Factors associated with first heterosexual sex; sexual coercion and sexual risk behaviors among adolescents in Botswana

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Although early sexual debut is highly prevalent in Botswana, its link to sexual risk practices has not been explored at the national level. The aim of this paper was to investigate the association between age-at-first-sex, experience of sexual coercion and subsequent sexual practices. We used data derived from the 2013 Botswana AIDS Impact Survey (BAISIV)—a fourth and latest in a number of nationally representative, population-based surveys meant to measure the sociodemographic and other effects of the HIV/AIDS epidemic in Botswana. A sample of 3796 adolescents in ages 10–24 years who had successfully completed BAISIV individual questionnaire were selected and included for analysis. Data was analyzed using descriptive and multivariate statistical methods. All comparisons were considered statistically significant at p < 0.05. Mean age at first sex for the sampled adolescents was 17.9 years. Using binary logistic regression analysis, results indicate that females (AOR1.16, CI = 1.08–1.63), adolescents who did not belong to any religious affiliation (AOR = 1.71, CI = 1.03–2.86) and those who started sexual activity earlier (AOR = 1.53, CI = 1.02–2.56) were more likely to report to have experienced sexual coercion. Moreover, the odds of reporting multiple sexual partnerships were significantly high among adolescents who started sexual activity earlier (AOR = 1.71, CI = 1.03–2.86) and those who resided in cities/towns (AOR = 1.61, CI = 1.08–2.38). There is need for adolescent HIV policies and programs to address circumstances around young people’s initiation into sexual intercourse, as well as the psychosocial, and cultural norms pertaining to initiation of sex.