Age at first sex in rural South Africa

Abstract

Objectives: To identify factors associated with sexual debut and early age at first sex (AFS) among young men and women (12-25 years) in a population with a high prevalence and incidence of HIV in rural South Africa. Methods: Longitudinal data from four rounds (2003-7) of a prospective population-based HIV and sexual behaviour survey in rural KwaZulu-Natal were used to investigate the distribution and predictors of earlier first sex. Survival analyses were used, and each analysis considered men and women separately. Results: Among the 4724 women and 4029 men who were virgins at the beginning of the period, the median AFS was 18.5 and 19.2 years, respectively. In multivariable models, factors associated with earlier AFS across gender were periurban residence (vs rural), ever use of alcohol and knowing at least one person who had HIV, while school attendance had a significant protective effect. Other factors were important for one gender only. Maternal death was significantly associated with earlier AFS for women, in the same way that paternal death was for young men, while mother's membership of the same household significantly delayed AFS of young men. The analysis of early first sex confirmed the same factors to be important as in the overall analyses for men and women. Conclusion: Given the association of individual, household and community level factors with sexual debut, a multisectorial approach to prevention and targeting in youth programmes is recommended.

The Effect of Socio-Demographic Factors on Risky-Sexual Behaviours of Adolescents in the North West Province of South Africa

“…families with both biological parents) reported later median age of first intercourse than youth living in any other family situation, including stepfamilies with two parents in the home. In a South African study, McGrath et al (2009) found that the hazard of first sex was statistically significantly higher for women and men whose mother or father had died, while on the other hand they found that the hazard of first sex was statistically significantly lower for women whose mother or father was a co-member of the same household.…”

HIV risk perception and consistency in condom use among adolescents and young adults in urban Cape Town, South Africa: a cumulative risk analysis

“…7 Sexual risky behaviours of unprotected sexual activity may increase the risk of unwanted pregnancy, HIV infection and other sexually transmitted infections (STIs) among young people. [8][9][10][11] The impact of HIV and AIDS, and underage pregnancy on aspects of population in a country are profound. People living with HIV and AIDS are more susceptible to developing opportunistic infections, increasing mortality rates among those affected, and reducing life expectancy.…”

The Relationship Between Alcohol Consumption and Human Immunodeficiency Virus Infection and Risk Behaviour: A Systematic Literature Review of High-Risk Groups, with a Focus on South Africa

“…A Chinese study (Xiao et al, 2010), showed that using alcohol diminished the likelihood of participants using condoms. In a South African study by McGrath et al, 2009, it was observed that for men, age at first sex was associated with having ever used alcohol (OR 1.89, CI 1.55-2.30, p<0.001). …”

“…This sample does not report the highest condom use . In a large sample of 4,724 young women and 4029 young men (12-25 years), having ever used alcohol was significantly associated with a lower age of first sex for both men and women (McGrath et al, 2009). In a study on 661 grade 9 students, alcohol and HIV prevention education affected HIV-related risk factors (Karnell et al, 2006).…”