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Individual- and Community-Level Influences on the Timing of Sexual Debut Among Youth in Nyanza, Kenya.
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- Author(s): Tenkorang, Eric Y.; Maticka-Tyndale, Eleanor
- Source:
International Perspectives on Sexual & Reproductive Health. Jun2014, Vol. 40 Issue 2, p68-78. 11p. 5 Charts. - Source:
- Additional Information
- Subject Terms: HIV prevention; COMMUNITIES; CONCEPTUAL structures; CONFIDENCE intervals; STATISTICAL correlation; HEALTH promotion; SEXUAL health; MULTIVARIATE analysis; QUESTIONNAIRES; STATISTICAL sampling; SCALE analysis (Psychology); STATISTICS; TEENAGERS' conduct of life; ADOLESCENT health; TIME; SOCIAL support; STRUCTURAL equation modeling; CROSS-sectional method; DESCRIPTIVE statistics; ODDS ratio
- Subject Terms:
- Abstract: CONTEXT: Delaying sexual debut is an important HIV prevention strategy, yet few studies have examined associations between both community- and individual-level characteristics and sexual debut among youth in Sub- Saharan Africa. METHODS: Cross-sectional survey data collected from 8,183 youth aged 11–17 in 160 schools in Nyanza, Kenya, were used to examine the relationships between individual and community measures and the timing of sexual debut. Multilevel discrete-time hazard models were used to identify bivariate and multivariate associations. RESULTS: At the individual level, youth were more likely to have initiated sex (or had done so at an earlier age) if they had felt pressure to engage in sex from a greater number of sources (odds ratios, 1.3–1.8); perceived that they had a small or (among females) moderate chance, rather than no chance, of contracting HIV (1.2–1.3); or endorsed a greater number of HIV transmission myths (1.1 for both sexes). In addition, males with higher abstinence selfefficacy had a reduced risk of sexual debut (0.95). At the community level, males and females had a reduced risk of sexual debut if they lived in a community where AIDS deaths were publicly acknowledged (0.6–0.8) or the Primary School Action for Better Health program had been implemented (0.8–0.95); risk was also reduced among young men who lived in communities where HIV was discussed at a greater number of parent-teacher association meetings (0.9) or where abstinence was the primary AIDS prevention message conveyed to youth (0.9). CONCLUSION: Community-level variables are frequently associated with sexual debut and should be included in future research. [ABSTRACT FROM AUTHOR]
- Abstract: Contexto: Retrasar el debut sexual es una estrategia importante de prevención del VIH; sin embargo, son pocos los estudios que han examinado las asociaciones entre las características tanto a nivel de la comunidad como a nivel individual y el debut sexual de jóvenes en África subsahariana. Métodos: Mediante una encuesta transversal, se recolectaron datos de 8,183 jóvenes en edades de 11 a 17 años de 160 escuelas en Nyanza, Kenia. Estos datos se utilizaron para examinar las relaciones entre algunas medidas individuales y comunitarias con el momento del debut sexual. Se utilizaron modelos multinivel de análisis de riesgo en tiempo discreto para identificar las asociaciones bivariadas y multivariadas. Resultados: A nivel individual, los jóvenes tuvieron más probabilidad de haber iniciado su actividad sexual (o lo habían hecho a una edad más temprana) si habían sentido presión para tener relaciones sexuales a partir de un mayor número de fuentes (cocientes de probabilidad, 1.3–1,8); si habían percibido que tenían un riesgo pequeño o moderado (entre las mujeres) de contraer el VIH en lugar de ningún riesgo (1.2–1.3); o si estaban de acuerdo con un mayor número de mitos sobre la transmisión del VIH (1.1 para ambos sexos). Además, los hombres con un nivel más alto de autoeficacia en la abstinencia tuvieron un riesgo reducido de debut sexual (0.95). A nivel de la comunidad, tanto hombres como mujeres tuvieron un riesgo reducido de debut sexual si vivían en una comunidad en donde las muertes por SIDA eran reconocidas públicamente (0.6–0.8) o si el programa “Acción en la escuela primaria para una mejor salud” [Primary School Action for Better Health] había sido implementado (0.8–0.95); el riesgotambién se redujo en el caso de los hombres jóvenes que vivían en comunidades en donde el VIH era tema de conversación en un mayor número de reuniones de la asociación de padres y maestros (0.9), o donde la abstinencia era el primer mensaje de prevención del SIDA transmitido a los jóvenes (0.9). Conclusión: Las variables a nivel de la comunidad se asocian frecuentemente con el debut sexual y deberían incluirse en investigaciones futuras. [ABSTRACT FROM AUTHOR]
- Abstract: Contexte: Différer les premiers rapports sexuels constitue une importante stratégie de prévention du VIH. Peu d’études ont cependant examiné les associations entre les caractéristiques de niveau communautaire et individuel et le début de l’activité sexuelle parmi les jeunes d’Afrique subsaharienne. Méthodes: Les données d’enquêtes transversales collectées auprès de 8.183 jeunes âgés de 11 à 17 ans dans 160 écoles de Nyanza (Kenya) ont servi à l’examen des liens entre les mesures individuelles et communautaires et le moment des premiers rapports sexuels. Des modèles de risque à temps discret multiniveaux ont permis d’identifier les associations bi- et multivariées. Résultats: Au niveau individuel, les jeunes étaient plus susceptibles d’avoir déjà eu des rapports sexuels (dans cette tranche ou avant) s’ils en avaient ressenti la pression d’un plus grand nombre de sources (RC, 1,3–1,8), s’ils percevaient courir un risque faible ou (côté féminin) moyen, plutôt que nul, de contracter le VIH (1,2–1,3), ou s’ils souscrivaient à un plus grand nombre de mythes concernant la transmission du VIH (1,1 pour les deux sexes). De plus, les garçons ayant une auto-efficacité d’abstinence supérieure présentaient un moindre risque d’avoir déjà eu des rapports sexuels (0,95). Au niveau communautaire, les garçons et les filles présentaient un moindre risque de premiers rapports consommés s’ils vivaient dans une communauté où les décès imputables au sida étaient reconnus publiquement (0,6–0,8) ou dans laquelle le programme Primary School Action for Better Health avait été mis en oeuvre dans les écoles (0,8–0,95). Le risque était également moindre parmi les jeunes hommes vivant dans les communautés où le VIH était discuté à un plus grand nombre de réunions de l’association parents-enseignants (0,9) ou dans lesquelles l’abstinence était le principal message de prévention du sida communiqué aux jeunes (0,9). Conclusion: Les variables de niveau communautaire sont souvent associées au début de l’activité sexuelle et doivent être incluses dans la recherche à venir. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of International Perspectives on Sexual & Reproductive Health is the property of Guttmacher Institute, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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