Young people's and stakeholders' perspectives of adolescent sexual risk behavior in Kilifi County, Kenya: A qualitative study.

Derrick Ssewanyana,Charles R Newton,Patrick N Mwangala,Amina Abubakar,Vicki Marsh,Irene Jao,Anneloes Van Baar

doi:10.1177/1359105317736783

Abstract

A lack of research exists around the most common forms of sexual risk behaviors among adolescents, including their underlying factors, in Sub-Saharan Africa. Using an Ecological Model of Adolescent Behavior, we explore the perceptions of 85 young people and 10 stakeholders on sexual risk behavior of adolescents in Kilifi County on the coast of Kenya. Our findings show that transactional sex, early sexual debut, coerced sex, and multiple sexual partnerships are prevalent. An urgent need exists to develop measures to counter sexual risk behaviors. The results contribute to understanding the range of risks and protective factors in differing contexts, tackling underlying issues at individual, family, local institutional, wider socio-economic, and political levels.

Highlights

Sexual risk behavior (SRB) and forms of sexual exploitation faced by adolescents in Sub-Saharan Africa (SSA) need to be addressed, since SRB, such as early sexual debut, multiple sexual partnerships, unprotected sex, intimate partner violence, and sexual exploitation through early marriage and transactional sex, have been extensively documented among adolescents within this region (Bankole et al, 2007; Idele et al, 2014; Wamoyi et al, 2015)
35 percent of sexually active Kenyan adolescents report having used any form of contraception (Obare et al, 2016), early sexual debut and cross-generational sex are prevalent (Luke, 2005; Nzioka, 2001), and 25 percent of the Kenyan adults report having experienced some form of sexual violence before the age of 18 years (United Nations International Children’s Emergency Fund (UNICEF) et al, 2012)
Teenage pregnancy rate is highest (21%) at the Kenyan coast, and the unmet need for family planning among married adolescent girls (15–19 years) is 59 percent, which is twice more than the national prevalence of 23 percent (KNBS and ICF International, 2014)

Summary

Introduction

Sexual risk behavior (SRB) and forms of sexual exploitation faced by adolescents in Sub-Saharan Africa (SSA) need to be addressed, since SRB, such as early sexual debut, multiple sexual partnerships, unprotected sex, intimate partner violence, and sexual exploitation through early marriage and transactional sex, have been extensively documented among adolescents within this region (Bankole et al, 2007; Idele et al, 2014; Wamoyi et al, 2015). 35 percent of sexually active Kenyan adolescents report having used any form of contraception (Obare et al, 2016), early sexual debut and cross-generational sex are prevalent (Luke, 2005; Nzioka, 2001), and 25 percent of the Kenyan adults report having experienced some form of sexual violence before the age of 18 years (United Nations International Children’s Emergency Fund (UNICEF) et al, 2012) Disparities exist such that adolescents living in the coastal region of Kenya face a disproportionately poorer state of adolescent sexual and reproductive health (ASRH) than those from most regions within the country (Kenya National Bureau of Statistics (KNBS) and ICF International, 2014). Adolescent SRB has been linked to consequences such as high teenage pregnancy (currently at 18% in Kenya) (Obare et al, 2016), unsafe abortions, school dropout, mental ill health, and sexually transmitted infections (Godia et al, 2014; Juma et al, 2014; UNICEF et al, 2012)

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Results

Discussion

Conclusion