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

Experiences of sexual relationships of young black women in an atmosphere of coercion

Negotiations surrounding sexual activity are characterised by multiple power disparities that include race; social status and age; with gender being the most dominant differential in heterosexual interactions. Research has shown that women are physiologically more at risk of contracting HIV than men; as indicated by the higher infection rates of the former. Many African societies operate via a hegemonic masculinity; with patriarchal governance and female subordination being the norm; placing women at even greater risk of HIV infection. In this qualitative phenomenological study; four black school-going adolescent women living in Grahamstown were interviewed using a semi-structured interview to gather data. An interpretative phenomenological analysis was conducted on the data to provide subjective insights of the experiences of the participants with regard to their interactions with men. From the findings; it became apparent that the participants felt pressured; coerced or manipulated by male counterparts. This pressure and coercion was not just felt in their interactions with older men; but also in their romantic partnerships. Three of the participants experienced pressure to engage in sexual intercourse with their boyfriends when they were unwilling or unready; and they reported being faced with additional pressure to engage in unprotected sex. Furthermore; it became apparent that each participant had an underlying fear of being raped and considered this as a genuine threat to her safety and sexual health. The atmosphere within which these participants negotiate their sexual agency is thus heavily informed by male control; coercion and the threat of violence or rape

Sexual Coercion and Adolescent Risk Behaviour: A Systematic Literature Review

Sexual coercion affects the individual through multiple short- and long-term medical; emotional; psychological and social consequences; and adolescents are particularly at high risk. Sexual coercion is hypothesised to negatively affect adolescents' decision-making around their sexual behaviours and other risk behaviours. Yet there is no previous systematic literature review on the topic to summarise current knowledge. The aim of this systematic literature review is to summarise previous research among adolescents investigating the associations between sexual coercion and risk behaviours; to critically appraise validity of the associations found; and to promote further research on the topic. Published articles were obtained by searching databases using specific keywords. Only 22 articles were found to fit the inclusion criteria. The evidence substantiates the hypothesised associations between sexual coercion and later risk behaviours (e.g. multiple sexual partners; condom non-use; and pregnancy). It also presents differences between genders. However; the influences on behavioural outcomes are multifaceted and largely impacted by bias. There is a need for improved quality of studies - specifically an increased number of longitudinal and experimental design studies - and a clearer understanding of mediators and confounders. Furthermore; emphasis should be placed on addressing the consequences of sexual coercion and promoting interventions that reduce the extent of sexual coercion. This will have added benefit in terms of reducing risk behaviours