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Kyei-Arthur F, Agyekum MW, Kyei-Gyamfi S. "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. Reprod Health 2024; 21:38. [PMID: 38521936 PMCID: PMC10960462 DOI: 10.1186/s12978-024-01775-4] [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: 08/30/2023] [Accepted: 03/16/2024] [Indexed: 03/25/2024] Open
Abstract
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.
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Affiliation(s)
- Frank Kyei-Arthur
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana.
| | - Martin Wiredu Agyekum
- Institute for Educational Research and Innovation Studies, University of Education, Winneba, Ghana
| | - Sylvester Kyei-Gyamfi
- Department of Children, Ministry of Gender, Children and Social Protection, Accra, Ghana
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Therriault D, Lemelin JP, Toupin J, Martin-Storey A, Déry M. Associations between externalizing behavior problems and risky sexual behaviors in adolescence: Attachment as a mediator. J Adolesc 2024; 96:394-410. [PMID: 38167998 DOI: 10.1002/jad.12285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/26/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Risky sexual behaviors in adolescence are associated with negative health and psychological functioning outcomes. Although the association between behavior problems and risky sexual behaviors is well established, addressing these problems requires understanding the mechanisms that help explain this association. Adolescent attachment, while related to risky sexual behavior, has not been extensively explored as an outcome of childhood externalizing problems. The two objectives of this study were to explore the links between parental and peer attachment and risky sexual behaviors and to examine the mediating effect of attachment on the links between behavior problems and risky sexual behaviors. METHODS Five hundred and ninety-eight French-Canadian adolescents (46.2% girls), Mage at T1 = 13.23; Mage at T2 = 14.28; Mage at T3 = 17.35) participated in this longitudinal study. RESULTS The quality of parental attachment at T2 was significantly and negatively associated with risky sexual behaviors 3 years later, at T3. More specifically, a lower quality parental attachment relationship was associated with having nonexclusive partners as well as with inconsistent condom use. Finally, parental attachment (T2) was a significant mediator between behavior problems (T1) and risky sexual behaviors (T3), but only for younger adolescents. CONCLUSIONS Findings suggest that in addition to behavior problems in adolescence, the quality of parental attachment relationships may help in understanding risky sexual behaviors in adolescence.
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Affiliation(s)
- Danyka Therriault
- Group for Research and Intervention on Children's Social Adjustment (GRISE), Department of Psychoeducation, Université de Sherbrooke, Sherbrooke, Canada
| | - Jean-Pascal Lemelin
- Group for Research and Intervention on Children's Social Adjustment (GRISE), Department of Psychoeducation, Université de Sherbrooke, Sherbrooke, Canada
| | - Jean Toupin
- Group for Research and Intervention on Children's Social Adjustment (GRISE), Department of Psychoeducation, Université de Sherbrooke, Sherbrooke, Canada
| | - Alexa Martin-Storey
- Group for Research and Intervention on Children's Social Adjustment (GRISE), Department of Psychoeducation, Université de Sherbrooke, Sherbrooke, Canada
| | - Michèle Déry
- Group for Research and Intervention on Children's Social Adjustment (GRISE), Department of Psychoeducation, Université de Sherbrooke, Sherbrooke, Canada
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Adebola OG, Ewemooje OS, Adebola FB. Predictors and differences in fertility level among Nigerian women of reproductive age: a function of subgroup social norms fertility behaviour. HUM FERTIL 2023; 26:1114-1128. [PMID: 36369930 DOI: 10.1080/14647273.2022.2137859] [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: 08/09/2021] [Accepted: 04/20/2022] [Indexed: 11/15/2022]
Abstract
Fertility rates in Nigeria are declining at such a modest rate, that if more proactive measures are not employed to reduce fertility, the nation may double its population before long. We empirically examined fertility behaviour as derivatives of specific subgroup social norms, and the variations in the factors responsible for different fertility behaviours, using the 2018 Nigeria Demographic and Health Survey. Descriptive bivariate, and multinomial logistic regression analyses were used to predict the contribution of demographic and sociocultural factors contributing to the fertility level, and findings were reported as odds ratios. Results revealed that age, religion and level of education are the most significant predictors of fertility level, with remarkable differences in birth rate across subgroups, whereas North-West Nigeria had the highest fertility level. Furthermore, marriage had a significantly negative effect on high fertility among North-Western women, whereas higher education significantly increased high fertility among North-Eastern women. In conclusion, subgroup social norms fertility behaviour is responsible for the persistent fertility differential outcome in Nigeria. Thus, the paper strongly advocates the need to intensify community-led, norm-based solution and not a universal approach in addressing fertility control in Nigeria.
