Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-17T21:21:07.011Z Has data issue: false hasContentIssue false
  • English
  • Français

ONSET OF SEXUAL ACTIVITY AMONG ADOLESCENTS IN HIV/AIDS-AFFECTED HOUSEHOLDS IN SUB-SAHARAN AFRICA

Published online by Cambridge University Press:  28 May 2014

MONICA A. MAGADI  and
JOSEPH UCHUDI
MONICA A. MAGADI*
Affiliation:
School of Social Sciences, University of Hull, UK
JOSEPH UCHUDI
Affiliation:
Merlin, Goma, North Kivu, Democratic Republic of the Congo
*
1Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Summary

This paper examines the effect of orphanhood and HIV status of adults in a household on onset of sexual activity among adolescent girls and boys aged 15–17 years in sub-Saharan Africa. Multilevel logistic regression models were applied to pooled Demographic and Health Surveys data from nineteen countries of sub-Saharan Africa where HIV test data were collected during 2003–2008 from nationally representative samples of men and women of reproductive age. The results highlight increased vulnerability among adolescent boys and girls living in households where an adult is infected with HIV, and adolescent boys who are paternal orphans. On average, adolescent boys and girls living in households where at least one adult is HIV-positive have about 25% higher odds of having initiated sexual activity compared with their counterparts of similar characteristics in households where no adult is HIV-positive. Furthermore, adolescent boys who are paternal orphans have about 25% higher odds of having initiated sexual activity than their non-orphan counterparts of similar individual characteristics. Further analysis reveals that household circumstances relating to living arrangements and poverty are important pathways through which household HIV/AIDS status is linked to adolescent sexual debut. The findings underscore the importance of international efforts in the sub-Saharan Africa region to address the plight of other children in HIV/AIDS-affected households, beyond orphans.

