Initiation Of Sexual Intercourse Research Articles

Prevalence and determinants of pregnancy termination in Ethiopia: a systematic review and meta-analysis

ObjectiveThis review aims to determine the prevalence of pregnancy termination and its determinant factors in Ethiopia.DesignSystematic review and meta-analysis.Data sourcesRelevant articles were retrieved from databases such as PubMed, EMBASE, Medline...

Trends and the Gender Gap in the Reporting of Sexual Initiation Among 15-Year-Olds: A Comparison of 33 European Countries

ABSTRACT Early sexual intercourse initiation has been associated with immediate and long-term risks, which makes the study of trends in sexual initiation an important topic for policy makers. This study investigated trends over time in reported sexual initiation among 15-year-olds across 33 countries between 2010–2018. In addition, we examined if there were cross-country differences in the gender gap in reported sexual initiation in 2018, and whether these could be attributed to gender inequality and gender role attitudes. To answer these questions, we combined individual-level data from the international Health Behaviour in School-aged Children study collected in 2010 (N = 57,656), 2014 (N = 56,745) and 2018 (N = 55,127) with country-level data on gender inequality and gender role attitudes. We found a decrease over time in early sexual initiation in most countries, but also cross-country differences in these trends. More boys than girls reported sexual initiation in 2018. This gender gap also varied across countries and slightly decreased over time. In countries with less progressive gender role attitudes and more gender inequality, fewer girls reported early sexual initiation, resulting in a larger gender gap in these countries. To conclude, policy makers, healthcare providers and educators should focus on changing stereotypical gender norms.

Prevalence and associated factors of early initiation of sexual intercourse among youth in Ethiopia: systematic review and meta-analysis

BackgroundEarly sexual initiation refers to engaging in sexual activity at a young age, typically before the age of 18. Even though many studies have been conducted in Ethiopia, the result is inconsistent between studies. In the study area, the pooled prevalence and associated factors of early initiation of sexual intercourse among youth were not done before. Therefore, this study aimed to determine the pooled prevalence and associated factors of early initiation of sexual intercourse among Youth in Ethiopia.MethodsThis study used a systematic review and meta-analysis of studies conducted from 2008 to 2022, in Ethiopia. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. PubMed, Cochrane Library, Hinari, and Google Scholar electronic databases were searched. The analysis was performed using STATA 17 software. Heterogeneity and publication bias were assessed using forest plots, I2, Cochran’s Q statistics and Funnel plots, Egger test, and Begg rank tests respectively. Duval and Tweedie’s ‘trim and fill’ method was also performed to adjust the pooled estimate. Pooled analysis was conducted using the inverse-variance fixed-effects model.ResultsA total of 10 articles were included in this systematic review and meta-analysis. The pooled prevalence of early initiation of sexual intercourse among youth in Ethiopia was 24.7% (95%CI: 10.4, 38.9). Being female (AOR = 3.57; 95% CI: 1.387, 5.743), having poor knowledge of HIV/AIDS prevention (AOR = 3.65; 95% CI: 1.981,5.309), alcohol use (AOR = 2.05; 95% CI: 1.415, 2.679), khat chewing (AOR = 3.03; 95% CI: 1.800, 4.254), Viewed pornographic film(AOR = 4.21, 95% CI: 2.135, 6.283), Cigarette smoking (AOR = 2.74; 95% CI: 2.102, 3.370) and Poor family controls (AOR = 4.39; 95% CI: 2.572, 6.199)were associated factors of early initiation of sexual intercourse.ConclusionsThe pooled prevalence of early initiation of sexual intercourse among Youth in Ethiopia was high. Being female, poor knowledge of HIV/AIDS prevention, alcohol use, khat chewing, Viewing pornographic films, Cigarette smoking, and poor family controls were associated factors of early initiation of sexual intercourse. It is recommended that targeted interventions be put in place to address the high prevalence of early initiation of sexual intercourse among youth in Ethiopia. These interventions should focus on addressing the associated factors such as poor knowledge of HIV/AIDS prevention, alcohol use, khat chewing, viewing pornographic films, cigarette smoking, and poor family controls. It is important that these interventions are gender-sensitive and take into consideration the unique challenges faced by females in accessing sexual and reproductive health services.

Longitudinal Patterns of Multidimensional Violence Exposure and Adolescent Early Sexual Initiation.

