Prevalence of Sexual Experience and Initiation of Sexual Intercourse Among Adolescents, Rakai District, Uganda, 1994-2011

John S. Santelli, Xiaoyu Song, Inge K. Holden, Kristin Wunder, Xiaobo Zhong, Ying Wei, Sanyukta Mathur, Tom Lutalo, Fred Nalugoda, Ronald H Gray, David M. Serwadda

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Abstract

Purpose The purpose of the study was to identify risk factors and time trends for sexual experience and sexual debut in rural Uganda. Methods Using population-based, longitudinal data from 15- to 19-year olds in Rakai, Uganda, we examined temporal trends in the prevalence of sexual experience and potential risk factors for sexual experience (n = 31,517 person-round observations) using logistic regression. We then identified factors associated with initiation of sex between survey rounds, using Poisson regression to estimate incidence rate ratios (IRR; n = 5,126 person-year observations). Results Sexual experience was more common among adolescent women than men. The prevalence of sexual experience rose for most age-gender groups after 1994 and then declined after 2002. Factors associated with higher prevalence of sexual experience (without adjustment for other factors) included age, not enrolled in school, orphanhood, lower socioeconomic status, and drinking alcohol in the past 30 days; similar factors were associated with initiation of sex. Factors independently associated with initiation of sex included older age, nonenrollment in school (IRR = 1.7 for women and 1.8 for men), alcohol use (IRR = 1.3 for women and men), and being a double orphan among men (IRR = 1.2). Sexual experience began to decline around 2000, whereas increases in school enrollment began as early as 1994 and declines in orphanhood occurred after 2004 (as antiretroviral therapy became available). Conclusions Sexual experience among youth in Rakai was associated with social factors particularly school enrollment. Changes in these social factors also appear to influence change over time in sexual experience.

Original languageEnglish (US)
Pages (from-to)496-505
Number of pages10
JournalJournal of Adolescent Health
Volume57
Issue number5
DOIs
Publication statusPublished - Nov 1 2015

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Keywords

  • Adolescent
  • Initiation of sexual intercourse
  • Orphanhood
  • Risk factors
  • School enrollment
  • Sexual behavior
  • Social determinants
  • Uganda

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health
  • Public Health, Environmental and Occupational Health

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