Community Factors Shaping Early Age at First Sex among Adolescents in Burkina Faso, Ghana, Malawi, and Uganda

Rob Stephenson, Rob Stephenson, Calleen Simon, Catherine Finneran
plethora of research examining individual-level factors associated with early initiation of sexual act (5-10), i.e. the existing literature tends to focus on an individual's own characteristics (e.g. religion, ethnicity, and educational level) when seeking to determine risks of adverse sexual health outcomes. Relatively few analyses, however, have gone beyond such individual-level factors to explore how community-level factors may be associated with sexual behaviour, knowledge, and perceptions
more » ... e, and perceptions among young people (11-20). This paper examines such community-level, contextual influences on the early initiation of sexual behaviour among adolescents in Burkina Faso, Ghana, Malawi, and Uganda. A fuller understanding of how the context in which the youths live influences their sexual behaviour has the potential to inform both HIV and unintended pregnancy prevention programmes. Individual-level factors associated with early initiation of sexual act in a variety of contexts are relatively well-documented. At the individual level, males (21-25) are more likely to have initiated sexual activity compared to females, as are older youths (1,7,9,10,23,26,27) compared to younger youths. Married female youths have been shown to be more sexually active and less likely to use condoms compared to unmarried female youths but unmarried female youths tend to report having ABSTRACT Using data from the National Survey of Adolescents (2004), we examine the community-level factors associated with early age at first sex among adolescents 14-19 years old in four African countries. Regression models are fitted separately by sex for each country for an outcome measuring early age at first sex, with a focus on community-level factors as potential influences of age on sexual debut. The community-level factors associated with adolescents' sexual debut vary widely by both country and gender. Community influences that emerge as risk or protective factors of early sexual debut include community levels of adolescent marriage, wealth, religious group affiliation, sex education, parental monitoring, reproductive health knowledge, media exposure, membership in adolescent social group, and use of alcohol. Results indicate the importance of context-specific understanding of adolescents' sexual behaviour and suggest how elements of place should be harnessed in the development of effective HIV and sexual health interventions.