Abstract
Objectives: To describe recent trends in age at first sex in African countries, identifying and making due allowances for a variety of common reporting errors.
Methods: Demographic and Health Surveys (DHS) data from six African countries conducting three or more surveys since 1985 were analysed using survival analysis techniques, combining information on virginity status and retrospective reporting of age at first sex. Hazard analysis was used to separate the effects of reporting error and compositional change and to estimate true changes in sexual debut over time. A multistate life table analysis incorporating transition to first marriage allowed cohorts to be classified according to person years spent as virgins, as sexually active unmarried, and married.
Results: Intersurvey comparisons generally suggested a slow secular rise in age at first sex. However, tracing birth cohorts between surveys revealed inconsistencies—median ages reported by female members of a birth cohort in their teens were generally higher than those reported when they reached their twenties, even when allowing for residence and education changes—probably a result of young, sexually active women denying they had ever had sex. Male birth cohorts tend to display the opposite kind of bias.
Conclusions: Uganda, Kenya, and Ghana have experienced a more pronounced and unambiguous decline in premarital sexual activity than Tanzania, Zambia, and Zimbabwe, with statistically significant increases in age at first sex. In addition, Uganda has maintained a very short interval between onset of sexual activity and marriage for both sexes.
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Selected References
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- Agyei W. K., Biritwum R. B., Ashitey A. G., Hill R. B. Sexual behaviour and contraception among unmarried adolescents and young adults in Greater Accra and Eastern regions of Ghana. J Biosoc Sci. 2000 Oct;32(4):495–512. doi: 10.1017/s0021932000004958. [DOI] [PubMed] [Google Scholar]
- Asamoah-Odei Emil, Garcia Calleja Jesus M., Boerma J. Ties. HIV prevalence and trends in sub-Saharan Africa: no decline and large subregional differences. Lancet. 2004 Jul 3;364(9428):35–40. doi: 10.1016/S0140-6736(04)16587-2. [DOI] [PubMed] [Google Scholar]
- Asiimwe-Okiror G., Opio A. A., Musinguzi J., Madraa E., Tembo G., Caraël M. Change in sexual behaviour and decline in HIV infection among young pregnant women in urban Uganda. AIDS. 1997 Nov 15;11(14):1757–1763. doi: 10.1097/00002030-199714000-00013. [DOI] [PubMed] [Google Scholar]
- Blanc A. K., Rutenberg N. Coitus and contraception: the utility of data on sexual intercourse for family planning programs. Stud Fam Plann. 1991 May-Jun;22(3):162–176. [PubMed] [Google Scholar]
- Blanc A. K., Way A. A. Sexual behavior and contraceptive knowledge and use among adolescents in developing countries. Stud Fam Plann. 1998 Jun;29(2):106–116. [PubMed] [Google Scholar]
- Bunnell R. E., Yanpaisarn S., Kilmarx P. H., Rhodes P. H., Limpakarnjanarat K., Srismith R., Mastro T. D., St Louis M. E. HIV-1 seroprevalence among childbearing women in northern Thailand: monitoring a rapidly evolving epidemic. AIDS. 1999 Mar 11;13(4):509–515. doi: 10.1097/00002030-199903110-00010. [DOI] [PubMed] [Google Scholar]
- Kilian A. H., Gregson S., Ndyanabangi B., Walusaga K., Kipp W., Sahlmüller G., Garnett G. P., Asiimwe-Okiror G., Kabagambe G., Weis P. Reductions in risk behaviour provide the most consistent explanation for declining HIV-1 prevalence in Uganda. AIDS. 1999 Feb 25;13(3):391–398. doi: 10.1097/00002030-199902250-00012. [DOI] [PubMed] [Google Scholar]
- Meekers D., Ahmed G. Contemporary patterns of adolescent sexuality in urban Botswana. J Biosoc Sci. 2000 Oct;32(4):467–485. doi: 10.1017/s0021932000004673. [DOI] [PubMed] [Google Scholar]
- Meekers D. Immaculate conceptions in sub-saharan Africa: exploratory analysis of inconsistencies in the timing of first sexual intercourse and first birth. Soc Biol. 1995 Fall-Winter;42(3-4):151–161. doi: 10.1080/19485565.1995.9988897. [DOI] [PubMed] [Google Scholar]
- Stoneburner Rand L., Low-Beer Daniel. Population-level HIV declines and behavioral risk avoidance in Uganda. Science. 2004 Apr 30;304(5671):714–718. doi: 10.1126/science.1093166. [DOI] [PubMed] [Google Scholar]
- Stover J. Revising the proximate determinants of fertility framework: what have we learned in the past 20 years? Stud Fam Plann. 1998 Sep;29(3):255–267. [PubMed] [Google Scholar]
- Wielandt H., Boldsen J. Age at first intercourse. J Biosoc Sci. 1989 Apr;21(2):169–177. doi: 10.1017/s0021932000017867. [DOI] [PubMed] [Google Scholar]