Socioecological analysis of determinants of early adolescent sexuality in Benin: a qualitative study

Introduction: early adolescent sexuality is associated with an increase in risky sexual behaviour, unwanted pregnancies, and the occurrence of sexually transmitted infections. However, despite the efforts of governments and their partners, the implementation and effectiveness of appropriate and adapted services to improve adolescent sexual and reproductive health are lagging. Therefore, this study aimed to document determinants of early adolescent sexuality in the central district of Tchaourou in Benin based on a socio-ecological approach. Methods: an explorative and descriptive qualitative study was conducted using focus groups and individual interviews based on the socio-ecological model. Participants included adolescents, parents, teachers, and community leaders in Tchaourou. Results: the number of participants in each focus group was 8 (32). There were 20 girls and 12 boys aged 10-19 years, of whom 16 were students (7 females and nine males) and 16 were apprentice dressmakers and hairdressers. In addition, five participants attended individual interviews (two community leaders, one religious' leader, one teacher and one parent). Four themes were identified that influence early sexuality among adolescents and grouped into individual determinants related to knowledge about early sexuality; interpersonal determinants related to adolescents' function, including the influence of family and peers; community and organizational determinants related to where harmful sociocultural norms; political determinants comprising the disadvantaged socioeconomic status of the communities where adolescents live. Conclusion: many factors at multiple social levels influence early adolescent sexuality in the commune of Tchaourou in Benin. Therefore, interventions directed at these various levels are needed urgently.

Factors associated with risky sexual behaviour among clients undertaking HIV testing and counselling services at a secondary referral hospital Lagos, Nigeria

Background: This study determined the prevalence of risky sexual behaviour and its associated factors among clients who accessed HIV counselling and testing services at a secondary referral hospital in Lagos, Nigeria. Methods: A retrospective review of clients' records was conducted. The Client Intake Form of people who accessed HIV counselling and testing services at Mainland Hospital in Lagos, Nigeria between July 1, 2016, and December 31, 2017, were reviewed. Multivariate analysis was conducted to determine the associated factors of risky sexual behaviour. Results: A total of 4273 client's records were analyzed, 3884 (90.9%) reported having sex before HIV counselling and testing (HCT). The prevalence of risky sexual behaviour among clients was 41.5%. More males and HIV positive clients had unprotected sex with a casual partner three months before HIV counselling and testing (p < 0.05). More singles than the married had unprotected sex with casual partners (p <0.001) and multiple sexual partners (p =0.002). The prevalence of risky sexual behaviour reduced with advancing age. Being single and having an HIV infection were associated with risky sexual behaviour in this study. Conclusion: Age, marital status and HIV status were associated factors of risky sexual behaviour

Sexual coercion at sexual debut and associated factors among young females in rural areas of Boset District, Eastern Ethiopia: a mixed method study

Objectives: Assess the prevalence and associated factors of sexual coercion at sexual debut among young females in rural areas of Boset district, Oromia Region, Eastern Ethiopia. Methods: Cross-sectional community-based study design was conducted using both qualitative and quantitative data collection methods. A sample of 632 young females aged 10-24 years was taken from six rural Kebeles by systematic random sampling for quantitative and data were collected using a pre-tested structured questionnaire. The collected data was analyzed using SPSS version 23. Principally Binary Logistic regression model was fitted. Moreover, eight focus group discussions targeting different groups were held and analyzed thematically. Results: The prevalence of sexual coercion at sexual debut was 36.5% (95%CI: 34.6%- 38.4%) among sexually active respondents. Married young female (AOR, 0.71; 95%CI: 0.42, 0.81), living away from their parents (AOR, 5.07; 95%CI: 1.07,24.01), age group of 15- 19 years (AOR, 0.19; 95%CI: 0. 06, 0.54), alcohol consumption (AOR, 2.44; 95%CI: 1.17, 5.08) and Khat chewing (AOR, 8.30; 95%CI: 1.89, 36.38) were factors predicting the likelihood of having sexual coercion at sexual debut. Conclusion: Sexual coercion at sexual debut is a major public health problem among young females in the study community. The emerging program interventions need to take this problem into consideration