Early sexual intercourse is associated with sexually transmitted infections, pregnancy, and depressive symptoms, and delay of intercourse allows adolescents opportunities to practice relationship skills (Coker et al., 1994; Harden, 2012; Kugler et al., 2017; Spriggs & Halpern, 2008). Thus, understanding predictors of early sexual intercourse is crucial. Prior research has suggested that violence exposure is associated with early initiation of sexual intercourse in adolescence (Abajobir et al., 2018; Orihuela et al., 2020). However, most studies have looked only at a single type of violence exposure. In addition, little research has examined longitudinal patterns of violence exposure in order to determine whether there are particular periods when the violence exposure may have the strongest impact on sexual behavior. Guided by life history and cumulative disadvantage theories, we use longitudinal latent class analysis and data from the Future of Families and Child Well-being Study (N = 3,396; 51.1% female, 48.9% male) to examine how longitudinal patterns of multiple types of violence exposures across ages 3 to 15 are associated with early sexual initiation in adolescence. Findings suggest that experiencing persistent physical and emotional abuse across childhood was associated with the greatest prevalence of early sexual initiation. Early exposure to violence was not consistently associated with greater likelihood of sexual initiation; instead, early abuse was more strongly associated with sexual initiation for boys, while late childhood abuse was more strongly associated for girls. These findings suggest that gender-sensitive programs are highly needed to address unique risk factors for boys' and girls' sexual behaviors.

Risk Factors for Early Sexual Intercourse in Adolescence: A Systematic Review of Cohort Studies.

This systematic review provides a comprehensive assessment of risk factors related to early sexual intercourse (ESI) among adolescents. We used PRISMA guidelines to identify eligible cohort studies published between January 1999 and December 2020. We searched on three databases: PubMed, Embase and LILACS. Studies were screened for quality and eligibility. Of 2787 identified studies, seven met our inclusion criteria. The studies examined a range of factors, which were organized into four dimensions - individual, family, social and environmental, and sociodemographic. Risk factors with strong associations for ESI were: adolescent and parental substance use, aggression and conduct disorders, family attachment, school achievement, family living situation, and maternal education. Three studies were birth cohorts. This review demonstrates the important roles of substance use, family attachment and academic factors in shaping adolescents' sexual behavior. A strength of this review is its focus on longitudinal studies, enabling exploration of exposures collected before initiation of sexual intercourse.

Association between childhood sexual abuse and early sexual debut among Chinese adolescents: The role of sexual and reproductive health education.

Despite accumulating evidence of the long-term impacts of childhood sexual abuse (CSA), few studies have investigated the association between CSA and early sexual debut among adolescents. In this study, we examine the relationship between CSA and early initiation of sexual intercourse among Chinese youth, and the role of school-based sex education in this association, based on a nationally representative survey. Data were collected from the Survey of Youth Access to Reproductive Health in China (YARHC) conducted in 2009. Multivariable logistic regression models were used to investigate the association between CSA experience and early sexual debut, and the interaction terms between sexual and reproductive health education and CSA were included to examine the role of education in the association between CSA and early sexual debut. Among 4,907 sexually experienced youth, 1,062 (21.6%) made their early sexual debut. After adjusting for sociodemographic characteristics, it was found that CSA experience was significantly associated with early sexual debut, with an adjusted odds ratio of 3.13 (95% CI: 1.67-5.87). Receiving any type of sexuality education (reproductive health, sexually transmitted disease (STD) and HIV prevention, or contraception use) was not associated with a decreased risk of early sexual debut. Our results indicate a greater risk of early sexual debut among Chinese adolescents with a history of CSA, and only 46.7% sexually experienced youth had received prior sex education, which suggested an inadequacy of school-based sexuality education. To reduce this risk, targeted intervention with timely and adequate sexuality education for both early starters of sexual intercourse and CSA victims is warranted in China.

Contraceptive utilization and associated factors among youths in Hossana town administrative, Hadiya zone, Southern Ethiopia.

