Prevalence and neighbourhood determinants of early sexual debut and multiple sexual partnerships among young people in Rwanda, Ghana and South Africa

Abstract

Background: The consequences of engaging in risky sexual behaviours (RSB) can lead to HIV infection, sexually transmitted diseases and  unintended pregnancy. The relationship between neighbourhood characteristics and youth involvement in RSB such as early sexual  debut and multiple sexual partnerships has been of great concern to government, researchers and policymakers. However, there are  very few empirical studies using demographic and health surveys to unpack the nature of this relationship in Rwanda, Ghana and South  Africa. The objective of this study was to estimate the prevalence and determinants of early sexual debut and condom use, and to explore the neighbourhood factors associated with early sexual debut and condom use in Rwanda, Ghana and South Africa.

Methods: This was a  cross-sectional study using the most recent Demographic and Health Survey Data (DHS 2014–2016) from Ghana, Rwanda and South  Africa to investigate the relationship between neighbourhood characteristics and risky sexual behaviour among the youth.

Results: The  prevalence of risky sexual behaviour in the three countries ranges from 56% (South Africa), 30% (Ghana) and 12% (Rwanda). Male youth  in the 20-to-24-year-old category had increased odds of engaging in multiple sexual partnerships for the three countries (AOR 4.58; 95%  CI 3.40–6.16), Rwanda (AOR 2.72; 95% CI 2.04–3.68) and South Africa (AOR 4.56; 95% CI 3.33–6.24). Meanwhile, at the community level,  community education significantly increased the odds of age sexual debut among female adolescents by 50% (South Africa), and 46% (Ghana), while in Rwanda, this factor had decreased odds with higher community education.

Conclusion: To lower the incidence of risky  sexual behaviour in the community, programmes aimed at appropriate policy options must be intensified. The implications of these  findings is helpful for a developmental approach aimed at reaching Africa’s long-term development goal of eliminating STIs among  young people.