Socioeconomic variations in risky sexual behavior among adolescents in 14 sub-Saharan Africa countries who report ever having had sex

Abstract

Background Equity is a guiding principle of the Global Strategy for Women, Children and Adolescents’ Health (2016–2030) aimed at improving adolescent health and responding more effectively to adolescents’ needs. We investigated the socioeconomic differentials in having multiple sexual partners and condom use among unmarried adolescents who reported ever having had sex aged 15–19 years in 14 sub-Saharan countries. Methods Using the most recent publicly available Demographic and Health Surveys conducted between 2011 and 2018, we calculated survey- and sex-specific proportions of two or more partners and condomless sex, both overall and by selected socioeconomic characteristics and we fitted logistic regression models to estimate the survey- and sex-specific adjusted odds ratios. The pooled adjusted odds ratios were estimated using multilevel logistic regression. Results In most countries, higher percentages of male adolescents than female adolescents reported having more than one partner in the last 12 months. Conversely, a lower percentage of young male reported having condomless sex when compared to young female: from 19.8% in Gabon to 84.5% in Sierra Leone among male adolescents and from 32.6% in Gabon to 93.2% in Sierra Leone among female adolescents. In the multilevel analyses, condomless sex was associated with place of residence, wealth and schooling for both female and male adolescents, while among male adolescents multiple partnerships was significantly associated with place of residence. Conclusion Our findings on disparities in condomless sex associated with socioeconomic characteristics might reflect constraint choice and decision making. Results also suggest the need for educational programming and services and better access to barrier methods.

Monitoring socioeconomic inequalities across HIV knowledge, attitudes, behaviours and prevention in 18 sub-Saharan African countries

“…Our results allow the comparison of inequalities across various HIV-related indicators. Overall, we did not observe large socioeconomic disparities in reporting having multiple sexual partners, consistently with recent results [27]. Large absolute and relative inequalities, overall, remain regarding lack of knowledge and stigmatizing attitudes toward PLHIV, and this may undermine HIV prevention, care and treatment [28].…”

Sexual Risk Behaviour Among School-going Adolescents in Sierra Leone and Liberia. A Secondary Analysis of the 2017 Global School Health Survey

“…In addition, close to half (48.7%) did not use a condom in their last sex, higher prevalence seen among Sierra Leoneans (58.6%) than Liberians (39.8%), and our ndings for both countries higher than the prevalence reported in studies conducted in Mozambique, Ghana and Ethiopia [11,31,34]. Our study's high prevalence of risky sexual behaviour is consistent with previous community-based studies conducted among adolescents and youths in both countries [7][8][9]29] and similar studies in other African countries [1,4,11,31]. The higher prevalence of risky sexual behaviour in our study may be attributed to increased trauma and economic hardships, changes in parenting styles, breakdown in the social fabric in our society and broken homes experienced by young people, which is due to civil war and lately the Ebola outbreak in these two countries [37][38][39].…”

“…Another study among Liberian youths found that 34% of those who were sexually active did so before the age of 15 (early sexual debut), and 21% of those who were sexually active had several sexual partners, and 26% of sexually active teenagers had never used a condom, 11% had gotten pregnant or helped someone become pregnant one or more times, and 11% had been sexually assaulted [8].A recent study reported that majority of sexually active Sierra Leone youths had condomless sex in their last sexual encounter [9]. A United Nations Population Fund report on the impact of Ebola on adolescent pregnancy in Sierra Leone found that close to half had their rst pregnancy during the Ebola outbreak period and close to a third had used ever use of any kind of family planning [10].…”

The Occurrence of Sexual Risk Behaviors and Its Association With Psychological Well-Being Among Kenyan Adolescents

“…The finding of this study indicates that lower education attainment among adolescents who experienced SRB compared with those who had not experienced SRB is corroborated by findings from other adolescent health studies within the Kenyan context (89,90). It is also reported that while most young adolescents (i.e., those who are 0-14 years old) have not initiated sexual intercourse, some are already exploring intimate relationships without adequate information to make informed decisions about their sexual and reproductive health (91).…”