Changes in sexual behaviour and practice and HIV prevalence indicators among young people aged 15–24 years in Zambia: An in-depth analysis of the 2001–2002 and 2007 Zambia Demographic and Health Surveys

Abstract

HIV and AIDS still pose a major public health problem to most countries in sub-Saharan Africa, Zambia included. The objective of the paper is to determine changes in selected sexual behaviour and practice and HIV prevalence indicators between 2001–2002 and 2007. We used the Demographic and Health Survey Indicators Database for the computation of the selected indicators. We further used STATA 10.0 to compute significance tests to test for statistical difference in the indicators. The results indicate some changes in sexual behaviour, as indicated by an increase in abstinence, use of condoms and the decrease in multiple partnerships. The overall percentage of abstinence among never-married young men and women aged 15–24 years in Zambia increased significantly by 15.2% (p = .000) and 5.9% (p = .001) respectively, between 2001–2002 and 2007. A statistically significant increase of 6.6% (p = .029) was observed in the percentage of young women who reported having used a condom during the last time they had had premarital sex. A statistically significant decrease of 11.0% (p = .000) and 1.4% (p = .000) was observed among young men and women, respectively, who reported having multiple partners in the preceding 12 months. The factorial decomposition using multivariate analysis reveals that the indicators which contributed to the statistically significant 2.6% decline in HIV prevalence among young women aged 15–24 years in Zambia include proportion reporting condom use during premarital sex (+6.6%), abstinence (+5.9%), sex before age 15 (– 4.5%), premarital sex (– 2.6%), sex before age 18 (– 2.4%) and proportion reporting multiple partnerships (– 1.4%). Remarkable strides have been achieved towards promoting responsible sexual behaviour and practice among young people in Zambia. Further research focusing on factors that predispose young women in Zambia to higher risk of infection from HIV is required. The results from this paper should be useful in the design of programmes to control the spread of HIV and AIDS, particularly among young people in Zambia and other sub-Saharan countries.

Sexual Abstinence and Associated Factors Among Young and Middle-Aged Men: A Systematic Review

“…The studies for adolescents and young men were more focused on the prevention of STIs and unwanted pregnancies in specific populations and circumstances, 16,17,29,30,32 and the results were more dependent on the characteristics of the participants in each study. Therefore, the factors identified are not generalizable to the wider population of young men.…”

“…Primary sexual abstinence in young men 11e14,16e20, 22,29e33,39e42 and middle-aged men ranged from 3.4% to 83.3% and 5.5%e32.8%, respectively. 11,39 Furthermore, the age categorization given in the selected studies showed that the prevalence for 10-to 19-year-old men was the highest (27.7%e 83.3%), 12,13,16,18,22,30,33,39 followed by 15-to 24-year-old men (3.4%e59.7%) 13,14,16,17,19,31,32,39,41 and 25-to 45-year-old men (5.5%e32.8%) 11,39 (Table 1). Table 1 shows that the overall prevalence of secondary abstinence reported in 22 studies ranged between 0% and 83.6% in men younger than 60 years ( Table 1).…”

“…39 A further study reported that young men living in urban areas had significantly lower odds of primary abstinence than those living in rural areas. 32 It was also reported that living in densely populated areas and in a neighborhood with the social disorder (fight by using weapons) had a significantly negative relationship with primary sexual abstinence in men. 39…”

“…Furthermore, age categorization in the selected studies showed that the prevalence of secondary sexual abstinence for 10-to 19year-old men ranged from 1.3% to 83.6%, 4,7,9,13,16,29 while for 15-to 24-year-old men, it ranged from 10.2% to 50.3%. 8,13,16,23,31,32,34,40,43 Based on the age categories given in the selected studies, the prevalence of secondary sexual abstinence was 0%e50.3% for men from 18 to 30 years old, 9,15,40,43,44…”

“…The range of the proportions of secondary sexual abstinence widened with increased duration of sexual abstinence, being lowest for 1 month (4.6%e 50.3%), 27,38,40,43 followed by 6e8 months (7.1%e 60.1%) 35,36,44 and 1 year (0%e83.6%). 4,7,10,13,16,23,28,31,32,34,37 Factors in Sexual Abstinence…”