Prevalence and correlates of early sexual initiation among Brazilian adolescents

Associations of tobacco and alcohol use with sexual behaviors among adolescents in 59 countries: a population-based study

BACKGROUND

Sexual behaviors, particularly risky sexual behavior, has become a serious public health concern among adolescents worldwide, presenting a substantial obstacle to the prevention of sexually transmitted infections, including human immunodeficiency virus (HIV). However, there is limited research using consistent and standardized methodology to examine associations between tobacco and alcohol use frequency and both total and risky sexual behaviors among adolescents. We aimed to examine the association between tobacco and/or alcohol use with both total and risky sexual behaviors among adolescents worldwide.

METHODS

Data were collected from the Global School-based Student Health Survey, which comprised 211,847 adolescents aged 12-17 years from 59 countries. The frequency of tobacco or alcohol use during the past 30 days was categorized as 0, 1-2, 3-5, 6-9, or ≥ 10 days. Tobacco and alcohol use were also categorized as non-use, tobacco use alone, alcohol use alone, and combined use. Multi-variable logistic regression analysis was used to examine both the independent and combined associations of tobacco and alcohol use with total and risky sexual behaviors.

RESULTS

Compared with no tobacco use, the odds ratio of engaging in sexual intercourse increased with the frequency of tobacco use from 1 to 2 days to ≥ 10 days (total: 2.03 [95% confidence interval 1.47-2.81] to 3.98[2.63-6.03]; risky: 2.43[1.75-3.38] to 4.21[3.26-5.42]), as well as with the frequency of alcohol use. Overall, combined users had greater likelihood of both total and risky sexual behaviors than tobacco users alone, alcohol users alone, and non-users. Similarly, the association between risky sexual behaviors and tobacco use alone was more pronounced among adolescent girls (vs. adolescent boys), as were those of risky sexual behaviors with alcohol use alone among younger adolescents aged 12-14 years (vs. aged 15-17 years) and with tobacco and/or alcohol use among adolescents in the Western Pacific region (vs. Regions of Africa and Americas).

CONCLUSIONS

Our findings suggest independent and combined associations between tobacco and/or alcohol use with sexual behaviors among adolescents, with variations across age, sex, and WHO region.

"You cannot stay with one person once you begin having sex at a young age": the prevalence, correlates and effects of early sexual debut among children in Ghana

BACKGROUND

Children's initiation of early sex has several negative implications on their sexual and reproductive health, growth and development. In Ghana, few studies on early sexual debut have focused on adolescents. Therefore, this study examined the prevalence, causes, correlates and effects of early sexual debut among children aged 8 to 17 in Ghana using secondary data from the Department of Children of the Ministry of Gender, Children, and Social Protection.

METHODS

A convergent parallel mixed-method approach guided the study. Descriptive statistics and multivariable binary logistic regression were used to analyse the quantitative data, while thematic analysis was used to analyse the qualitative data.

RESULTS

The study found that the prevalence of early sexual debut among children was 13.2%, which is more predominant among female children. The main causes of early sexual debut include engaging in sex after watching pornography, self-desire to have sex, and being influenced by alcohol consumption. Also, age, sex, education, marital status, religion, ecological zone, living arrangements, and access to the Internet were significant correlates of early sexual debut. Early sexual debut increases children's risk of unwanted pregnancy, which leads to the termination of children's education or induced abortion. Also, early sexual debut had adverse impacts on the wellbeing of pregnant children and increased children's risk of multiple lifetime sexual partners.

CONCLUSIONS

This study demonstrated that socio-demographic characteristics of children (e.g., age, sex, education, and marital status) were significant correlates of early sexual debut. Policymakers need to design appropriate interventions, considering the socio-demographic characteristics of children, to curb its occurrence in Ghana.

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.

Personal, Interpersonal, and Sociocultural Factors of Condom Use in Rural Indigenous Nahuas Adolescents in Mexico

The goal of this research was to determine the personal, interpersonal, and sociocultural predictors of condom use among rural Indigenous adolescents. Predictor variables were selected from Bandura's Social Cognitive Theory and Leininger's Transcultural Theory. The sample consisted of 419 Nahuas adolescents randomly selected from the total number of neighborhood blocks in a rural community in Puebla, Mexico. The instruments had acceptable psychometric characteristics (Cronbach alpha and validity scores). Multiple linear regression models were used. Results: 56.8% of participants were female, and 50.40% were students. Mean age was M = 17.5 (SD = 0.97), and the majority (63%) identified as Catholic. Age at menarche/first ejaculation (β = -1.2, p = 0.038), attitude toward condom use (β = 0.13, p < 0.001), ethnic identity (β = 0.21, p < 0.001), and ability to negotiate condom use (β = 0.13, p = 0.003) predicted (R² = 22.3) condom use. This study provided a basis for integration of the cultural values of Indigenous adolescents within interventions for sexual health promotion.