Sexual Experiences of Infertile Women: A Qualitative Study

It is suggested that stress related to infertility causes marriage conflicts and decreases in the frequency of sexual intercourse. Aim: This study aimed to explore the experiences of the sexuality of infertile women. Patients and Methods: A phenomenological design was used in this study. We conducted face-to-face, semistructured, in-depth interviews with 11 infertile women. The interviews were audio-recorded, and a thematic approach was used to assess the data. Results: The average age of the women was 33.05 ± 3.40 years, and their age of first sexual intercourse was 23.0 ± 2.8 years and all of them are legally married. The durations of experiencing the problem of infertility were as follows; 3-5 years in 33%, 6-10 years in 27%, and 11 years and above in 38%. According to interpretative phenomenological analysis, two main themes emerge. Two main themes were determined: Perception of Sexuality and Sexual Problems. The results show that infertile women have a higher risk for sexual dysfunction than fertile women. Conclusion: These findings suggest that the diagnosis of infertility is an important factor in assessing the differences in the sexual satisfaction of women. In infertility counseling, health professionals must explain the gender differences. Also, infertile couples must encourage to share each other's feelings and this may help couples to cope with the communication problems they may experience.

Parental mediation of adolescent media use and demographic factors as predictors of Kenyan high school students' exposure to sexual content in television

Research in Western nations suggests that parents' involvement in their children's media use can make a difference in how adolescents select; process and respond to sexual television messages. Little or no published research has investigated this issue in sub-Saharan Africa; even though adolescents and young adults remain among the groups at highest risk for HIV transmission. This study investigated the relationship between Kenyan adolescents' level of exposure to sexual television content and their parents' mediation of their television use. A cluster sample of 427 Nairobi public high school students was surveyed regarding parental mediation of their media use and their intake of sexual television content. Co-viewing with opposite sex friends was associated with higher intake of sexual TV content. This relationship was stronger among boarding school students than among day school students. Parental mediation and co-viewing variables predicted three times as much variance among boarding than among day school students

Disabling sexualities: exploring the impact of the intersection of HIV, disability and gender on the sexualities of women in Zambia

Background: Women with a disability are often characterised as a homogenous social group consigned to a cultural stereotype with assumptions of dependence; asexuality and gender neutrality. Furthermore; there is a void of research about the experience of people with disabilities following diagnosis with HIV. Little is known about how HIV diagnosis intersects with disability and gender and how it shapes the experiences of intimacy and gender roles of those negotiating this intersection. Objective: The objective of this study was to explore how HIV; disability and gender shape the perspectives of HIV-positive women with disabilities regarding intimacy and gender roles. Methods: Twelve women in Lusaka; Zambia were recruited for in-depth semi-structured interviews to explore their experiences of having a disability and living with HIV. Interviews were conducted in eng; Bemba; Nyanja and Zambian sign language. Descriptive and thematic analyses were conducted; followed by in-depth gender analyses of data relating to intimacy and gender roles. Results: Data analysis led to the identification of two main themes: the impact of HIV diagnosis on intimate relationships amongst the participants; and the disruption and renegotiation of gender roles. These findings demonstrate the loss of intimacy (often decided by the participants) and changes in women's gender roles (infrequently decided by them). Conclusions: The narrow approaches to sexuality and HIV that reinforce misconceptions and stereotypes need to change. In their place should be inclusive and disability and sex-positive approaches that are informed by the diverse realities of women's lives. Further research is needed to develop stronger evidence of the impact of HIV and disability on gender roles and sexuality

Mothers Perception of Sexuality Education for Children

Background:Sexuality education is the process of acquiring information and forming attitudes and beliefs about sex; sexual identity; relationships and intimacy. It develops young people's skills so that they make informed choices about their behaviour; and feel confident and competent about acting on these choices. It also equips children to face developmental challenges and empowers them against the ills of abuse; exploitation; unwanted pregnancies amongst others. Mothers who are the primary caregivers should be well informed about sexuality issues. The objective of the study is to determine mothers' perception of sexuality education in children; in PortHarcourt. Methodology:A structured; anonymous and selfadministered questionnaire; used as instrument for data collection; was distributed amongst a convenient sample of women attending a Christian women's convention in Port Harcourt. Results:One hundred and fifty eight women participated in the study. Most of them were married (80.4); and belonged to the 30-49 years age bracket. Seventy one (44.9) of the respondents had tertiary education. Over 80agreed that children needed sexuality education but only 15 women (9.5) had a good knowledge of the concept of sexuality education. One hundred and eleven (70.2) believed it was the responsibility of both parents to educate their children and over 70acknowledged that the home was the best place for such education. 64 (40.5) believed that 6-10 years was the ideal age for starting sex education while 49thought that the ideal age was 11-15 years. 65of respondents discussed sexuality issues with their children at least occasionally; the content mostly involved description of body parts and reproductive organs. The average age of menarche amongst respondents was 14.0. One hundred (63) of the women had prior knowledge of menstruation before menarche. About half of them had received information from their mothers. Conclusion:The study highlights the need for enlightenment of women on sexuality education to enable them empower their children against the ills of child abuse

