Determinants of HIV-risk sexual behaviors among Zambian adolescents: The role of gendered power

Abstract

Sub-Saharan African adolescents account for a disproportionate share of the global HIV infection rates with adolescent females carrying the heavy burden. Vulnerability to negative sexual health outcomes have been attributed to varying life contexts and power differentials influencing adolescent sexual behaviors. Using social dominance theory and the four bases of gendered power, this study examines the relationship between gender based power and adolescent HIV-risk sexual behavior. Data was derived from the 2013‐14 Zambia Demographic Health Survey (ZDHS). We utilize gender stratified multivariate logistic regression to determine whether the four bases of gendered power are predictive of condom use and multiple sexual partnering among sexually active adolescents (N = 1908), ages 15–19. Findings highlight the significant effects of sexual abuse, resource constraints (low levels of education, condom access, poverty) and gender-unequal beliefs and values on the odds of adolescent HIV-risk sexual behavior. We found gender variant effects of these factors on sexual behavior. For males, beliefs in gender-unequal norms acted as a barrier to condom use. Among females, having no education facilitated multiple sexual partnering. Implications for policy and practice are provided.