Regional and Sex Differences in the Prevalence and Correlates of Early Sexual Initiation Among Adolescents Aged 12–15 Years in 50 Countries

Kushal, Sayedul Ashraf; Amin, Yahia Md; Reza, Shusama; Hossain, Faruque M.; Shawon, Md Shajedur Rahman

doi:10.1016/j.jadohealth.2021.10.027

Cited by 32 publications

(31 citation statements)

References 34 publications

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“…Furthermore, pornography use by adolescents results in unprotected penetrative and oral sex, a high frequency of casual sex, and an earlier onset of sexual activity [74]. The current study also highlighted that male participants were more likely to experience penetrative sexual experiences, which is consistent with findings from Reis et al [75], Kushal et al [76], and Roman et al [61]. This may be due to masculinity norms encouraging boys to early sexual initiation [75].…”

Section: Discussionsupporting

confidence: 90%

Sexual experiences among early adolescents aged 12-14 Years in four districts of Rwanda: a cross-sectional study

Mbarushimana,

Goldstein,

Conco

2024

Preprint

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Background Globally, early adolescents (10-14 years) represent 8% of the world population, and Africa accounts for 25% of them. Although a minority of early adolescents have initiated sexual intercourse, their sexual curiosity results in the exploration and understanding of sexuality. Early sexual intercourse may lead to sexually transmitted infections, HIV/AIDS, early pregnancy or fatherhood, and early marriage. Early sexual activity is associated with high rates of unplanned pregnancy, multiple sexual partners, and other forms of risky sexual behaviours. Understanding sexual activity among early adolescents can contribute to designing interventions that adequately address their needs. However, there is limited information about early adolescents' sexual activity and the social-ecological factors associated with their sexual experiences. This study aimed to determine the prevalence of sexual activity and the social-ecological factors associated with sexual experiences among early adolescents (12-14 years) in Rwanda. Methods We conducted a cross-sectional study among early adolescents (12-14 years) from four districts and 16 secondary schools between November and December 2020. A multistage sampling technique was used to select 56 participants from each school, including 28 males and females from grades one and two, who were randomly selected. We used an adapted version of the Illustrative Questionnaire for Interview - Surveys with Young People. Questions focused on nonpenetrative and penetrative sexual experiences in addition to sociodemographic and other social-ecological characteristics. Ethical clearance was obtained from the University of Rwanda and the University of the Witwatersrand, Johannesburg. Written parental or legal guardian consent and participants' assent were obtained. We conducted the data analysis in Stata 14.2 and used descriptive statistics (frequencies and proportions), bivariate and multivariate logistic regression analyses with 95% confidence intervals (CIs) and a significance level of p-value <0.05. Results The study included 811 participants, 55.1% of whom were aged 14, 30.5% were aged 13, and 14.4% were aged 12. Most participants (n=539, 73.5%) lived with both parents, and 48.8% (n=395) described the socioeconomic status of their households as well-off. Nearly 81% (n=658) of the participants indicated that they had experienced non-penetrative sex, and 53 of 759 participants (7%) reported that they had experienced penetrative sex. The social-ecological factors significantly associated with nonpenetrative sexual experiences were attending parties (AOR=6.8, 95% CI= 1.6-29.2), internet use (AOR=1.9, 95% CI= 1.1-3.3) (individual level), and their fathers’ low education (primary: AOR=2.6, 95% CI= 1.4-5.0; secondary: AOR=1.9, 95%CI: 1.0-3.8) (family level). Individual level factors such as male sex (AOR: 4.6, 95% CI= 1.8-12.4), alcohol consumption (AOR=3.5, 95% CI= 1.4-8.8), watching pornography (3-4 times: AOR=7.5, 95% CI= 1.6-34.9, ≥ five times: AOR= 5.1, 95% CI= 1.7-15.0), being a double orphan (AOR:17.8, 95% CI= 1.9-170.2), discussing sex matters often with one’s father (AOR=6.5, 95% CI= 1.8-23.2) (family and relationship level), and forced sexual intercourse (AOR=8.2, 95% CI= 2.7-25.4) (community level) were social-ecological factors associated with penetrative sexual experience. Conclusion Nonpenetrative sexual experience was common, with few participants reporting penetrative sexual experience. The social-ecological factors associated with sexual experiences among early adolescents are modifiable and can assist in planning healthy sexual interventions for this age group.

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Section: Discussionsupporting

confidence: 90%

Sexual experiences among early adolescents aged 12-14 Years in four districts of Rwanda: a cross-sectional study

Mbarushimana,

Goldstein,

Conco

2024

Preprint

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“…Most heterogeneity was partially explained by variations from sex, with female participants having higher pooled prevalence in four of the seven outcomes, compared to their male counterparts. Differences in the way emerging female adults are socialized in the African context may have impacted on their increased SRTB [39, 41]. In addition, low socio-economic status, along with cultural practices like child marriage and coercion of young girls into early sexual activities with adults are common and may have led to increased SRTB among emerging female adults [39].…”

Section: Discussionmentioning

confidence: 99%

Sexual risk-taking behavior amongst emerging adults in Africa: a systematic review and meta-analysis