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Affiliation(s)
| | - Olusegun Sunday Ewemooje
- Department of Statistics, Federal University of Technology, Akure, Nigeria
- Department of Statistics, University of Botswana, Gaborone, Botswana
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Simelane MS, Chemhaka GB, Shabalala FS, Simelane PT, Vilakati Z. Prevalence and determinants of inconsistent condom use among unmarried sexually active youth. a secondary analysis of the 2016-2017 Eswatini HIV incidence measurement survey. Afr Health Sci 2023; 23:400-409. [PMID: 37545960 PMCID: PMC10398441 DOI: 10.4314/ahs.v23i1.42] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
INTRODUCTION In sub-Saharan Africa, youth continue to have a high burden of sexually transmitted infections and unplanned pregnancies that could be reduced through improved condom use. We aimed to investigate inconsistent condom use with the three most recent sexual partners among unmarried sexually active youth in Eswatini. METHODS Data were analysed for 1,324 youth from the 2016-2017 Swaziland HIV incidence measurement survey (SHIMS2) using multivariable logistic regression method. RESULTS The prevalence of inconsistent condom use among youth was 56.8% in 2017. Higher odds of inconsistent condom use were observed among youth aged 20-24, residents in the Lubombo region, those aged less than 18 years at sexual debut and those who had two or more sexual partners in the last 12 months before the survey. Lower odds of inconsistent condom use were observed among males, and those that knew their partners reported HIV status to be negative. CONCLUSION Our findings highlight a notable prevalence of inconsistent condom use among youth in Eswatini. Programs that aim to reduce the incidence of HIV infections and STIs among youth in Eswatini should focus on these factors associated with inconsistent condom use.
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Affiliation(s)
- Maswati S Simelane
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Eswatini
| | - Garikayi B Chemhaka
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Eswatini
| | - Fortunate S Shabalala
- Department of Community Health Nursing Science, Faculty of Health Sciences, University of Eswatini, Mbabane, Eswatini
| | - Portia T Simelane
- Department of Human and Social Sciences, Townsville, Education Office, Queensland, Australia
| | - Zodwa Vilakati
- Department of Statistics and Demography, Faculty of Social Sciences, University of Eswatini, Kwaluseni, Eswatini
- Department of Population Studies, University of Zambia
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Roman Lay AA, Fujimori E, Simões Duarte L, Vilela Borges AL. Prevalence and correlates of early sexual initiation among Brazilian adolescents. PLoS One 2021; 16:e0260815. [PMID: 34905552 PMCID: PMC8670678 DOI: 10.1371/journal.pone.0260815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 11/17/2021] [Indexed: 11/18/2022] Open
Abstract
Background Early adolescence is a critical stage in adolescents. This is the phase at which many young people start their sexual life early, increasing the risk of sexually transmitted infections and unintended pregnancy. Few studies have analyzed the factors associated with early sexual initiation in very young adolescents in low- and middle-income countries. Therefore, this study assessed the early sexual initiation stratified by sex and its correlates in a sample of Brazilian adolescents. Methods The study sample included Brazilian adolescents aged 12–14 who participated in The Study of Cardiovascular Risk in Adolescents (ERICA), a multicenter, school-based, country-wide, cross-sectional study. Early sexual initiation was defined as the first sexual intercourse at or before 14 years old. Multivariate logistic regression was used to identify independent factors associated with early sexual initiation. Results The prevalence of early sexual initiation was 7% among girls and 18% in boys. In a multivariate analysis, the adolescent’s age, mother’s schooling, smoking, alcohol consumption, and Tanner Stages were associated with early sexual initiation for both boys and girls. For girls, living with both parents, common mental disorders, and age at menarche were predictors of early sexual initiation, while race and type of school were correlated to early sexual initiation only for boys. Conclusions The early sexual initiation was associated with sociodemographic, lifestyle risk factors and secondary sexual characteristics in both sexes, while there were differences between the predictors of early sexual initiation among girls and boys. It emphasizes the importance of sex education and promotes healthy lifestyles in environments through families and schools in early adolescence.
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Affiliation(s)
| | - Elizabeth Fujimori
- Public Health Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil
| | - Luciane Simões Duarte
- Public Health Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil
| | - Ana Luiza Vilela Borges
- Public Health Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil
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Exploring condom use decision-making among adolescents: the synergistic role of affective and rational processes. BMC Public Health 2021; 21:1894. [PMID: 34666719 PMCID: PMC8527692 DOI: 10.1186/s12889-021-11926-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Condom use remains the most effective behavioural method for the prevention of HIV and unplanned pregnancies. However, condom use remains inconsistent among young people. Exploring the condom use decision-making processes that adolescents engage in might provide information that would assist in the prevention of many challenges related to poor sexual and reproductive health outcomes. This study therefore aimed to explore the factors that influenced decision-making about sexual debut and condom use of adolescents from two schools in the Western Cape, South Africa. METHODS A sample of 16 adolescents were selected using purposive sampling. Data were collected using semi-structured, individual interviews. Thematic analysis was used to analyse the data generated. RESULTS The link between sexual debut and affective processes was frequently discussed in condom use decision-making. Decisions about sexual debut were influenced by the belief that sex was a perceived symbol of 'true love' on the one hand, and respect for perceived parental expectations of age-appropriate sex, on the other. Condom use decision-making was shaped by adolescents' concerns about their future and lack of stability in their lives. Adolescents' fears of pregnancy, parenthood and disease shaped their condom use decision-making. It became evident that rational and affective decision-making in condom use choice were not mutually exclusive, but that these processes happened simultaneously. CONCLUSIONS The study highlighted the role of affective states as part of the process of examining alternatives when deciding to use a condom or not. Interventions to strengthen condom use decision-making should therefore incorporate not only rational but also affective processes to improve adolescent sexual and reproductive outcomes.