Prevalence and associated factors of early sexual initiation among youth female in sub-Saharan Africa: a multilevel analysis of recent demographic and health surveys

Background

Early sexual initiation is a major public health concern globally, specifically in Sub-Saharan African (SSA) countries where reproductive health care services are limited. It is strongly related to increased risk of HIV/AIDS, sexually transmitted diseases, unwanted pregnancy, adverse birth outcomes, and psychosocial problems. However, there is limited evidence on the prevalence and associated factors of early sexual initiation among youth females in SSA.

Methods

A secondary data analysis was employed based on the recent DHSs of sub-Saharan African countries. A total weighted sample of 184,942 youth females was considered for analysis. Given the hierarchical nature of DHS data, a multilevel binary logistic regression model was fitted. The Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), and Likelihood Ratio (LR) test were used to assess the presence of clustering. Four nested models were fitted and the model with the lowest deviance (-2LLR0 was selected as the best-fitted model. Variables with p-value < 0.2 in the bivariable multilevel binary logistic regression analysis were considered for the multivariable analysis. In the multivariable multilevel binary logistic regression analysis, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) was reported to declare the strength and statistical significance of the association.

Results

The prevalence of early sexual initiation among youth females in sub-Saharan Africa was 46.39% [95%CI: 41.23%, 51.5%] ranging from 16.66% in Rwanda to 71.70% in Liberia. In the final model, having primary level education [AOR = 0.82, 95% CI; 0.79, 0.85], and [AOR = 0.50, 95%CI; 0.48, 0.52], being rural [AOR = 1.05, 95%CI: 1.03, 1.07], having media exposure [AOR = 0.91, 95%CI: 0.89, 0.94], and belonged to a community with high media exposure [AOR = 0.92, 95%CI: 0.89,0.96] were found significantly associated with early sexual initiation.

Conclusion

The prevalence of early sexual initiation among youth females in SSA was high. Educational status, wealth index, residence, media exposure, and community media exposure have a significant association with early sexual initiation. These findings highlight those policymakers and other stakeholders had better give prior attention to empowering women, enhancing household wealth status, and media exposure to increase early sexual in the region.

Characterization of adolescent sexual practices

OBJECTIVE

to characterize adolescents' sexual practices and their association with sociodemographic variables, sources of information and behavioral habits.

METHOD

a descriptive, observational, cross-sectional study conducted with 85 adolescents from public elementary and high schools in a city in the state of São Paulo. Data were collected through a structured, self-administered and anonymous questionnaire. Statistical analysis was performed using the χ2 test and Fisher's test.

RESULTS

21.2% had started their sexual life through oral sex, with a predominance of females (94.4%), self-reported brown color (55.0%). The practice of vaginal sex was reported in 31.8%, with a mean age of initiation at 14.5 years. The female sex was predominant (77.0%), with a self-reported brown color (40.0%). The practice of anal sex was detected in 7.1%, with a mean age of 14.4 years, prevalent in females (83.3%), with a self-reported black color (50.0%). There was an association of alcohol, drugs and tobacco use with sexual practices (p<0.05).

CONCLUSION

a diversity of sexual practices associated with substance use was detected, emphasizing the importance of the nurse's role in planning and carrying out health education interventions with adolescents and families.

(1) Analysis of the sequence and time of initiation of sexual practices, demonstrating the diversity of sexual activities performed by adolescents. (2) Family context and low openness to dialogue and its correlation with the initiation of adolescent sexual practices. (3) Behavioral habits: association of alcohol, tobacco and drug consumption by adolescents with sexual activities.

Characterization of adolescent sexual practices

OBJECTIVE

to characterize adolescents' sexual practices and their association with sociodemographic variables, sources of information and behavioral habits.

METHOD

a descriptive, observational, cross-sectional study conducted with 85 adolescents from public elementary and high schools in a city in the state of São Paulo. Data were collected through a structured, self-administered and anonymous questionnaire. Statistical analysis was performed using the χ2 test and Fisher's test.

RESULTS

21.2% had started their sexual life through oral sex, with a predominance of females (94.4%), self-reported brown color (55.0%). The practice of vaginal sex was reported in 31.8%, with a mean age of initiation at 14.5 years. The female sex was predominant (77.0%), with a self-reported brown color (40.0%). The practice of anal sex was detected in 7.1%, with a mean age of 14.4 years, prevalent in females (83.3%), with a self-reported black color (50.0%). There was an association of alcohol, drugs and tobacco use with sexual practices (p<0.05).

CONCLUSION

a diversity of sexual practices associated with substance use was detected, emphasizing the importance of the nurse's role in planning and carrying out health education interventions with adolescents and families.

(1) Analysis of the sequence and time of initiation of sexual practices, demonstrating the diversity of sexual activities performed by adolescents. (2) Family context and low openness to dialogue and its correlation with the initiation of adolescent sexual practices. (3) Behavioral habits: association of alcohol, tobacco and drug consumption by adolescents with sexual activities.

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.