Abstract
Adolescent sexual behavior is shaped by individual, social, and structural factors that can increase HIV-risk, unwanted pregnancy, and sexually transmitted disease. To inform the development of a comprehensive sexuality education program, 239 secondary school adolescents ages 14–19 in Maun, Botswana, completed a survey of sexual and reproductive health knowledge, attitudes, and behaviors in February–March 2020. Bivariate and multivariate analyses examined factors associated with sexual experience and perceived ability to insist on condoms. Approximately 21% of respondents reported having had sexual intercourse. More than half felt able to insist on condoms. Sources of information about human reproduction, alcohol use, attitudes about when sex is acceptable, and perceived sexual activity by one’s peers were predictive of sexual experience. Age, confidence in correct condom use, perceived acceptability of adolescent sex with condoms, and endorsement of prevailing gender norms were significantly associated with perceived ability to insist on condom use.
Highlights
Celeste León-Moreno and Eighty-eight percent of all new adolescent HIV infections occur in Sub-SaharanAfrica [1]
This study examines various associations between the characteristics of adolescents in northwestern Botswana, their attitudes toward various sexual and reproductive health topics, and two behaviors: having had sexual intercourse and insistence on condom use
Adolescent sexual behavior and condom use in northwestern Botswana are shaped by a complex web of individual, social, and structural factors that give rise to increased risk of HIV infection, unwanted pregnancies, and sexually transmitted disease
Summary
Celeste León-Moreno and Eighty-eight percent of all new adolescent HIV infections occur in Sub-SaharanAfrica [1]. Girls disproportionately bear the burden of HIV in the region, accounting for 83% of all new infections in eastern and southern Africa. A considerable body of scholarly work has used an ecological model as a framework for characterizing the protective and risk factors associated with adolescent sexual behavior, in the context of HIV and other sexual transmitted diseases [6,7,8]. A systematic review of the literature on adolescents in developing countries published between 1990 and 2010 found that most studies focused on one of two outcomes: sexual initiation and condom use [9]. Being in school was found to be a protective factor against early sexual initiation in the majority of studies, and condom use was positively associated with more years of education and being able
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