In low-income countries out of, 60.7 million unintended pregnancies, 19% of them are subjected to abortion of which 11% of were unsafe. Surprisingly, about 2.5 million occur in women under the age of 20 years. Aim of this study is to measure the level of contraceptive utilization and associated factors among youths in Hosanna town administration. Institutional based cross-sectional study was conducted in Hossana town administration, Hadiya zone, Southern Ethiopia. A multistage sampling procedure was employed by clustering health facilities into reproductive health clubs and health facilities to select 781 study participants. Data was collected by using structured pre-tested, self-administered questionnaires. All coded and cleaned data were entered into EPI-info version 3.5.1 and it was exported to SPSS version 16.0 for recoding and further analysis. Among youths who had been sexually active within the last 12 months, 67.6% had used contraceptives prior to the survey. Multivariate analysis was found statistically significant association between contraceptive utilization and education status of mothers who attained university AOR = 4.57 [95% CI (1.29, 16.19)], utilization of sexual and reproductive health services within last 12 months AOR = 2.26 [(95% CI: 1.33, 3.86)], age initiation of first sex between 15-19 year OR = 2.63 [(95% CI 1.48,4.64)], discussion with sexual partner AOR = 1.99 [(95% CI: 1.27, 3.13)], good knowledge on contraceptive advantage AOR = [1.89 (95%CI: 1.07, 3.32)]. Whereas educational status: being secondary level decrease utilization of contraceptives by 51% AOR = 0.49 [95% CI (0.27, 0.94)]. The findings of our study imply that level of contraceptive utilization is higher than as compared to the previous studies. Discussion with a sexual partner as well as with a spouse, having awareness on contraceptive advantages, early age initiation of sexual intercourse, maternal educational status and getting sexual and reproductive health services recently were identified as predictors of contraceptive utilization.

Youth Assets and Initiation of Sexual Intercourse by Family Structure: A Longitudinal Cohort Study.

The purpose of this study was to assess the protective influence of individual, family, and community assets from the initiation of sexual intercourse (ISI) for adolescents living in one-parent households compared with adolescents living in two-parent households. Five waves of data were collected annually over a 4-year period (N = 591, 52.5% female, mean age = 14.0 years) from a racially/ethnically diverse sample of adolescents. Extended Cox models were used to assess the relationship between assets and time of ISI while controlling for demographic variables. Potential interactions between adolescent's household structure and assets were examined. Five of 17 assets were prospectively and significantly associated with a reduced risk of ISI among adolescents living in one-parent households compared with 11 of 17 assets for adolescents living in two-parent households. Adolescents living in one-parent households who possessed any one of five assets (e.g., general aspirations for the future, relationship with mother, positive peer role models) had between a 27% and 57% lower risk of ISI, whereas adolescents living in two-parent households who possessed any of one of 11 assets (e.g., responsible choices, family communication, community involvement) had between a 20% and 42% lower risk of ISI. The results suggest that strengthening specific youth assets across multiple dimensions of behavioral influence may decrease the risk of ISI for adolescents living in both one-parent and two-parent households. Public health efforts focused on developing programs to promote asset building tailored to adolescent's family structure are warranted.

Determinants of adolescent childbearing in Ethiopia, analysis of 2016 Ethiopian demographic and health survey: a case-control study

Pregnancy and birth complications experienced by adolescents are also problems of older women. But it is severe among the young due to physical immaturity and social condemnation from basic reproductive health services. The study was aimed to analyze determinants of adolescent childbearing in Ethiopia using the Ethiopian demographic and health survey. The data source for this study was the 2016 demographic and health survey. Records of 359 cases and 1436 randomly selected controls (1:4 ratio) were included in the analysis. Adolescent childbearing was the main outcome variable and the independent variables were sociodemographic and sexual & reproductive factors. Multivariable logistic regression analysis was used to identify factors associated with adolescent childbearing. The mean age of girls at first cohabitation was 15.28 ±1.64 and the mean age of first birth was 16.47±1.35. Adolescent childbearing was found to be higher in the Afar region (34.8%), and the lowest was in Addis Ababa city (4.1%). Finding from the multivariable analysis showed that place of residence, survey time age, and age at first sexual intercourse were the factors that have an association with adolescent childbearing. The odd of childbearing was higher among rural residents (AOR = 1.74; 95 % CI: 1.12, 2.72), early (<18 years) initiation of sexual intercourse (AOR =12.5; 95% CI: 5.97,25.18) and the risk is also higher among older teenagers (AOR =7.92; CI:3.92,15.90). Place of residents, age, and timing of first sexual intercourse was found to be the influencing factors of adolescent childbearing. Our finding indicates that the place of residence of the adolescent mothers must be considered in planning policies that attempt to disrupt successive cycles of socioeconomic deprivation. Public health interventions should focus their programs to be based on community and aim on prevention of early sexual intercourse and marriage.

