Neighbourhood Determinants of Early Sexual Debut and Multiple Sexual Partnerships: A cross-sectional Analysis of Adolescents in Rwanda, Ghana and South Africa.

Background: The relationship between neighbourhood characteristics and youth involvement in risky sexual behaviour such as early sexual debut and multiple sexual partnerships is well established in the literature. However, there are very few empirical studies using Demographic and Health Surveys to unpack the nature of this relationship in Africa. This study aims to identify the neighbourhood characteristics influencing young people's engagement in risky sexual behaviour in sub-Saharan Africa. Methods: Univariate, bivariate, and multivariate analyses on young people aged 15 to 24 years were conducted using the most recent Demographic and Health Survey Data (DHS 2014-2016) from Ghana, Rwanda, and South Africa to investigate the relationship between neighbourhood characteristics and youth risky sexual behaviour. Results: Individual and, in particular, neighbourhood characteristics (community poverty, community occupation, community media access, and community education) were found to be substantially linked with youth risky sexual behaviour. Conclusion: To lower the incidence of risky sexual behaviour in the community, programs aimed at appropriate policy options must be intensified. Adopting the implications of these findings is critical for a developmental approach aimed at reaching Africa’s long-term development goal of eliminating STIs among young people.

Early Sexual Debut among Ghanaian Women: Correlates and Psychological Effect

Early sexual initiation is linked to an increased risk of HIV/AIDS and other STIs among teenagers, as well as having multiple partners, not using contraception, unintended pregnancy, and illegal abortions. Aim. To identify the correlates and psychological effects of early sexual debut among not-in-union women in Ghana. A descriptive cross-sectional survey was used for this study using data from Ghana Multiple Indicator Cluster Survey (MICS) for the year 2017/2018. SPSS software was used for data analysis, bivariate analysis for association was done using chi-square, and the prediction was done using a binary logistic regression model. The national prevalence of nonmarital early sexual initiation this current study recorded was 56.9%. Predictors variables were age, 15-24/≥35 years ( AOR = 1.51 , 1.28-1.78), ever educated ( AOR = 0.50 , 0.43-0.60), urban address ( AOR = 0.85 , 0.74-0.98), married/single ( AOR = 1.23 , 1.07-1.42), cohabitation/single ( AOR = 1.43 , 1.19-1.72), Greater Accra Region/Upper West Region ( AOR = 0.67 , 0.49-0.92), and health insurance ( AOR = 0.89 , 0.79-0.998). As the wealth indices of the woman decrease from the richest to poorest, the likelihood of early sexual debut inversely increases: fourth/richest ( AOR = 1.23 , 1.04-1.45), middle/richest ( AOR = 1.31 , 1.09-1.58), second/richest ( AOR = 1.38 , 1.11-1.72), and poorest/richest ( AOR = 1.44 , 1.12-1.86); use of the internet ( AOR = 0.58 , 0.50-068); substance use and alcohol ever use ( AOR = 1.32 , 1.17-1.49); cigarette ever use ( AOR = 2.58 , 1.44-4.64); contraceptive use ( AOR = 1.31 , 1.16-1.49); and ever heard of HIV ( AOR = 59 , 0.42-0.82). In conclusion, the prevalence of early sexual debut is still high in Ghana, especially among the northern regions. Several factors predicted early sex debut, and low life satisfaction and happiness were related to early sexual debut.

Assessment of the Reach, Usability, and Perceived Impact of “Talking Is Power”: A Parental Sexual Health Text-Messaging Service and Web-Based Resource to Empower Sensitive Conversations with American Indian and Alaska Native Teens

Background: Early sexual debut among American Indian and Alaska Native (AI/AN) adolescents has been associated with an increased risk of teenage pregnancies and sexually transmitted infections, along with an increased risk of having multiple lifetime sexual partners, and engaging in greater frequency of sex, substance abuse, and lack of condom use. A major protective factor against early sexual debut among AI/AN youth is the familial system. Interventions aiming to improve parent–child communication and parental warmth toward adolescent sexual health topics were reported to contribute to positive youth sexual health outcomes, specifically among minority youth. Healthy Native Youth thus developed the Talking is Power text-messaging service to guide parents and caring adults on how to initiate sensitive topics with youth and how to support them in making informed decisions regarding sex and healthy relationships. Methods: Descriptive statistics were used to demonstrate website analytics and reach per views and time spent on each page, and for displaying participants’ responses to the questions on the usability of the Talking is Power text-messaging series. To assess the perceived impact of the series, the differences in mean percentage scores of the question assessing parental comfort in engaging in sexual health topics with youth between pre- and post-intervention were calculated using two-sample t-tests of equal variances. Descriptive content analysis was adopted to highlight emerging themes from open-ended items. Results: When looking at reach, 862 entrances were recorded during the specified time period (5.8% of total entrances to HNY website), while the bounce rate was set at 73.1% (22.6% greater than the industry average), and the exit rate was 54.3% (15.2% greater than the industry average). Series usability was highly ranked on the 5-Likert scale in terms of signing up for a similar series on a different topic, quality of images, texts, and links, relating to prompts, and change in sparking sensitive conversations with youth. High likelihood of recommending the series to a friend or colleague was also reported by participants (0–10). No significant difference in parental comfort levels was reported (p = 0.78 > 0.05). Main themes provided suggestions for improving the series mode of delivery, while others included positive feedback about the material, with the possibility of expanding the series to other adolescent health topics. Conclusion: Lessons learned during the design, dissemination, and evaluation of the resource’s usability, reach, and perceived impact may be of interest to other Indigenous communities who are in the process of adapting and/or implementing similar approaches.

