Factors Associated with Sexual Abstinence among Adolescents in Four Sub-Saharan African Countries
Abstract
Drawing on nationally representative data collected from Burkinabé, Ghanaian, Malawian, and Ugandan adolescents, this study examines differences among four groups of never married, 15-19 year olds: primary abstainers (sexually inexperienced), secondary abstainers (last sex more than 12 months prior to the survey), recent abstainers (sexually active in last year but not in the last 3 months), and sexually active (had sexual intercourse in the last 3 months). The percentage of primary abstinent adolescents ranged from 42% (Malawian males) to 85% (Ghanaian males). In general, a greater proportion of females than males were primary abstainers. Primary abstainers were younger than sexually experienced adolescents. Current involvement in a romantic relationship was a significant predictor of sexual status with primary abstainers being the least likely to be romantically involved. Overall, findings suggest that adolescents' gender, prior sexual experiences and contextual circumstances, such as romantic partnerships, should be considered when designing abstinence promotion programs.
Keywords: Adolescents, Sexual abstinence, Sexual activity, Sub-Saharan Africa
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Kelly GF. Sexuality Today: The Human Perspective. 7th ed. New York, NY: McGraw-Hill; 2001.
Neema S, Musisi N, Kibombo R. Adolescent Sexual and Reproductive Health in Uganda: A Synthesis of Research Evidence. New York & Washington, DC: The Alan Guttmacher Institute; 2004.
Awusabo-Asare K, Abane AM, Kumi-Kyereme A. Adolescent Sexual and Reproductive Health in Ghana: A Synthesis of Research Evidence. New York: The Alan Guttmacher Institute; 2004.
Brown L, Karim AM, Hutchinson P, Agha S, MacIntyre K, Magnani R. Church and clubs: Influence on secondary abstinence in KwaZulu-Natal, South Africa - 1999-2001. Paper presented at the Population Association of America Annual Meeting April 1-3, 2004; Boston, Massachusetts.
Davis KR, Weller SC. The effectiveness of condoms in reducing in reducing heterosexual transmission of HIV. Fam Plann Perspect 1999;31:272-279.
Lindberg LD, Ku L, Sonenstein F. Adolescents' reports of reproductive health education, 1988 and 1995. Fam Plann Perspect 2000;32:220-226.
Nagy S, Watts GFD, Nagy C. Coital status and perceptions about sexual abstinence refusal skills. J Adolesc Health 2002;31:79-
Starkman N, Rajani N. The case for comprehensive sex education. AIDS Patient Care STDs 2002;16:313-318.
Blinn-Pike L. Why abstinent adolescents report they have not had sex: Understanding sexually resilient youth. Fam Relat 1999;48:295-301.
Wiley D. The ethics of abstinence-only and abstinence-plus sexuality education. J Sch Health 2002;72:164-167.
The President's Emergency Plan for AIDS Relief. The Power of Partnerships: Third Annual Report to Congress on PEPFAR (2007). 2007 [cited 2007 March 26]; Available from: http://www.pepfar. gov/documents/organization/81019.pdf
The President's Emergency Plan for AIDS Relief. ABC Guidance #1 For United States Government In-Country Staff and
Implementing Partners Applying the ABC Approach To Preventing Sexually-Transmitted HIV Infections Within The President's Emergency Plan for AIDS Relief. 2006 [cited 2007 February 14]; Available from: http://www.state.gov/documents/organization/57241.pdf
Loewenson PR, Ireland M, Resnick MD. Primary and secondary sexual abstinence in high school students. J Adolesc Health 2004;34:209-215.
Lammers C, Ireland M, Resnick M, Blum R. Influences on adolescents' decision to postpone onset of sexual intercourse: A survival analysis of virginity among youths aged 13 to 18 years. J Adolesc Health 2000;26:42-48.
UNAIDS/WHO. UNAIDS/WHO Global HIV/AIDS Online Database 2007 [cited 2007 August 16]; Available from: http://www.who.int/globalatlas/dataQuery/default.asp
Alan Guttmacher Institute. Adolescents in Ghana: Sexual and reproductive health. Research in Brief. 2004 Series, No. 1; 2004. [cited August 16, 2007]; Available from: http://www.guttmacher.org/sections/sti.php.
Alan Guttmacher Institute. Adolescents in Burkina Faso: Sexual and reproductive health. Research in Brief. 2004 Series, No. 3; 2004. [cited August 16, 2007]; Available from: http://www.guttmacher. org/sections/sti.php.
Alan Guttmacher Institute. Adolescents in Malawi: Sexual and reproductive health. Research in Brief, 2005 Series No. 3; 2005. [cited August 16, 2007]; Available from: http://www.guttmacher.org/sections/sti.php.
Alan Guttmacher Institute. Adolescents in Uganda: Sexual and reproductive health. Research in Brief. 2004 Series, No. 2; 2005. [cited August 16, 2007]; Available from: http://www.guttmacher.org/sections/sti.php.
Whitbeck LB, Yoder KA, Hoyt DR, Conger RD. Early adolescent sexual activity: A developmental study. J Marriage Fam 1999;61(4):934-946.