Experience in the Management of Vaginal Cuff Dehiscence and Evisceration: A Retrospective 37-Year Single-Center Study.

PurposeVaginal cuff dehiscence (and evisceration) (VCD(E)) is an extremely rare and late-onset complication of total hysterectomy (TH). Limited evidence is available to guide clinicians in managing VCD(E). This study aimed to summarize the clinical characteristics of patients with VCD(E) treated in our center and share our experience in managing VCD(E).Patients and methodsFrom 1983 to 2020, a total of 14 cases of VCD(E), including 10 cases in our hospital and 4 cases in other hospitals, were included. Medical records were reviewed to summarize the clinical features and management of VCD(E).ResultsThe incidence of VCD(E) in our hospital was 10/46,993 (0.02%), and all 10 patients underwent laparoscopic hysterectomy. The median TH-to-VCD(E) interval was 3.13 months (8 days–27.43 months), and 11/14 (78.57%) patients experienced VCD(E) after coitus. The 3 major symptoms included abdominal pain in 11 patients, irregular vaginal bleeding in 8, and sensation of bulging or prolapsed organs in 4. Except for 2, most patients presented to our hospital within 72 h since the onset of the discomfort. All 14 cases were diagnosed through speculum examination: 3 had simple VCD, and 11 had VCDE. The protruding bowels of 4 patients were immediately manually repositioned in the emergency department without anesthesia. Regarding the surgical approach, 11 patients underwent simple transvaginal, 2 patients underwent laparoscopic-vaginal combined (transvaginal cuff closures), and 1 patient underwent laparoscopic. All but 1 patient did not undergo resection of the eviscerated organs. The median follow-up period was 39.33 (7.9–159.33) months. No patients showed any evidence of recurrence to date.ConclusionsLaparoscopic hysterectomy is a risk factor for VCD(E), and early initiation of sexual intercourse is the most common trigger of VCD(E). Clinicians should educate patients to postpone sexual intercourse for at least 3–6 months after TH. Immediate medical attention and patient-specific surgical management are crucial to avoid serious complications.

Prenatal cocaine exposure, early cannabis use, and risky sexual behavior at age 25

BackgroundPrior research on prenatal cocaine exposure (PCE) indicates that exposed children experience behavioral dysregulation resulting in risky adolescent behavior including earlier initiation of cannabis use and sexual intercourse. The goal of this study was to examine the long-term effects of PCE on adult sexual behavior. MethodsThis is a prospective cohort study of the association between PCE and risky adult sexual behavior and sexually transmitted infections (STIs) in 202 young adults (mean age = 27, SD = 0.98 years). The sample was 55% female, 46% White, and 54% Black. Data from the prenatal, childhood, and adolescent phases of the study were used to delineate pathways from PCE to adult sexual behavior. ResultsThe most common risky sexual behavior was having sex while drunk or high (63%). One-third of the sample reported that they “almost always” had sex while drunk or high. We found evidence for an indirect pathway from PCE to adult sex while drunk or high via early cannabis initiation. There were no other effects of PCE on adult risky sexual behavior or on risk for STIs, after controlling for sex assigned at birth, race, age at sexual initiation, and family history of drug and alcohol problems. ConclusionsAlthough PCE has been associated with earlier initiation of sex in prior studies, PCE was not directly associated with risky adult sex or history of STI. Exposed individuals were at greater risk of sex under the influence of alcohol or drugs via earlier initiation of cannabis use during adolescence.

Sexual debut among college students in China: effects of family context.

This study examines family context and sexual debut among young people in China. Using data from the 2018 Panel Study of Chinese University Students (PSCUS), it explores how the family is correlated with sexual debut among young people in China aged 18-24 years. The Kaplan-Meier method was adopted to detect a survival function for different family factors and related demographic variables. Cox proportional hazard regression analysis was adopted to calculate hazard ratios for the timing of sexual debut. The average age of sexual debut among the college students was 18.39 years. The Kaplan-Meier analysis showed that sexual intercourse initiation was earlier for female students who had no siblings, and those who had a mother with senior high school (including technical school) education or higher family income, but this correlation was insignificant among male students. The multivariate hazard regression analysis revealed that living in a family with a higher level of fathers' education, having a lower level of family income and having siblings had positive correlations with later sexual debut among the college students. Moreover, family factors showed gender differences in their associations with the timing of sexual debut, typically parent's education level, family income and left-behind experience. This study provides a comprehensive perspective on the role of family influences in timing of sexual debut among youth in China.