Chea

Kagonya

Abdullahi

et al. 2022

Preprint

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BackgroundIncidence of HIV and other sexually transmitted infections (STIs) among emerging adults (EmA) is high in some African settings. Estimates on sexual risk-taking behavior (SRTB) among EmA is varied in literature, which presents a challenge when designing targeted interventions. We aimed to review and summarize literature on prevalence and risk factors of SRTB among EmA in Africa.MethodsA search for studies published in PubMed, Embase and Psych Info involving EmA (18 – 25 years), conducted in Africa and reporting one or more SRTB was done. Pooled prevalence estimates were summarized using forest plots. Heterogeneity in SRTB was explored by sex, geographic region, year of publication and outcome definition. Risk factors were synthesized using a modified socio-ecological model.ResultsOverall, 117 studies were analyzed. Non-condom use had the highest pooled prevalence (46.0% [95% CI: 14.0-51.0]), followed by study-defined SRTB (37.0% [95% CI: 23.0 -51.0]), concurrency (35.0% [95% CI: 19.0-53.0]), multiple sex partnerships (30.0% [95% CI: 24.0-37.0]), younger age at sexual debut (25.0% [95% CI: 19.0-31.0]), age disparate relationships (24.0% [95% CI: 17.0-32.0]) and transactional sex (17.0% [95% CI: 11.0-24.0]). In four of the seven outcomes, heterogeneity was partially explained by sex, with female participants having higher pooled prevalence estimates compared to their male counterparts. In four of the seven outcomes, alcohol/drug use was the most common risk factor.ConclusionsSRTB was common among EmA and differentially higher in emerging female adults. Non-condom use had the highest pooled prevalence, which may contribute to the propagation of HIV and other STIs in this population. Interventions targeting emerging female adults and alcohol/drug use may reduce SRTB, which may in-turn mitigate propagation of HIV and other STIs among EmA in Africa.

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“… 6 , 7 This discrepancy in prevalence can be explained by complex interactions between social context, religion, education status, gender norms and even diverse methodological approaches. 2 , 14 Different understandings of what “sexual intercourse” means may result in the frequencies found underestimated or overestimated, and may even influence an adolescent’s understanding of whether or not oral sex is included in its definition. 2 In addition, cultural patterns common in many regions explain the difference between the sexes, encouraging males to engage in sexual activities and punishing females for engaging in them.…”

Section: Discussionmentioning

confidence: 99%

“… 2 In addition, cultural patterns common in many regions explain the difference between the sexes, encouraging males to engage in sexual activities and punishing females for engaging in them. 14 , 15 …”

Section: Discussionmentioning

confidence: 99%

“…Adolescents with various types of psychosocial disorders may be more likely to engage in sexual activities to relieve emotional distress. 14 It is common for males to be more likely to perpetrate bullying than females and that behind young perpetrators of bullying there is a context of other risk factors that lead them to play the role of the bully, especially physical and sexual abuse in childhood, considered to be the most consistent indicators underlying the perpetuation of violence by youths. 24 As such, efforts to reduce bullying must also address sexual harassment and social links with adults, whereby parents and teachers can be protective factors directly.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of sexual initiation and associated factors in school adolescents in Piauí, Brazil, 2015

Castro

Viana

Rufino

et al. 2023

Epidemiol. Serv. Saúde

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Objetivo: analisar prevalência e fatores associados à iniciação sexual de adolescentes do Piauí. Métodos: estudo transversal, com dados da Pesquisa Nacional de Saúde do Escolar, 2015. Realizou-se análise hierarquizada por regressão de Poisson. Resultados: foram entrevistados 3.872 adolescentes. A prevalência de iniciação sexual foi de 24,2%; sexo masculino [razão de prevalência (RP) = 2,11; intervalo de confiança de 95% (IC95%) 1,77;2,35], idade > 15 anos (RP= 2,70; IC95% 2,21;3,01), morar com a mãe (RP = 0,69; IC95% 0,54;0,80), trabalhar (RP = 1,88; IC95% 1,61;2,12), estudar em escola pública (RP = 1,33; IC95% 1,10;1,79), praticar bullying (RP = 1,51; IC95% 1,32;1,70), usar álcool (RP = 2,39; IC95% 2,11;2,67), cigarro (RP = 1,44; IC95% 1,20;1,66) e drogas ilícitas (RP = 1,41; IC95% 1,11;1,68) foram fatores de risco para o evento. Conclusão: a prevalência de iniciação sexual foi alta e associada a características sociodemográficas e comportamentos vulneráveis à saúde, demandando estratégias de promoção de saúde.

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Regional and Sex Differences in the Prevalence and Correlates of Early Sexual Initiation Among Adolescents Aged 12–15 Years in 50 Countries

Cited by 32 publications

References 34 publications

Sexual experiences among early adolescents aged 12-14 Years in four districts of Rwanda: a cross-sectional study

Sexual experiences among early adolescents aged 12-14 Years in four districts of Rwanda: a cross-sectional study

Sexual risk-taking behavior amongst emerging adults in Africa: a systematic review and meta-analysis

Prevalence of sexual initiation and associated factors in school adolescents in Piauí, Brazil, 2015

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