.43-0.60), urban address (AOR = 0.85, 0.74-0.98), married/single (AOR = 1.23, 1.07-1.42), cohabitation/single (AOR = 1.43, 1.19-1.72), Greater Accra Region/Upper West Region (AOR = 0.67, 0.49-0.92), and health insurance (AOR = 0.89, 0.79-0.998). As the wealth indices of the woman decrease from the richest to poorest, the likelihood of early sexual debut inversely increases: fourth/richest (AOR = 1.23, 1.04-1.45), middle/richest (AOR = 1.31, 1.09-1.58), second/richest (AOR = 1.38, 1.11-1.72), and poorest/richest (AOR = 1.44, 1.12-1.86); use of the internet (AOR = 0.58, 0.50-068); substance use and alcohol ever use (AOR = 1.32, 1.17-1.49); cigarette ever use (AOR = 2.58, 1.44-4.64); contraceptive use (AOR = 1.31, 1.16-1.49); and ever heard of HIV (AOR = 59, 0.42-0.82). In conclusion, the prevalence of early sexual debut is still high in Ghana, especially among the northern regions. Several factors predicted early sex debut, and low life satisfaction and happiness were related to early sexual debut.

Burden of Risk Factors for Cervical Cancer Among Women Living in East Africa: An Analysis of the Latest Demographic Health Surveys Conducted Between 2014 and 2017

In East Africa, cervical cancer is a leading cause of morbidity and mortality among women diagnosed with cancer. In this study, we describe the burden of risk factors for cervical cancer among women of reproductive age in five East African countries.

Prevalence and Factors Associated with Early Sexual Initiation among College Students in Southwest Ethiopia

Background

Early age at first sexual practice is a public health issue and now common around the world especially in the developing countries. The development of effective strategies to reduce the adverse consequences of early sexual initiation becomes real when sufficient data is available. Therefore, this study is aimed at assessing the prevalence and factors associated to early sexual initiation among college students in southwest Ethiopia.

Methods

A cross-sectional study was conducted among 453 college students in southwest Ethiopia from April to May 2018. A two-stage stratified sampling technique was used to select the study participants. The data were collected using structured pretested self-administered questionnaire. The collected data were entered using Epi-Data version 4.2.0.0 and analyzed using SPSS version 20. Logistic regression models were fitted to assess the effect of independent variables on the outcome variable. Significance was declared at p < 0.05 in the multivariable logistic regression analysis.

Results

The proportion of early sexual initiation among college students was 17.9%, 95% CI (14.4%-24.4%). The mean age of sexual intercourse was 17.6 (±2 SD) years. Nearly three-fourths (73.4%) of the respondent's reason for early sexual intercourse was falling in love. More than half (62.2%) of the respondents used a condom for their first sexual intercourse. The factors associated with early sexual initiation were being female (AOR = 2.09and 95% CI [1.17-2.35]), chewing khat (AOR = 7.05 and 95% CI [3.81-13.1]), exposed to pornographic materials at age < 18 years (AOR = 3.57 and 95% CI [1.94-6.89]), and poor knowledge of sexually transmitted diseases (AOR = 8.69 and 95% CI [3.52-21.5]).

Conclusion

The prevalence of early sexual initiation among college students was alarmingly high. This may be associated with a huge burden of poor sexual and reproductive health. Therefore, creating awareness of the factors and related negative sexual and reproductive health effect of early sexual initiation for young peoples through the use of mass media (television and radio), school teachers, and parents plays a paramount importance.

Sexual Intercourse and Its Correlates Among School-aged Adolescents in Indonesia: Analysis of the 2015 Global School-based Health Survey

Objectives

This study aimed to determine the prevalence and correlates of sexual intercourse among junior secondary and high school students in Indonesia from the 2015 Global School-based Health Survey (GSHS).

Methods

The survey was conducted among 11 110 students from 75 schools in Indonesia using a self-administered questionnaire. Univariate and multivariate analyses were conducted to explore associations between sexual intercourse and socio-demographic variables, substance use, mental distress, and protective factors.

Results

Overall, 5.3% of students reported having ever had sex (6.9% of boys and 3.8% of girls). Of students who engaged in sexual intercourse, 72.7% of boys and 90.3% of girls had an early sexual debut (before reaching the age of 15) and around 60% had multiple sex partners. Sexual intercourse was associated with gender, school grade, smoking, alcohol consumption, drug use, suicidal ideation, truancy, peer support, and parental supervision.

Conclusions

These findings indicate a pressing need to develop more comprehensive sexual health education in the national curriculum. An effective strategy should also address other risky behaviours.