Predictors of primary and secondary sexual abstinence among never-married youth in urban poor Accra, Ghana

Nurudeen Alhassan,F Nii-Amoo Dodoo

doi:10.1186/s12978-020-0885-4

Abstract

BackgroundSexual abstinence is a key component of the strategy to address unwanted pregnancies, sexually transmitted infections and HIV among youth in sub-Sahara Africa. But contextual pressures make abstaining from sex a formidable task for urban poor youth in the sub-region. Nevertheless, some youth in these settings still manage to resist the pressure to initiate sex early, while others choose abstinence after an initial sexual debut. Few studies in the sub-region have examined sexual abstinence among urban poor youth. We therefore examined the factors that predict primary and secondary sexual abstinence among youth in urban poor Accra. The findings highlight the protective factors associated with sexual intercourse and should help to address the needs of youth at risk of unprotected sex.MethodsThe study analysed pooled data from two rounds of the Urban Health and Poverty Survey. The surveys analysed were conducted in 2011 and 2013. The analysis was restricted to unmarried youth between age 20 and 24 years. The total sample comprised 235 female and male youth. We conducted multinomial logistic regression analysis to examine the predictors of primary and secondary abstinence relative to current sexual intercourse.ResultsThe results showed that being female, sexual communication with only fathers, sexual communication with only friends and slum residence were negatively associated with primary sexual abstinence. Contrarily, being in school, attaching importance to religion, residing in a household that received social support and sexual communication with both parents were positively associated with primary abstinence. Regarding secondary abstinence, only the sexual communication variables had significant effects. Sexual communication with both parents positively predicted secondary abstinence while communication with fathers-only and friends-only had a negative effect.ConclusionSexual abstinence is predicted by factors which range from individual through household factors to the locality of residence. Despite the importance of all the predictors, the study found that sexual communication with both parents was the only factor that predicted a higher likelihood of both primary and secondary sexual abstinence. We therefore recommend sexual communication between parents and youth as a key strategy for promoting sexual abstinence among urban poor youth in Accra, Ghana.

Highlights

Sexual abstinence is a key component of the strategy to address unwanted pregnancies, sexually transmitted infections and HIV among youth in sub-Sahara Africa
Youth who talk about sex with only their fathers, those who talk about sex with only their friends and those living in a slum were less likely to abstain from sex
Sexual abstinence among urban poor youth in Accra is influenced by gender, schooling, religion, household support, communication about sex with both parents, fathers-only and only friends as well as residence in a slum

Summary

Introduction

Sexual abstinence is a key component of the strategy to address unwanted pregnancies, sexually transmitted infections and HIV among youth in sub-Sahara Africa. Contextual pressures make abstaining from sex a formidable task for urban poor youth in the sub-region. Few studies in the sub-region have examined sexual abstinence among urban poor youth. We examined the factors that predict primary and secondary sexual abstinence among youth in urban poor Accra. In Ghana, the proportion of unmarried youth between ages 15 and 24 years that have initiated sexual intercourse increased significantly over the last decade [3, 4]. Only 35% of sexually active unmarried females between ages 20 and 24 years use modern contraception [4]. It is estimated that 26% of new HIV cases occur among youth aged 15–24 years [5]

Results

Discussion

Conclusion