Forced Sexual Initiation and Early Sexual Debut and Associated Risk Factors and Health Problems Among Adolescent Girls and Young Women — Violence Against Children and Youth Surveys, Nine PEPFAR Countries, 2007–2018

Howard, Ashleigh; Pals, Sherri; Walker, Brianna; Benevides, Regina; Massetti, Greta M.; Oluoch, Rose Patricia; Ogbanufe, Obinna; Marcelin, Louis Herns; Cela, Toni; Mapoma, Chabila C; Gonese, Elizabeth; Msungama, Wezi; Magesa, Daniel; Kayange, Alick; Galloway, Katelyn; Apondi, Rose; Wasula, Lydia; Mugurungi, Owen; Ncube, Getrude; Sikanyiti, Iven; Hamela, Justin; Kihwele, Gerald V; Nzuza-Motsa, Nozipho; Saul, Janet; Patel, Pragna

doi:10.15585/mmwr.mm7047a2

Cited by 16 publications

(14 citation statements)

References 6 publications

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“…Besides, early sexual debuts are common in African settings, ranging from 26.8% in Nigeria [27] to 55% in Ghana [28]. Despite studies on the prevalence and associated factors of early sexual initiation have been undertaken in various east African countries [1,2,29,30], there is limited evidence on the region's pooled prevalence and associated factors of early sexual beginning. Although various studies on early sexual initiation have been conducted, the majority of them have failed to take into account community-level factors that may influence the possibility of early sexual initiation.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and associated factors of early sexual initiation among female youth in East Africa: further analysis of recent demographic and health survey

et al. 2022

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Background Early sexual initiation is one of the risky sexual practices. Early sexual beginning is associated with an increased risk of HIV/AIDS, sexually transmitted infections (STIs), unexpected pregnancies, unsafe abortion, premature deliveries, and psychosocial issues. However, there is still a lack of evidence, particularly in East Africa, where community-level factors are not investigated. Therefore, this study aimed to estimate the pooled prevalence and to identify associated factors of early sexual initiation among female youth in Eastern Africa. Methods A total weighted sample of 49,716 female youth was included in this analysis. STATA version 14 software was used for data extraction, recoding, and analysis. A multilevel binary logistic regression model was fitted to identify determinants of early sexual initiation in the region. Finally, Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was reported to declare the factors that are significantly associated with early sexual initiation. Result The prevalence of early sexual initiation in East Africa was 21.14% [95% CI: 20.00%, 21.50%]. In the multivariable multilevel analysis; being age 20–24 years [AOR = 0.65: 95% CI; 0.61, 0.69], primary [AOR = 0.73: 95% CI; 0.67, 0.78], secondary &above education [AOR = 0.30: 95% CI; 0.27,0.33], married [AOR = 1.85: 95% CI; 1.73,1.97], middle wealth [AOR = 0.78: 95% CI; 0.72,0.84], richest [AOR = 0.74: 95% CI; 0.68,0.80], and reading newspaper [AOR 0.77: 95% CI;0.71,0.83] were significantly associated with early sexual initiation. Conclusion The study revealed that early sexual initiation among female youth was high in East Africa. Educational status, respondent age, marital status, wealth index, age at first cohabitation, contraceptive use, reading newspaper, and place of residence were associated with early sexual initiation. Therefore, the survey findings will help policymakers, as well as governmental and non-governmental organizations, design the most effective interventions. Moreover, strengthening information, education, and wealth status are important intervention areas to delay the age of early sexual debut.

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Section: Introductionmentioning

confidence: 99%

Prevalence and associated factors of early sexual initiation among female youth in East Africa: further analysis of recent demographic and health survey

et al. 2022

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“…However, contrary to other studies this study did not demonstrate any link between adolescent gender and suicidal behavior this could be accounted for since adolescents in this study were in the formative stages of their secondary school education, they are, arguably, a homogeneous group and the unique gender differences and challenges that they are likely to face throughout secondary school were yet to emerge. Adolescent sexual activity - especially early sexual debut or initiation - is another factor that previous studies have associated with suicidal ideation and behavior [ 20 ], as well as a moderate to high risk of suicidal behavior in Kenya [ 21 ]. Sexual activity was not shown as statistically significantly associated with the risk of suicidal behavior in this study.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the risk of suicidal behavior among adolescents transitioning to secondary school in Nairobi County, Kenya: a cross-sectional study