Zulu EM, Dodoo FN-A, Ezeh AC. Sexual risk-taking in the slums of Nairobi, Kenya, 1993-98. Popul Stud (Camb). 2002;56(3):311-323.
Neema S, Ahmed FH, Kibombo R, Bankole A. Adolescent Sexual and Reproductive Health in Uganda: Results from the 2004 National Survey of Adolescents. New York: The Alan Guttmacher Institute; 2006.
Awusabo-Asare K, Biddlecom A, Kumi-Kyereme A, Patterson K. Adolescent Sexual and Reproductive Health in Ghana:Results from the 2004 National Survey of Adolescents. New York: The Alan Guttmacher Institute; 2006.
Guiella G, Woog V. Santé sexuelle et reproductive des adolescents au Burkina Faso: Résultats d'une enquête nationale en 2004. New York: The Alan Guttmacher Institute; 2006.
Munthali A, Zulu EM, Madise N, Moore AM, Konyani S, Kaphuka J, et al. Adolescent Sexual and Reproductive Health in Malawi: Results from the 2004 National Survey of Adolescents. New York: The Alan Guttmacher Institute; 2006.
Gupta N, Mahy M. Sexual initiation among adoles-cent girls and boys: Trends and differentials in sub-Saharan Africa. Arch Sex Behav 2003;32 (1):41-53.
Flewelling RL, Bauman KE. Family structure as a predictor of initial substance use and sexual intercourse in early adolescence.
Journal of Marriage and the Family 1990;52(1):171-181.
SPSS. SPSS for Windows (Version 14.0.1). Chicago: SPSS Inc. 2005.
Amuyunzu-Nyamongo M, Biddlecom AE, Ouedraogo C, Woog V. Qualitative Evidence of Adolescents' Views of Sexual and Reproductive Health in sub-Saharan Africa. New York: The Alan Guttmacher Institute; 2005.
Munthali AC, Chimbiri A, Zulu EM. Adolescent Sexual and Reproductive Health in Malawi: A Synthesis of Research Evidence. New York: The Alan Guttmacher Institute; 2004.
Muula AS. Male circumcision to prevent HIV transmission and acquisition: What else do we need to know? AIDS Behav 2007;11(3):357-363.
Paradise JE, Cote J, Minsky S, Lourenco A, Howland J. Personal values and sexual decision-making among virginal and sexually experienced urban adolescent girls. J Adolesc Health 2001;28(5): 404-409.
Rossi AS. The impact of family structure and social change on adolescent sexual behavior. Child Youth Serv Rev 1997;19:369-
De Gaston JF, Weed S, Jensen L. Understanding gender differences in adolescent sexuality. Adolescence 1996;31(121):217-231.
UNAIDS, UNFPA, UNIFEM. Women: Meeting the Challenges of HIV/AIDS 2003 [cited January 19, 2007]; Available from: http://www.unifem. org/attachments/products/WomenAids Brochure_2003_eng.pdf.
Bauni EK, Jarabi BO. Family planning and sexual behavior in the era of HIV/AIDS: The case of Nakuru District, Kenya. Stud Fam Plann 2000; 31:69-80.
Kiragu K, Zabin LS. The correlates of premarital sexual activity among school-age adolescents in Kenya. Int Fam Plan Perspect 1993;19:92-97, 109.
Taylor M, Dlamini SB, Kagoro H, Jinabhai CC, de Vries H. Understanding high school students' risk behaviors to help reduce the HIV/AIDS epidemic in KwaZulu-Natal, South Africa. J Sch Health 2003;73(3):97-100.
Wilson D, Manual A, Lavelle S. Psychological predictors of condom use to prevent HIV transmission among Zimbabwean students. Int J Psychol 1991;26:705-721.
Ahlberg BM. Is there a distinct African sexuality? A critical response to Caldwell. Africa 1994;64(2): 220-242.
Gorgen R, Maier B, Diesfeld HJ. Problems related to schoolgirl pregnancies in Burkina Faso. Stud Fam Plann 1993;24(5):283-
Blum RW. Uganda AIDS Prevention: A,B,C and Politics. J Adolesc Health 2004;34:428_432. 43.
Kaaya SF, Flisher AJ, Mbwambo JK, Schaalma H, Aaro LE, Klepp K. A review of studies of sexual behaviour of school students in sub-Saharan Africa. Scand J Public Health 2002;30:148-160.
Gilbert L, Walker L. Treading the path of least resistance: HIV/AIDS and social inequalities - South African case study. Soc Sci
Med 2002;54:1093_1110.
Meyer-Weitz A, Reddy P, Weijts W, van den Borne B, Kok G. The socio-cultural contexts of sexually transmitted diseases in South Africa: implications for health education programmes. AIDS Care 1998;10 Suppl 1:S39-55.
Izugbara CO. Representations of Sexual Abstinence Among Rural Nigerian Adolescent Males. Sex Res Social Policy 2007;4(2):74-87.
Ott MA, Pfeiffer EJ, Fortenberry JD. Perceptions of sexual abstinence among high-risk early and middle adolescents. J Adolesc Health 2006;39:192-198.
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