Factors associated with sexual intercourse initiation: a retrospective cohort of Lebanese adolescents in schools

ObjectivesEarly sexual initiation is known to be associated with deleterious health outcomes. The objective of this study was to evaluate factors (bullying, weight status, smoking and alcohol consumption, peer influence, relations with parents) associated with the initiation of sexual intercourse among Lebanese adolescents in schools. MethodsA retrospective cohort was formed using a convenient sampling of Lebanese students (n=1635) in private schools from Beirut and Mount Lebanon. ResultsYounger age of adolescents at first sexual intercourse was significantly associated with finding it very easy to talk about things that worry them with an older brother, having a best friend who drinks sometimes compared to no drinking, and a best friend who smokes sometimes or every day compared to not smoking. Moreover, older age at the first sexual relationship was significantly associated with female gender (HRa=0.25), as was older age at first time drinking alcohol, first time getting drunk, and smoking cigarettes. ConclusionThis study sheds light on some of the factors associated with age at first sexual intercourse in Lebanese adolescents.

Women's Knowledge of Cervical Cancer: A cross-sectional study in Al Buraimi Governorate, Oman.

ObjectivesThis study aimed to assess knowledge of cervical cancer and its prevention among Omani women aged 20–65 years.MethodsThis cross-sectional study took place across eight primary healthcare institutions in Al Buraimi Governorate, Oman, between November 2018 and February 2019. It was carried out on the basis of a predesigned, validated and self-administered questionnaire containing 55 questions.ResultsData from 791 completed questionnaires were included in the final analysis, which represents a response rate of 79.1%. The results indicated that 86.7% of surveyed women had previously heard of cervical cancer and 13.0% expected this disease to affect them in the future. The results also showed that women were less aware of the association between the human papillomavirus (HPV) and cervical cancer (24.7%). The participants considered the HPV infection and initiation of sexual intercourse below 17 years of age as the lowest risks associated with cervical cancer. Moreover, 63.8% of the participants were unaware of the availability of a vaccination ‘against HPV-related cervical cancer’ and many respondents were unaware of a Pap test. Those women aged over 30 years, married and with a high level of education were more likely to be aware of cervical cancer.ConclusionGenerally, there was inadequate knowledge and awareness of cervical cancer among women aged 20–65 years. Young women aged 20–30 years showed relatively lesser knowledge of cervical cancer as compared to their older counterparts. Thus, concerted efforts are needed to promote such awareness among women in Oman.

Risk factors for precancerous cervical lesion among women screened for cervical cancer in south Ethiopia: Unmatched case-control study.

BackgroundNearly 90% of deaths from cervical cancer occur in a low resource setting. In Ethiopia, the magnitude of precancerous cervical lesions ranges from 7% to 28%. Precancerous cervical lesions may progress to cervical cancer. Early screening and treatment of precancerous cervical lesions is a cost-effective way to avert the growth of cervical cancer. However, there has been limited research on risk factors for precancerous cervical lesions in Ethiopia. Therefore, this study aimed to identify risk factors for precancerous cervical lesions among women screened for cervical cancer in south Ethiopia.MethodA facility-based unmatched case-control study was carried out in five health facilities in south Ethiopia between 8 May to 28 September 2018. Interviewer administered questionnaires were used to collect data from 98 cases and 197 controls. Multivariate logistic regression was employed to identify determinants of precancerous cervical lesions.ResultsWomen aged 30–39 years (AOR = 2.51, 95% CI: 1.03–6.08), monthly income ≤66 (AOR = 3.51, 95% CI: 1.77–6.97), initiation of first sexual intercourse at age less than or equal to 20 (AOR = 2.39, 95% CI: 1.14–5.47), having more than one lifetime sexual partner (AOR = 4.70, 95% CI: 2.02–10.95), having a partner/ husband with more than one lifetime sexual partner (AOR = 2.98, 95% CI: 1.35–6.65) had higher odds of precancerous cervical lesions.Conclusion and recommendationStrategies to prevent precancerous cervical lesions should focus on modification of lifestyle and sexual behaviour. The findings of this study highlight several implications for policymakers: targeting older women for cervical cancer screening, addressing inequalities and education relating to risky sexual behaviour may reduce precancerous cervical lesions. Furthermore, future longitudinal studies are needed to assess the awareness of women about cervical cancer screening.