Mokaya¹,

Kikuvi²,

Khasakhala³

et al. 2022

Pan Afr Med J

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Introduction adolescence is a transitory stage in the lives of young people. The transition from primary to secondary school among adolescents is associated with suicidal behavior but is not well characterized in the Kenyan context. This study sought to elucidate factors associated with the risk of suicidal behavior among adolescents aged 11-18 years in transition to secondary school. Methods a cross-sectional design was employed in the study that was conducted among adolescents in 5 randomly selected secondary schools in Nairobi County. The study involved 539 students who had joined form 1 in January 2020. Data were collected using the suicide behavior questionnaire-revised (SBQ-R) in March 2020. Factors associated with suicidal behavior were assessed using a generalized linear model (GLM), using a poisson distribution with a log-link function to estimate adjusted prevalence ratios (aPR), and a significance level of p=.05. Results one-fifth (20.04%) of adolescents with a median age of 14 years were at risk of suicidal behavior. Depression (aPR=3.16, C.I {1.85, 5.41}, p=0.001) and lifetime alcohol use (aPR=1.87, C.I {1.17, 2.97}, p=0.009) were found to be significant factors for suicidal behavior. Conclusion depression and lifetime alcohol use are associated with the risk of suicidal behavior among adolescents transitioning from primary to secondary school. Interventions may need to be targeted at the pre-secondary or primary school level to prevent underage alcohol use and enhancement of social support to prevent depression in this demographic of the population.

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“…Other studies had a wider geographic scope, but they analyzed only few risk factors (7). More recent studies analyzed changes of some HIV risk factors and behaviors over time (8)(9)(10). These studies often used descriptive statistics and regression analyses.…”

Section: Introductionmentioning

confidence: 99%

Changes of sociobehavioural characteristics and HIV in 29 Sub-Saharan African countries, 2000-2018

Post

Ng’ambi²,

Keiser

et al. 2023

Preprint

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Introduction: HIV epidemics and associated sociobehavioural characteristics vary widely across Sub-Saharan African (SSA) countries. In this study, we investigated how national changes on sociobehavioural characteristics may be associated with trajectories in HIV epidemics. Methods: We analyzed aggregated data from 80 DHS surveys of 29 SSA countries between 2000 and 2018. We described each national survey by 46 pre-selected demographic, socio-economic, behavioural and HIV-related variables. Using Principal Component Analysis, we reduced the dimensionality of surveys and visualized them on a 2-dimensional space. We used consensus clustering to identify groups of countries with similar sociobehavioural characteristics over time, and identified the main drivers of change. We used k-means clustering with dynamic time warping to group countries based on the evolution of their national HIV effective contact rates since 1990 (computed based on UNAIDS estimates of yearly HIV incidence and prevalence). Results: We identified three groups of countries with similar sociobehavioural and HIV-related characteristics that persisted from 2000 to 2018. While countries within groups remained similar since 2000, differences between the groups increased over time. The most important characteristics that explained the change in the sociobehavioural space since 2000 were: ART coverage, HIV testing, increase in accepting attitudes towards People Living with HIV/AIDS and increasing knowledge about AIDS. We also identified two groups of countries with characteristic evolutions of HIV effective contact rates since 1990. The first group of countries was characterized by a rapid decrease of effective contact rate since the early 1990. The second group experienced a slow decrease of the effective contact rate in the early 1990, followed by a faster decrease after 1995. While the three clusters based on sociobehavioural characteristics were associated with different peak levels of HIV incidence, the two clusters based on the progression of the effective contact rate were associated with the timing when peak HIV incidence levels were reached. Conclusions: Our findings suggest that the initial conditions of nascent epidemics, likely determined by sociobehavioural characteristics, are crucial in determining the long-term progression of HIV epidemics. Our methods can help to predict the effects of behavioural change on the HIV epidemic and design targeted interventions to reach epidemic control.

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Forced Sexual Initiation and Early Sexual Debut and Associated Risk Factors and Health Problems Among Adolescent Girls and Young Women — Violence Against Children and Youth Surveys, Nine PEPFAR Countries, 2007–2018

Cited by 16 publications

References 6 publications

Prevalence and associated factors of early sexual initiation among female youth in East Africa: further analysis of recent demographic and health survey

Prevalence and associated factors of early sexual initiation among female youth in East Africa: further analysis of recent demographic and health survey

Factors associated with the risk of suicidal behavior among adolescents transitioning to secondary school in Nairobi County, Kenya: a cross-sectional study

Changes of sociobehavioural characteristics and HIV in 29 Sub-Saharan African countries, 2000-2018

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