Increases in both HIV and syphilis among men who have sex with men in Vietnam: Urgent need for comprehensive responses

The objective of this study was to determine the temporal trends and factors associated with HIV and syphilis infection among men who have sex with men (MSM) in southern Vietnam. Data from the 2014–2018 national HIV sentinel surveillance of MSM aged 16 years or older were collected from three provinces, including An Giang ( N = 761), Can Tho ( N = 900), and Ho Chi Minh City ( N = 1426), and examined for changes in prevalence rates of HIV and syphilis and risk behaviors over time. Multivariate logistic regression was performed to assess the trends and correlates of HIV and syphilis infections among MSM. There were upward trends for HIV (9.5% in 2014 to 14.2% in 2018, p-trend<0.01), syphilis (4.9% in 2014 to 8.0% 2018, p-trend<0.01), and HIV/syphilis co-infection (1.9% in 2014 to 3.1% in 2018, p-trend=0.01). Factors associated with HIV infection included place of residence, early sexual debut, consistent condom use and not engaging in anal sex during the past month, not knowing one’s HIV test results, having ever injected drugs, and having active syphilis. Additionally, early sexual debut and being HIV positive were associated with syphilis infection. Rising prevalences of these infections among MSM suggests an urgent need for comprehensive intervention packages for HIV/STI prevention.

What predicts the early sexual debut among unmarried adolescents (10–19 years)? Evidence from UDAYA survey, 2015–16

Introduction The societal norm in India is such that adolescents are expected to respect and follow traditional values and view early sexual debut as undesirable and deviant from the social mores. However, a dramatic shift in attitudes towards sex before marriage has been observed in India. We in this study, aim to study the factors associated with early sexual debut among unmarried adolescents. Materials and methods The study used data from the Understanding the lives of adolescents and young adults (UDAYA) survey conducted in 2016 with 15,388 adolescents aged 10–19 years from two Indian states. Bivariate and logistic regression analyses were performed to determine the associated factors. Results Adolescent boys (9%) were more prone to early sexual debut compared to girls (4%). Both boys (17.2%) and girls (6%) who were school dropouts had significantly higher chances of early sexual debut. Boys who had rare [OR: 2.28; CI: 1.12–4.64] or frequent media exposure [OR: 2.70; CI: 1.36–5.32] were significantly more likely to report early sexual debut than those who had no media exposure. Further, the likelihood of early sexual debut was significantly higher among boys [OR: 3.01; CI: 2.34–3.87] and girls [OR: 1.87; CI: 1.12–3.12] who had exposure to pornography compared to their counterparts. The odds of early sexual debut were higher among boys [OR: 1.89; CI: 1.19–3.01] and girls [OR: 1.77; CI: 1.30–2.41] who had moderately-severe/severe depressive symptoms compared to their counterparts. Conclusions The results highlight that Indian unmarried adolescents demand the appropriate knowledge to promote safer sexual behavior and lead a responsible and healthy lifestyle. The preventive efforts must be multifaceted with involvement at the individual and parental levels. Especially, interventions appear advantageous to be parents-focused emphasizing family life education that can prevent risky sexual behaviors among adolescent boys and girls. And the public programs should focus on sexual health promotion considering the physical and psychosocial changes during early ages of sex life.

Peer influence and sexual debut : A mathematical approach

Objectives: Early sexual debut is one of the major causes of STIs and unwanted pregnancy. A deterministic mathematical model to attempt to understand the role of prostitution and peer influence on early sexual debut is developed and analyzed. Results: The thresholds known as the reproduction number and equilibria for the model are determined and stabilities analyzed. Analysis of the reproduction number suggests that prostitution and economic hardships enhance early sexual debut. Sensitivity analysis of the reproduction number is carried out and it suggests that a reduction in prostitution has the greatest impact in reducing the reproduction number. Using the multi-domain pseudo-spectral relaxation method (MD-SRM), numerical simulations are carried out. Numerical simulations suggest that prostitution and peer influence enhances early sexual debut.