Abstract
BackgroundEarly and unprotected sex with multiple partners among adolescents carries a high risk of acquiring HIV infections, other sexually transmitted infections as well as high rates of teenage pregnancy. Sub-Saharan Africa (SSA) has a higher burden of HIV/AIDS: the leading cause of deaths among adolescents. We estimated the prevalence and examined the correlates of sexual intercourse among in-school adolescents of SSA. The purpose is to inform the public health programs dedicated to tackling the burden of HIV/AIDS.MethodsWe did a secondary analysis of the Global School-based Student Health Surveys (GSHS) datasets pooled from five SSA countries Benin, Mozambique, Namibia, Seychelles, and Tanzania. Our current analysis included a sample of 15,318 in-school adolescents. The primary independent variables were ever had sexual intercourse and sex with multiple partners, while the dependent variables were smoking cigarettes, alcohol use, use of marijuana and amphetamine, and parental connectedness. We performed descriptive statistics, and multivariate logistic regression stratified by gender using SPSS Complex Sample Statistics. A p-value of less than 0.05 was considered statistically significant at 95% confidence intervals.ResultsOut of 15,318 participants, the overall prevalence of ever had sexual intercourse and sex with multiple partners were 43·5% (6670) and 20·9% (3204), respectively. In overall and across each country, male adolescents had a significantly higher proportion of sex with multiple partners than female adolescents, p < 0·001. The predictors of sexual intercourse with multiple partners in both male and females were smoking cigarettes, alcohol use, and use of marijuana and amphetamine. Female adolescents who smoked cigarettes and used marijuana had a significant likelihood of sex with multiple partners than male adolescents: [aOR 3.6, 95% CI: 2.6-5.1] vs [aOR 2.1, 95% CI: 1.7-2.7] and [aOR 2.4, 95% CI: 1.6-3.7] vs [aOR 1.9, 95% CI: 1·3-2·7], respectively.ConclusionsAdolescents sexual intercourse and more especially sex with multiple partners was prevalent and strongly correlated with substance use. However, the correlation was higher among female adolescents than male adolescents. A customized public health intervention that targets multiple risk factors concurrently may benefit adolescents with clustering of sexual and non-sexual risk-taking behaviors.
Highlights
And unprotected sex with multiple partners among adolescents carries a high risk of acquiring Human Immunodeficiency Virus (HIV) infections, other sexually transmitted infections as well as high rates of teenage pregnancy
Female adolescents who currently smoked cigarettes and used marijuana had a significant likelihood of sex with multiple partners than male adolescents: [Adjusted odds ratio (aOR) 3.6, 95% CI: 2.6-5.1] vs [aOR 2.1, 95% CI: 1.7-2.7] and [aOR 2.4, 95% CI: 1.6-3.7] vs [aOR 1.9, 95% CI: 1·3-2·7], respectively
About two-thirds of HIV/Acquired Immune Deficiency Syndrome (AIDS)-related infections and mortality in the world occur in Sub-Saharan Africa (SSA) [12], and adolescents and young adults comprise more than one-third of its total population (49)
Summary
And unprotected sex with multiple partners among adolescents carries a high risk of acquiring HIV infections, other sexually transmitted infections as well as high rates of teenage pregnancy. Adolescence period has different critical transitions such as physical, economic, and psychosocial development It is a preferred period for initiating sexual and reproductive health promotion programs [1]. Sexual intercourse in adolescence increases the risk of acquiring HIV infections, sexually transmitted infections (STIs) [5,6,7], and unintended teenage pregnancy [7,8,9]. It is associated with unprotected sexual intercourse [10], having multiple sexual partners and other health-related risks behaviors, later in life [5, 8, 11]. In SSA, up to 25% of adolescents aged 15-19 years have ever had sexual intercourse before the age of 15 years, this can vary across the countries [12]
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