The Occurrence of Sexual Risk Behaviors and Its Association With Psychological Well-Being Among Kenyan Adolescents

Abstract

Objective: Sexual risk behavior during adolescence is an important public health problem. Self-esteem and hopefulness are potentially important psychological factors that may play a role in the behavioral regulation mechanisms of adolescents. These factors are inadequately explored in sub-Saharan Africa. This study aimed at exploring patterns and associated factors for sexual risk behavior (SRB), self-esteem, and hopefulness among adolescents from a resource-poor setting in Kenya.Method: A cross-sectional study conducted in 2019 among 296 adolescents (12–17 years old) from rural Kilifi (n = 133) and urban informal settings of Nairobi (n = 163) in Kenya. Participants completed the Kilifi Health Risk Behavior Questionnaire, Rosenberg self-esteem questionnaire, and Hope scale administered via computerized tablets. A binary outcome variable based on the experience of adolescents of at least one of the five forms of SRB: transactional sex, sexual violence, intergenerational sex, early sexual debut, and condom non-use was generated. Bi-variate analysis was conducted to summarize various social-demographic and psychosocial factors. A multivariable logistic regression model was fitted to investigate factors associated with the occurrence of SRB, self-esteem, and hopefulness among adolescents.Results: About 13% of the participants had experienced a form of SRB, and among these, 36% reported co-occurrence of multiple forms of SRB. Adolescent SRB was largely characterized by having experienced sexual violence, as well as intergenerational and transactional sex. Higher scores of hopefulness were reported among adolescents who never experienced SRB (P = 0.03) at bivariate analysis level. However, both self-esteem and hopefulness were not significantly associated with the occurrence of SRB in the adjusted logistic regression analysis. Having depressive symptoms (Adj. OR = 3.8, 95% CI: 1.39–10.4), feeling unsafe in the neighborhood (Adj. OR = 3.4, 95% CI: 1.6–7.2), and being in higher compared with lower primary education level (Adj. OR = 0.3, 95% CI: 0.1–0.8) were statistically significantly associated with the occurrence of SRB.Conclusion: Targeted reproductive health interventions, designed with the cognizance of structural and social drivers of adolescent SRB, are needed to concurrently tackle multiple forms of SRB. It is important to integrate mental health promotion within these interventions. More research is needed to understand the mechanisms and implications of self-esteem and hopefulness for adolescent sexual and reproductive health.

Sexual Risk Behaviors of Adolescents with Type 1 Diabetes in Comparison with Their Peers

“…Although low income and minority youth are often considered at greater risk for drug and alcohol use, studies indicate that white adolescents living in suburban or middle-class households are actually more likely to drink alcohol and use illicit drugs [ 38 ]. Regarding sexually risky behaviors in adolescents without T1D, previous studies have not identified any association with household socioeconomic status [ 13 , 39 , 40 ]. In only one study, timing of sexual debut among 16-year-old boys in Oslo [ 41 ] presented a U-shaped pattern of parental social class, with upper managerial and manual working classes having similarly high proportions of early debutants.…”

Determinants of sexuality development amongst adolescents in the faculty of nursing sciences, Niger Delta University, Amassoma, Bayelsa state, Nigeria

“…This is especially significant in the context of adolescent sexuality since bad judgments made owing to a lack of cognitive and/or emotional maturity can have longterm effects [8]. Because of the interdependence of sexual development, cognitive development, and emotional development, early adolescence is a risky stage in adolescents' sexual development [10]. Adolescents at this age lack the cognitive and emotional development required to make intelligent and healthy sexuality decisions, and they are illprepared to deal with the repercussions of sexual engagement.…”

“…The bio-psycho-social model can better explain these adolescent developmental stages. Biological, psychological, and social variables all have a role in shaping the development of sexuality in adolescents [10]. Biological variables include genetic and neuro-endocrinal elements that impact the biological sex as well as the psychological sex.…”

“…Sexual and reproductive health is one of the most important aspects of adolescent development [4]. This is why access to credible and plentiful information on sexual and reproductive health is one of the younger generation's fundamental rights, and it plays a significant part in the formation of sexual concepts, tendencies, behavior, and roles [10]. Adolescents' understanding of sexuality grows during their school years.…”

“…According to Ssewanyana et al, [10], there are roughly 1.2 billion teenagers (10-19 years of age) worldwide. Developing nations are home to about 70% of the world's adolescent (10-19-year-old) population.…”