Estimating the Prevalence and Risk Factors of Obstetric Fistula in Ethiopia: Results from Demographic and Health Survey.

IntroductionObstetric fistula is the most common obstetric problem in low- and middle-income countries where maternal care is inaccessible. Obstetric fistula has serious social and economic consequences resulting in devastating health problems for women. There is a lack of national studies that show the burden of obstetric fistula and risk factors; as a result, this study aimed to estimate the prevalence of obstetric fistula, its symptoms, and risk factors in Ethiopia.MethodsA population-level cross-sectional study was conducted with a total of 7590 women who gave birth in the last 5 years, using data from the 2016 Ethiopian Demographic and Health Survey. Complex sample analysis and normalized weighting were used to compensate for the disproportionate sampling in the survey. A multivariable logistic regression model was fitted to find a significant association between obstetric fistula and covariates. Both odds ratios (crude and adjusted) with their corresponding 95% confidence intervals (CI) were reported.ResultsAmong the 7590 women having given birth in the last 5 years, 32 (0.42%) women with obstetric fistula were identified. Of these, 64% developed obstetric fistula after live birth and 23.1% developed obstetric fistula after stillbirth. More than 72.8% were associated with prolonged and very difficult labor. No history of contraceptive use (AOR = 3.43; 95% CI: 1.05–11.21), having a big problem of distance from the health facility (AOR = 3.7; 95% CI: 1.05–11.21), early marriage (AOR = 1.52; 95% CI: 1.12–3.5), and being a rural resident (AOR = 1.5; 95% CI:1.2–5.05) were risk factors associated with obstetric fistula.ConclusionThis study finding revealed that obstetric fistula is the most common devastating obstetric problem in Ethiopia. Early marriage, early initiation of sexual intercourse, distance from the health facility, no history of contraceptive use, and rural residence were the predisposing factors to develop an obstetric fistula. Thus, interventions should focus on creating community awareness regarding early marriage and its consequences, early seeking of health facility visiting, and avoiding unintended pregnancy to minimize the subsequent complications.

Trends in adolescent alcohol and other risky health- and school-related behaviours and outcomes in Australia.

Adolescent drinking has been declining in Australia over the past two decades, but this trend may be part of a broader shift towards healthier lifestyles for adolescents. We examined trends in the prevalence of multiple risky health- and school-related behaviours and outcomes to test whether this was the case. Data on multiple behaviours and outcomes were collated from Australian government agencies and other relevant sources for 10-19-year-olds from the year 2000 onward. Trends were examined descriptively. Rates of substance use, youth offending and injuries due to underage driving declined over the study period. Some health-related behaviours (physical activity and diet) worsened between 2001 and 2017; however, obesity rates remained stable. Risky sexual behaviours increased in terms of early initiation of lifetime sexual intercourse and decreased condom use. However, sexual health outcomes improved with a reduction in teenage pregnancies and there was a recent decline in sexually transmitted infection rates from 2011 onward. Suicide rates and rates of major depressive disorders increased. School attendance and engagement in full-time work or study remained stable. The decline in adolescent drinking does not appear to correspond with increased engagement in healthier behaviours; however, it may be related to a more risk-averse way of living. Future work could be directed towards identifying which social, economic, policy and environmental factors have impacted positive changes in risky behaviours. Public health efforts can then be directed towards behaviours or outcomes, which have not yet improved.

Sexual Intercourse Initiation and Adolescent Behaviors of Youth Living with Perinatal HIV Infection in Thailand