HIV/AIDS Shaping People's Livelihoods Promotion Processes: The Case of a Village Highly Affected by HIV/AIDS in Bukoba Rural District; Tanzania

Whereas HIV/AIDS has been largely explained and addressed based on the biomedical and African permissive sexuality thesis perspectives; they are not exhaustive. This paper argues that a meaningful life discourse complements the existing approaches to improve our understanding of the reality of HIV/AIDS. Both of the older discourses have resulted into different practices in the livelihoods promotion processes of the people. The paper tries to explain these practices and how have they influenced people's livelihoods promotion processes. The study is conducted in a highly HIV/AIDS affected area; using the life stories; which are analysed through content analysis. The results indicate that there are different practices according to the different discourses. The article concludes by arguing that looking at the practices and their intentions; some people have been shaped to promote HIV/AIDS; others to suppress it; others to alleviate it; and others to collaborate the more in general community livelihoods promotion processes. Key words: HIV/AIDS discourse; social arena; strategic actors; strategic rationalities; coping mechanisms; adaptive mechanisms; organising practices

Sexuality and health: a study of Tanzanian men's experiences of living with HIV/AIDS

The aim of this study was to explore Tanzanian men's experiences regarding their health and sex life after they had been diagnosed with HIV. In-depth interviews were performed with a purposive sample of ten men living in an urban area in Tanzania and who had been HIV positive for more than one year. A phenomenological-hermeneutic approach was used for analyzing the transcribed interviews. Three themes emerged from the texts; "awareness of HIV infection", "perceived and ideal health", and "sex life a source of happiness and caring". Living with HIV meant profound adjustments to daily life activities for the participants. HIV forced them to learn new ways of having sexual intercourse and new ways of acting as a man. The meaning of being a "real man" had changed from being a man with great sexual prowess to being a "caring man" within one relationship. (Afr Reprod Health 2008; 12[1]:35-46)

The Youths' Perceptions of Sexuality in the Limpopo Province of South Africa

This study was a qualitative; exploratory and descriptive study; conducted in the Vhembe District Municipality of the Limpopo Province in four selected villages. The purpose of the study was to explore and describe the views of young people regarding sexuality. Data were collected from October 2004 to January 2005 using focus group discussions; key-informant interviews; semi-structured interviews and observation. Young people's views about sexuality were centred around heterosexual sexual intercourse and the prevention of sexually transmitted infections (STIs); prevention of the Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS); use of contraceptives; performance of sex; activities that take place during intercourse for example touching; kissing and penetration by the man's penis; making babies and use of condoms

Sexuality; Contraception and Unintended Pregnancy among Female Student Nurses in Calabar; Nigeria

Background - There has been increased concern on human sexuality; especially with respect to contraception and the control of sexually transmissible infections. There is need to identify the sociodemographic characteristics that influence sexual behaviour and contraceptive use among young women. Methods - A descriptive cross sectional study that focused on the socio-demographic characteristics; sexuality; knowledge and use of modern contraceptive technology as well as interventions taken in the event of inadvertent pregnancy was conducted. A structured; close- ended questionnaire was randomly administered to 195 female nursing students with 60; 65 and 70 of them in their first; second and third year respectively. Results - Majority (76.7) of the students were in the age bracket of 20 - 24years. While 65.6of them were sexually active; only 54.9had knowledge of family planning. Condom was the commonest contraceptive used (37.4) and the main reasons were that of effectiveness (31.8) and safety (30.3). There was a significant relationship between respondents with multiple sexual partners and incidence of unwanted pregnancies (p=0.003). The majority (51.2) of those with unwanted pregnancies resorted to induced abortion

Comportement sexuel des etudiants de l'universite de Bangui (Centrafrique)

Encouraging re s p o n s i ble sexual behavior has become an important issue in recent ye a rs mainly due to the world-wide human immu n o d e fi c i e n cy virus (HIV) epidemic and to the high number of unwanted pregnancies that often end in highrisk abortions. Young people and in particular students in higher education are high-risk groups for both unwanted preg nancyand HIV. The purpose of this report is to describe the findings of a month-long survey conducted among students at the University of Bangui (UB) in 1998-1999. Individual students we re asked to give immediate responses to semi-open questions. The Chitest was used to assess corre l ation between a number of vari ables. A total of 422 UB students including 218 males (51.7) and 204females (48.3) were included in the survey. Mean age was 24.9 years for females and 26.1 years for males. Over half of the students of both sexes reported having their first sexual relation between the ages of 15 and 19 years. Males were more satisfied by their fi rst ex p e rience than females. The percent of married students (male or female) was 5.9. Most students (62.1) had at least 2 sex partners and 58.3had at least one child. The preferred contraceptive method was condom use for males and the Ogino technique for females. The percent of female students expressing fear of HIV infection was 27.4. The results of this study show that information and education campaigns are needed to encourage UB students to practice sexual behavior to avoid both unwanted pregnancies and sexually transmitted diseases such as HIV infection

