1
|
Chemhaka GB, Simelane MS. Timing of sexual debut and associated sociodemographic and HIV risk factors among young people in Eswatini. PLoS One 2024; 19:e0303942. [PMID: 38875299 PMCID: PMC11178172 DOI: 10.1371/journal.pone.0303942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/03/2024] [Indexed: 06/16/2024] Open
Abstract
Young people in sub-Saharan Africa and specifically in Eswatini (previously Swaziland), continue to be disproportionately affected by HIV despite having equitable access to antiretroviral treatment. Early sexual debut is one of the many factors linked to HIV infection that is discussed in the context of general public health. Monitoring this behavior is essential for developing preventative, evidence-based interventions. This study aims to describe the early and/or typical sexual debut among young people in Eswatini and examines sociodemographic and HIV risk factors associated with early and typical sexual debut timing. We analyzed cross-sectional secondary data from the 2016/17 Swaziland HIV Incidence Measurement Survey (SHIMS), which had a representative sample of 2,383 young people aged 18-24. Respondents were selected using a two-stage stratified probability sampling design. We applied descriptive statistics and multivariable multinomial logistic regressions to examine the data. Out of the 2,383 respondents, 71.3% had sexual experience, with 4.1% and 26.5% reporting early sexual debut (<15 years) and typical sexual debut (<18 years), respectively. Our study found that age, sex, education, marital status, wealth, sexual partners in the past 12 months, and alcohol use were significantly associated with early and/or typical sexual debut. It is crucial to consider the sociodemographic factors and HIV risk factors of young people when designing programs and interventions aimed at preventing early sexual debut or transition. This approach is necessary to promote better sexual and reproductive health in alignment with sustainable development goals.
Collapse
Affiliation(s)
- Garikayi B Chemhaka
- Department of Statistics and Demography, University of Eswatini, Kwaluseni, Manzini, Eswatini
| | - Maswati S Simelane
- Department of Statistics and Demography, University of Eswatini, Kwaluseni, Manzini, Eswatini
| |
Collapse
|
2
|
Budu E, Seidu AA, Armah-Ansah EK, Frimpong JB, Aboagye RG, Anin SK, Hagan JE, Ahinkorah BO. Prevalence and predictors of premarital sexual intercourse among young women in sub-Saharan Africa. Reprod Health 2023; 20:99. [PMID: 37386443 PMCID: PMC10311722 DOI: 10.1186/s12978-023-01626-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/21/2023] [Indexed: 07/01/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Korle Bu Teaching Hospital, P.O.Box 77, Accra, Ghana
| | - Abdul-Aziz Seidu
- REMS Consult, Takoradi, Ghana
- Centre for Gender and Advocacy, Takoradi Technical University, P.O. Box 256, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | | | - James Boadu Frimpong
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Department of Kinesiology, New Mexico State University, Las Cruces, NM USA
| | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Stephen Kofi Anin
- School of Public Health, Bielefeld University, P.O. Box 100131, 33501 Bielefeld, Germany
- Department of Industrial and Health Sciences, Faculty of Applied Sciences, Takoradi Technical University, P.O. Box 256, Takoradi, Ghana
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
| | - Bright Opoku Ahinkorah
- REMS Consult, Takoradi, Ghana
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| |
Collapse
|
3
|
Nxumalo NC, Shongwe MC, Gwebu N, Ngcamphalala C, Nsibandze BS, Nkambule R, Nuwagaba-Biribonwoha H. "Our parents kiss in front of us": Reasons for early sexual debut among in-school youth in the Manzini Region in Eswatini. PLoS One 2023; 18:e0282828. [PMID: 36897882 PMCID: PMC10004614 DOI: 10.1371/journal.pone.0282828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/24/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Early sexual debut (i.e., sex before the age of 15 years), especially if it is unprotected, may increase the risk of acquiring HIV, sexually transmitted infections, and unwanted pregnancies. We investigated the reasons for early sexual debut among in-school youth in Eswatini, a setting with high HIV incidence among youth. METHODS This was a qualitative, exploratory-descriptive study whereby data were collected from 81 sexually active in-school youth through seven focus group discussions (FGDs) in four purposively selected public high schools (two urban and two rural) in the Manzini region, Eswatini. In each school, except one, two FGDs (one for boys and one for girls) were conducted. Qualitative data were coded and analyzed thematically in Dedoose version 8.2.14. RESULTS Nearly 40% of the participants reported having initiated sexual activity before 18 years. Six major themes emerged from the data: i) Intrapersonal factors (feeling mature, religiosity, nutritional or dietary patterns); ii) Parenting and household factors (living arrangement, lack of sexuality education, working parents, negative role-modeling from adults); iii) Peer and partner pressure (pressure from friends, threats from sexual partners, intergenerational sexual partnerships and transactional sex, testing sexual prowess, desire to fit in); iv) Contextual factors (neighborhood, location); v) Mass media (cell phone ownership, social media, and television shows or movies); and vi) Cultural factors (attending traditional ceremonies, loss of cultural norms, values, and traditions, and dress code). CONCLUSION AND RECOMMENDATIONS The poor monitoring and negative role-modeling by elders highlight the importance of involving parents or guardians as key stakeholders when designing interventions targeting risky sexual behavior among youth. The multifaceted nature of the cited reasons for early sexual debut calls for interventions aimed at curbing risky sexual behavior to be culturally sensitive and responsive to the themes identified in this study.
Collapse
Affiliation(s)
- Nomathemba C. Nxumalo
- Health Research Training Program (HRTP), ICAP at Columbia University, Mbabane, Eswatini
- Faculty of Health Sciences, Department of Community Health Nursing Science, University of Eswatini, Mbabane, Eswatini
| | - Mduduzi Colani Shongwe
- Faculty of Health Sciences, Department of Community Health Nursing Science, University of Eswatini, Mbabane, Eswatini
- Faculty of Health Sciences, Department of Midwifery Science, University of Eswatini, Mbabane, Eswatini
- * E-mail:
| | - Nontobeko Gwebu
- ICAP at Columbia University, Mailman School of Public Health, Mbabane, Eswatini
| | | | - Bonisile S. Nsibandze
- Health Research Training Program (HRTP), ICAP at Columbia University, Mbabane, Eswatini
- Faculty of Health Sciences, Department of General Nursing Science, University of Eswatini, Mbabane, Eswatini
| | - Rejoice Nkambule
- Ministry of Health, Government of the Kingdom of Eswatini, Mbabane, Eswatini
| | - Harriet Nuwagaba-Biribonwoha
- ICAP at Columbia University, Mailman School of Public Health, Mbabane, Eswatini
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| |
Collapse
|