Today, youth living with perinatal HIV (YLPHIV) have grown-up receiving antiretroviral treatment. We determine the frequency of sexual intercourse initiation and associated factors among YLPHIV in Thailand. YLPHIV age between 15 and < 25 years were recruited from either HIV clinics or the community via youth networks from Dec 2017 to Feb 2018. Data were collected using a self-administered questionnaire on a mobile device. The questionnaire included demographic and socioeconomic background, their lifetime sexual and adolescent behaviors, reasons for not having sexual intercourse, and future plans for sexual intercourse. Comparisons between sexes, age groups, and sexual experiences were made; logistic regression was used to identify associated factors. A total of 120 YLPHIV were enrolled; 58 (48%) were female. Their mean ± SD age and duration on ART were 20.3 ± 2.6 and 12.7 ± 3.0 years, respectively. Thirty-six (30%) reported having initiated sexual intercourse by the time of the study; 61 (51%) reported being in romantic relationships, and 58 (48%) reported having sexual contact. The only factor associated with sexual intercourse initiation based on the multivariate analysis was going out after midnight (odds ratio 3.968, 95% CI 1.540–10.226; p = 0.004). Among those who had not initiated sexual intercourse, the top three reasons for not initiating sexual intercourse were concern for their parents’ feelings (76%), not wanting to get sexually transmitted diseases (70%), and not wanting to spread HIV to others (62%). Half of YLPHIV who had not initiated sexual intercourse reported being uncertain whether, or when to have sex in the future. Sexual intercourse initiation and adolescent behaviors are part of growing-up for YLPHIV. Sexual education and HIV knowledge that are both age-appropriate and culturally appropriate should be included in HIV services, and counseling sessions to help these youths to plan for their future safely and responsibly.

Sexual Debut Among Heterosexual Men of African and Caribbean Descent: Are the Youth Initiating Sex Earlier than the Older Generation?

Although age at first sex is considered a measure of sexual risk and vulnerability for HIV infection, there is a dearth of literature on age at sexual debut in the Canadian context. This study examined time variations to first sex among heterosexual African, Caribbean, and Black (ACB) men in four Ontarian cities. A population-based retrospective survey (n = 879) on timing to first sexual intercourse was conducted between 2018 and 2019 among self-identified heterosexual ACB men 16years or older and residing in London, Ottawa, Toronto or Windsor. We used the lognormal survival analysis technique to examine variations in time to first sexual intercourse among age cohorts and between cities. The findings showed a generational shift in the pattern of sexual initiation, with younger heterosexual ACB men initiating sexual intercourse earlier compared with those currently older than 50years. We observed those between 16 and 19years, 20 and 29years, and 30 and 39years of age to have significantly higher risk ratios of TR = 0.852, TR = 0.869, and TR = 0.855, respectively. At city level, the results show marked spatial variations, with youth in cities of Toronto, Ottawa, and London at the highest risk of early sexual debut relative to those in Windsor. Early initiation of first sexual intercourse among heterosexual ACB youth was observed with those in the larger cities being at a relatively higher risk. There is the need for programs aimed at delaying sexual debut among youth in general. It is, however, important to recognize the relative risk of those in the larger cities.

Prevalence of Cervical Cancer and Associated Factors Among Women Attended Cervical Cancer Screening Center at Gahandi Memorial Hospital, Ethiopia.

Background:Despite the fact that cervical cancer is preventable disease, it is the fourth most frequently diagnosed cancer and leading cause of cancer death in women. An estimated 604 000 women were diagnosed with cervical cancer worldwide and 342 000 women died from the disease. Therefore, the purpose of this study was to determine the prevalence and factors associated with cervical cancer among women attended cervical cancer screening center in Gahandi memorial Hospital.Methods:An institutional-based cross-sectional study was conducted at Gahandi Memorial Hospital in which simple random sampling technique was used to select 422 registration books of women who visited the hospital between May 2015 and May 2019. Texts, tables, and graph were used to present results. Binary logistic regression with a P-value of <.25 and multivariate logistic regression with a P-value of <.05 were used to determine the association between independent variables and outcome variable.Results:In this study, from the total of 422 women screened with visual inspection with acetic acid (VIA) screening test, 23.5% of them were found to be positive for VIA test. From those who were diagnosed positive with VIA screening test, about 10.1 % were identified with high grade lesions. Having multiple sexual partners (AOR = 1.83, 95% CI: 1.21-3.29), being HIV-positive (AOR = 2.22, 95% CI:1.10-4.69), having a history of Sexual Transmitted Infection (STI) (AOR = 6.76, 95% CI: 1.14-3.90), and beginning sexual intercourse at early age (AOR = 1.38, 95% CI: 1.20-5.13) were factors associated with cervical cancer.Conclusion:The study concluded that the high prevalence of cervical cancer. Having multiple sexual partners, being Human Immune Deficiency Virus (HIV) positive, having STI history and early initiation of sexual intercourse were factors associated with cervical cancer. Therefore, avoiding multiple sexual partners, delaying of early sexual contact, and self-protection from STI infections might help to prevent cervical cancer.