Sexualite et planning familial chez l'adolescente en milieu scolaire

Une etude prospective de 300 adolescentes portant sur la sexualite et le planning familial chez l'adolescente; est colligee au College Moderne de Jeunes Filles de Yopougon du 1~ Mars 2004 au 30 Mai 2004. Dans notre travail; l'age moyen des adolescentes est de 15;6 ans et celui des menarches 12;9 ans. Les rapports sexuels surviennent precocement avec un age moyen de 14;7 ans dont 77;5 pour cent n'avaient pas utilise de contraception avant le premier rapport. Ceci ayant pour consequence la survenue de grossesse dont 69;2 pour cent ont abouti a une IVG; les raisons evoquees etaient dominees par leo celibat (84;6 pour cent) et la pression familiale (53;8 pour cent). Les adolescentes ont ete informees dans 94;7 pour cent pour le condom et 66 pour cent pour les autres methodes contraceptives; 98;7 pour cent sur la sexualite et les IST et 99 pour cent sur le VIH/SIDA. La source d'information predominante est representee par les enseignants: 84;8pour cent pour la sexualite et les IST; 83;2 pour cent pour le VIH/SIDA et 64;5 pour cent pour le planning familial. Les adolescentes de parents separes avaient plus de rapport sexuel (41 pour cent). La religion et l'argent de poche ne semblent pas exercer une influence sur la survenue de rapports sexuels. Plusieurs suggestions ont ete faites a savoir l'information; l'education; la communication sur la sexualite et le planning familial. Elles ont propose l'implication des agents de sante et l'amelioration de la communication parents enfants

Sexual networks in Uganda: Casual and Commercial sex in a trading town

"A longitudinal study of the sexual behavior of high-risk men and women living in a trading town on the trans-Africa highway showed that distinct sexual networks operated within the town. Forty-eight prostitutes kept daily records for 6 months of all their sexual contacts including the occupation and place of residence of each client and the price paid. Details of 4573 sexual contacts of the women were recorded. Three classes of women were identified: (1) 20 ""high-class' women who charged a mean price of over US$4/- per contact. The majority of their clients were from large urban areas of Uganda (55) or neighbouring countries (32) - 70were truck-drivers or their mates; (2) 18 ""low-class' women; charging an average of US$0.4 per contanct; who were unskilled casual workers (58); (3) 10 women fell into an intermediate category in terms of price and the residence of their clients. Thirty-eight male potential clients were recruited in low-costs bars where some of the women worked. They provided similar details of their daily sexual contacts. All were resident in the toown and 22 had occupations which were classified as unskilled. Of the 1621 sexual contacts recorded by the men 25were with new partnets."

L'adolescence face a la sexualite

La sexualite occupe une place centrale a l'adolescence. Ni enfant; ni adulte; l'adolescent voit son corps se transformer; il ressent de nouveaux besoins et de desirs. La maturite des organes genitaux; acquise a la puberte et leur fonctionnement marque par la premiere ejaculation; les premieres regles ont un impact tres important. Il s'agit pour l'adolescent d'integrer ces changements corporels en meme temps que les nouvelles conditions externes (socio-culturelles) et internes (transformations cognitives; affectives et rationnelles) pour trouver une organisation sexuelle definitive integree a sa personnalite

Sante sexuelle et reproductive des jeunes : mythes et realites

Les jeunes ne sont pas un probleme; ils portent en eux une partie des solutions. On oublie souvent que la jeunesse correspond aussi a une periode particulierement riche et creatrice du developpement humain. Les adultes doivent prendre en charge cette composante pour s'efforcer de changer la representation et l'image negative de la societe. L'auteur fait une analyse sur les nouveaux enjeux de la sexualite et de la sante liees a la procreation

Satisfaire les besoins de sante des hommes qui ont des rapports sexuels avec d'autres hommes au Senegal

Ce document presente les resultats d'une etude sur les hommes qui ont des rapports sexuels avec d'autres hommes (MSM) au Senegal.La sexualite des MSM; leur vulnerabilite aux IST/VIH; le role de la violence et du stigmate ainsi que le manque de services de sante sexuelle et d'information disponible pour couvrir leurs besoins specifiques; y sont decrit