Type
Articles
Information
Journal of Biosocial Science , Volume 47 , Issue 2 , March 2015 , pp. 238 - 257
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abebe, T. & Skovdal, M. (2010) Livelihoods, care and the familial relations of orphans in Eastern Africa. AIDS Care 22(5), 570–576.Google Scholar
Birdthistle, I. J., Floyd, S., Machingura, A., Mudziwapasi, N., Gregson, S. & Glynn, J. R. (2008) From affected to infected? Orphanhood and HIV risk among female adolescents in urban Zimbabwe. AIDS 22, 759–766.Google Scholar
Birdthistle, I. J., Floyd, S., Nyagadza, A., Mudziwapasi, N., Gregson, S. & Glynn, J. R. (2009) Is education the link between orphanhood and HIV/HSV-2 risk among female adolescents in urban Zimbabwe? Social Science & Medicine 68, 1810–1818.Google Scholar
Coleman, J. S. (1988) Social capital in the creation of human capital. American Journal of Sociology 94, S95–120.Google Scholar
Collins, J. & Rau, B. (2000) AIDS in the context of development. UNRISD Programme on Social Policy and Development, Paper No. 4. UNAIDS and UNRISD.Google Scholar
Doyle, A. M., Weiss, H. A., Maganja, K., Kapiga, S., McCormack, S.et al. (2011) The long-term impact of the MEMA kwa Vijana adolescent sexual and reproductive health intervention: effect of dose and time since intervention exposure. PloS ONE 6, e24866. doi:10.1371/journal.pone.0024866Google Scholar
Enaik, E., Patel, M. P., Persad, A. S., Westhoff, W. & Galwankar, S. (2002) Adolescent high-risk sexual behavior in the Dominican Republic: an assessment of familial factors. Paper presented at the International Conference on AIDS,Barcelona, Spain.Google Scholar
Funkquist, A., Eriksson, B. & Muula, A. S. (2007) The vulnerability of orphans in Thyolo District, southern Malawi. Tanzanian Health Research Bulletin 9(2), 102–109.Google Scholar
Goldstein, H. (2003) Multilevel Statistical Models (3rd edition). Arnold, London.Google Scholar
Gregson, S., Nyamukapa, C., Garnett, G. P., Wamba, M., Lewis, J. J. C., Mason, P. R.et al. (2005) HIV infection and reproductive health in teenage women made vulnerable by AIDS in Zimbabwe. AIDS Care 17(7), 785–794.Google Scholar
Harrison, A., Cleland, J., Gouws, E. & Frohlich, J. (2005) Early sexual debut among young men in rural South Africa: heightened vulnerability to sexual risk. Sexually Transmitted Infections 81, 259–261.Google Scholar
ICF Macro (2010). HIV Prevalence Estimates from the Demographic and Health Surveys. ICF Macro, Calverton, MD.Google Scholar
Juma, M., Askew, I. & Ferguson, A. (2007) Situation Analysis of the Sexual and Reproductive Health and HIV Risks and Prevention Needs of Older Orphaned and Vulnerable Children in Nyanza Province. Department of Children's Services, Government of Kenya.Google Scholar
Kaggwa, E. B. & Hindin, M. J. (2010) The psychological effect of orphanhood in a matured HIV epidemic: an analysis of young people in Mukono, Uganda. Social Science & Medicine 70(7), 1002–1010.Google Scholar
Lammers, C. M. I., Resnick, M. D. & Blum, R. W. (2000) Influences on adolescents' decision to postpone onset of sexual intercourse: a survival analysis of virginity among youths aged 13 to 18 years. Journal of Adolescent Health 26(1), 40–48.Google Scholar
Leclerc-Madlala, S. (2009) Cultural scripts for multiple and concurrent partnerships in southern Africa: why HIV prevention needs anthropology. Sexual Health 6(2), 103–110.Google Scholar
Maticka-Tyndale, E. (2012) Condoms in sub-Saharan Africa. Sexual Health 9, 59–72.Google Scholar
Meekers, D. & Calvès, A-E. (1997) “Main" girlfriends, girlfriends, marriage, and money: the social context of HIV risk behavior in Sub-Saharan Africa. Health Transition Review 7 (Supplement), 361–375.Google ScholarPubMed
Mmari, K. (2011) Exploring the relationship between caregiving and health: perceptions among orphaned and non-orphaned adolescents in Tanzania. Journal of Adolescence 34(2), 301–309.Google Scholar
Nkosana, J. & Rosenthal, D. (2007) The dynamics of intergenerational sexual relationships: the experience of schoolgirls in Botswana. Sexual Health 4(3), 181–187.Google Scholar
Nyamukapa, C. A., Gregson, S., Lopman, B., Saito, S., Watts, H. J., Monasch, R.et al. (2008) HIV-associated orphanhood and children's psychosocial distress: theoretical framework tested with data from Zimbabwe. American Journal of Public Health 98(1), 133–141.Google Scholar
Oman, R. F., Vesely, S. K. & Aspy, C. B. (2005) Youth assets and sexual risk behavior: the importance of assets for youth residing in one-parent households. Perspectives on Sexual Reproductive Health 37, 25–31.Google Scholar
Operario, D., Pettifor, A., Cluver, L., MacPhail, C. & Rees, H. (2007) Prevalence of parental death among young people in South Africa and risk for HIV infection. Journal of Acquired Immune Deficiency Syndromes 44(1), 93–98.Google Scholar
Operario, D., Underhill, K., Chuong, C. & Cluver, L. (2011) HIV infection and sexual risk behaviour among youth who have experienced orphanhood: systematic review and meta-analysis. Journal of International AIDS Society 14, 25. URL: http://www.jiasociety.org/content/14/1/25Google Scholar
Palermo, T. & Peterman, A. (2009) Are female orphans at risk for early marriage, early sexual debut, and teen pregnancy? Evidence from Sub-Saharan Africa. Studies in Family Planning 40, 101–112.Google Scholar
Rasbash, J., Steele, F., Browne, W. & Prosser, B. (2005) A Users' Guide to MLwiN, Version 2.0. Centre for Multilevel Modelling, University of Bristol.Google Scholar
Rutstein, S. O. & Johnston, K. (2004) The DHS Wealth Index. DHS Comparative Reports No. 6. ORC Macro, Calverton, MD.Google Scholar
Snijders, T. A. B. (2005) Power and sample size in multilevel modelling. In Everitt, B. S. & Howell, D. C. (eds) Encyclopedia of Statistics in Behavioral Science 3, 1570–1573.Google Scholar
Swidler, A. & Watkins, S. C. (2007) Ties of dependence: AIDS and transactional sex in rural Malawi. Studies in Family Planning 38, 147–162.Google Scholar
Thurman, T. R., Brown, L., Richter, L., Maharaj, P. & Magnani, R. (2006) Sexual risk behaviour among South African adolescents: is orphan status a factor? AIDS Behaviour 10(6), 627–635.CrossRefGoogle ScholarPubMed
Uchudi, J., Magadi, M. & Mostazir, M. (2012) A multilevel analysis of the determinants of high risk sexual behavior in sub-Saharan Africa. Journal of Biosocial Science 44, 289–311.CrossRefGoogle ScholarPubMed
UNAIDS (2013) Report on the Global AIDS epidemic. UNAIDS, Geneva.Google Scholar
UNAIDS, UNICEF & USAID (2004) Children on the Brink 2004: A Joint Report of the New Orphan Estimates and a Framework for Action. URL: http://www.unicef.org/publications/files/cob_layout6-013.pdfGoogle Scholar
UNICEF (2006) Africa's Orphaned and Vulnerable Generations: Children Affected by AIDS. United Nations, New York.Google Scholar
WHO (2008) Promoting Adolescent Sexual and Reproductive Health Through Schools in Low Income Countries: An Information Brief. WHO, Geneva. URL: http://whqlibdoc.who.int/hq/2009/WHO_FCH_CAH_ADH_09.03_eng.pdf (accessed 21st February 2014).Google Scholar
Winship, C. & Radbill, L. (1994) Sampling weights and regression analysis. Sociological Methods & Research 23, 230–257.Google Scholar
Wringe, A., Cremin, I., Todd, J., McGrath, N., Kasamba, I., Herbst, K.et al. (2009) Comparative assessment of the quality of age-at-event reporting in three HIV cohort studies in sub-Saharan Africa. Sexually Transmitted Infections 85 (Supplement 1), i56–63.Google Scholar
Zidron, A. M., Juma, E. & Ice, G. H. (2009) Does being an orphan decrease the nutritional status of Luo children? American Journal of Human Biology 21(6), 844–851.Google Scholar