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How old are young people when they start having sex? Unravelling the applicability of Cox proportional hazards regression. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01619-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Rouche M, Castetbon K, Dujeu M, Méroc E, Lebacq T, Pedroni C, Senterre C, Godin I, Moreau N. Feelings about the timing of first sexual intercourse and health-related quality of life among adolescents. BMC Public Health 2019; 19:408. [PMID: 30987628 PMCID: PMC6466645 DOI: 10.1186/s12889-019-6728-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 03/31/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early sexual intercourse (SI) may have long-lasting negative impacts on health-related quality of life (HRQoL). So far, these impacts have been studied using age for defining early SI instead of feelings about its timing. The present study examined the association between feelings about the timing of first SI and current HRQoL. METHODS Data came from the 2014 cross-sectional Health Behaviour in School-aged Children (HBSC) study in French-speaking Belgium. Among participants aged 16-20 years who already had SI, 1778 were included in analyses. Univariate and multivariate logistic regressions were performed, including potential confounders. RESULTS One quarter of adolescents (26.4%) had poor HRQoL, 19.8% expressed a negative feeling about the timing of first SI and 19.6% did not think about it. Compared with adolescents who thought first SI happened at the right time or wished it had happened sooner, adolescents who had a negative feeling about the timing and those who did not think about it were more likely to have a poor HRQoL (cOR = 1.67 (1.28-2.17) and cOR = 1.37 (1.05-1.80), respectively). After adjustment, associations were no more significant (aOR = 1.22 (0.91-1.63) and aOR = 1.22 (0.91-1.64)). Sex disparity in expressing a negative feeling mostly explained the difference between crude and adjusted analyses. CONCLUSION Further research is needed to better understand such a complex relationship. The high proportion of adolescents having poor HRQoL and negative feeling about the timing of first SI shows how important it is to find out effective prevention for both domains.
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Affiliation(s)
- Manon Rouche
- Service d'Information Promotion Education Santé (SIPES), School of Public Health, Université libre de Bruxelles (ULB), CP598, Route de Lennik 808, B-1070, Brussels, Belgium.
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium.
| | - Katia Castetbon
- Service d'Information Promotion Education Santé (SIPES), School of Public Health, Université libre de Bruxelles (ULB), CP598, Route de Lennik 808, B-1070, Brussels, Belgium
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Maud Dujeu
- Service d'Information Promotion Education Santé (SIPES), School of Public Health, Université libre de Bruxelles (ULB), CP598, Route de Lennik 808, B-1070, Brussels, Belgium
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
- Research Centre in Social Approaches to Health, School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Estelle Méroc
- Service d'Information Promotion Education Santé (SIPES), School of Public Health, Université libre de Bruxelles (ULB), CP598, Route de Lennik 808, B-1070, Brussels, Belgium
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Thérésa Lebacq
- Service d'Information Promotion Education Santé (SIPES), School of Public Health, Université libre de Bruxelles (ULB), CP598, Route de Lennik 808, B-1070, Brussels, Belgium
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Camille Pedroni
- Service d'Information Promotion Education Santé (SIPES), School of Public Health, Université libre de Bruxelles (ULB), CP598, Route de Lennik 808, B-1070, Brussels, Belgium
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Christelle Senterre
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Isabelle Godin
- Research Centre in Social Approaches to Health, School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Nathalie Moreau
- Service d'Information Promotion Education Santé (SIPES), School of Public Health, Université libre de Bruxelles (ULB), CP598, Route de Lennik 808, B-1070, Brussels, Belgium
- Research Centre in Epidemiology, Biostatistics and Clinical Research, School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
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The Use of Sexually Explicit Material and Its Relationship to Adolescent Sexual Activity. J Adolesc Health 2018; 62:563-569. [PMID: 29503032 DOI: 10.1016/j.jadohealth.2017.11.305] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/27/2017] [Accepted: 11/28/2017] [Indexed: 11/23/2022]
Abstract
PURPOSE There is growing concern that sexually explicit material (SEM) may influence young people's sexual activity. The present study aimed to assess the longitudinal association between frequency of SEM use and adolescent sexual debut. METHOD The present study used two independent panel samples of Croatian adolescents (with four and five data collection waves, respectively). We employed discrete-time event history approach and propensity matching score analysis to explore the target association. RESULTS A consistent lack of significant association between SEM use and sexual debut was observed among male adolescents. Among female adolescents, the findings were inconclusive. We also found some evidence for the role of timing of first exposure to SEM. CONCLUSIONS Our findings are relevant for educational and adolescent health specialists, as well as concerned parents. Considering that this study focused on middle adolescence, future research should address a potential link between SEM use and early sexual debut.
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