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Geographical variations and contextual effects on age of initiation of sexual intercourse among women in Nigeria: a multilevel and spatial analysis.

Uthman OA - Int J Health Geogr (2008)

Bottom Line: There was significant positive spatial relationship between median age of marriage and spatial lag of median age of sexual debut (Bivariate Moran's I = 0.646, (p = .001).After adjusting for both individual-level and contextual factors, the probability of starting sex at an earlier age was associated with respondents' current age, education attainment, ethnicity, region, and community median age of marriage.The study found that individual-level and community contextual characteristics were independently associated with early sexual debut, suggesting that interventions to reduce adolescent high-risk sexual behaviour should focus on high-risk places as well as high-risk groups of people.

View Article: PubMed Central - HTML - PubMed

Affiliation: Center for Evidence-Based Global Health, Save the Youth Initiative, Ilorin, Kwara state, Nigeria. uthlekan@yahoo.com

ABSTRACT

Background: The age of initiation of sexual intercourse is an increasingly important issue to study given that sexually active young women are at risk of multiple outcomes including early pregnancies, vesico-vaginal fistula, and sexually transmitted infections. Much research has focused on the demographic, familial, and social factors associated with sexual initiation and reasons adolescents begin having consensual intercourse. Less is known, however, about the geographical and contextual factors associated with age of initiation of sexual intercourse. Therefore, the purpose of this study was to examine the extent of regional and state disparities in age of initiation of sexual intercourse and to examine individual- and community-level predictors of early sexual debut.

Methods: Multilevel logistic regression models were applied to data on 5531 ever or currently married women who had participated in 2003 Nigeria Demographic and Health Survey. Coital debut at 15 years or younger was used to define early sexual debut. Exploratory spatial data analysis methods were used to study geographic variation in age at first sexual intercourse.

Results: The median age at first sexual intercourse for all women included in the study was 15 years (range; 14 - 19). North West and North East had the highest proportion of women who had reported early sexual debut (61% - 78%). The spatial distribution of age of initiation of sexual intercourse was nonrandom and clustered with a Moran's I = 0.635 (p = .001). There was significant positive spatial relationship between median age of marriage and spatial lag of median age of sexual debut (Bivariate Moran's I = 0.646, (p = .001). After adjusting for both individual-level and contextual factors, the probability of starting sex at an earlier age was associated with respondents' current age, education attainment, ethnicity, region, and community median age of marriage.

Conclusion: The study found that individual-level and community contextual characteristics were independently associated with early sexual debut, suggesting that interventions to reduce adolescent high-risk sexual behaviour should focus on high-risk places as well as high-risk groups of people.

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Related in: MedlinePlus

Bivariate LISA (BiLISA) cluster map for community median age of marriage and spatial lag of community median age of sex initiation in Nigeria, 2003.
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Figure 4: Bivariate LISA (BiLISA) cluster map for community median age of marriage and spatial lag of community median age of sex initiation in Nigeria, 2003.

Mentions: Figure 1 shows geographic variation in state-specific median age of sexual initiation. The median age of sexual debut was lowest in North West (14 years) and highest in Kwara, Osun, and Abia states (19 years). Figure 2 presents a state map of the smoothed proportion of women who had reported early sexual debut. The smoothed proportions present clearer patterns and show clearly, where the problem was most severe. The spatial empirical bayes "smooth" estimates technique was able to deal with spatial heterogeneity. The estimation technique guarantees that estimates of neighboring states are more alike than estimates of states that are far away. North West and North East had the highest proportion of women who had reported early sexual debut (61% to 78%). The proportion of women who had reported early sexual intercourse was lowest in South West, South South, South East, and Kwara State (8% to 25%). The prevalence of early sexual debut was checked for spatial patterns by use of a Moran scatter plot. The results of this plot show statistically significant autocorrelation (Moran's I = 0.635, p = .0001) (Figure 3). In addition, the bivariate Local LISA Moran's I statistics for spatial correlation between median age of marriage and spatial lag of median age of sex initiation is 0.646, (p = .001), indicating a significant positive spatial relationship between median age of marriage and median age of initiation of sexual intercourse. As expected, in the northern regions there is significant correlation between low median age of marriage and low median age of initiation of sexual intercourse neighbours (Figure 4).


Geographical variations and contextual effects on age of initiation of sexual intercourse among women in Nigeria: a multilevel and spatial analysis.

Uthman OA - Int J Health Geogr (2008)

Bivariate LISA (BiLISA) cluster map for community median age of marriage and spatial lag of community median age of sex initiation in Nigeria, 2003.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2414823&req=5

Figure 4: Bivariate LISA (BiLISA) cluster map for community median age of marriage and spatial lag of community median age of sex initiation in Nigeria, 2003.
Mentions: Figure 1 shows geographic variation in state-specific median age of sexual initiation. The median age of sexual debut was lowest in North West (14 years) and highest in Kwara, Osun, and Abia states (19 years). Figure 2 presents a state map of the smoothed proportion of women who had reported early sexual debut. The smoothed proportions present clearer patterns and show clearly, where the problem was most severe. The spatial empirical bayes "smooth" estimates technique was able to deal with spatial heterogeneity. The estimation technique guarantees that estimates of neighboring states are more alike than estimates of states that are far away. North West and North East had the highest proportion of women who had reported early sexual debut (61% to 78%). The proportion of women who had reported early sexual intercourse was lowest in South West, South South, South East, and Kwara State (8% to 25%). The prevalence of early sexual debut was checked for spatial patterns by use of a Moran scatter plot. The results of this plot show statistically significant autocorrelation (Moran's I = 0.635, p = .0001) (Figure 3). In addition, the bivariate Local LISA Moran's I statistics for spatial correlation between median age of marriage and spatial lag of median age of sex initiation is 0.646, (p = .001), indicating a significant positive spatial relationship between median age of marriage and median age of initiation of sexual intercourse. As expected, in the northern regions there is significant correlation between low median age of marriage and low median age of initiation of sexual intercourse neighbours (Figure 4).

Bottom Line: There was significant positive spatial relationship between median age of marriage and spatial lag of median age of sexual debut (Bivariate Moran's I = 0.646, (p = .001).After adjusting for both individual-level and contextual factors, the probability of starting sex at an earlier age was associated with respondents' current age, education attainment, ethnicity, region, and community median age of marriage.The study found that individual-level and community contextual characteristics were independently associated with early sexual debut, suggesting that interventions to reduce adolescent high-risk sexual behaviour should focus on high-risk places as well as high-risk groups of people.

View Article: PubMed Central - HTML - PubMed

Affiliation: Center for Evidence-Based Global Health, Save the Youth Initiative, Ilorin, Kwara state, Nigeria. uthlekan@yahoo.com

ABSTRACT

Background: The age of initiation of sexual intercourse is an increasingly important issue to study given that sexually active young women are at risk of multiple outcomes including early pregnancies, vesico-vaginal fistula, and sexually transmitted infections. Much research has focused on the demographic, familial, and social factors associated with sexual initiation and reasons adolescents begin having consensual intercourse. Less is known, however, about the geographical and contextual factors associated with age of initiation of sexual intercourse. Therefore, the purpose of this study was to examine the extent of regional and state disparities in age of initiation of sexual intercourse and to examine individual- and community-level predictors of early sexual debut.

Methods: Multilevel logistic regression models were applied to data on 5531 ever or currently married women who had participated in 2003 Nigeria Demographic and Health Survey. Coital debut at 15 years or younger was used to define early sexual debut. Exploratory spatial data analysis methods were used to study geographic variation in age at first sexual intercourse.

Results: The median age at first sexual intercourse for all women included in the study was 15 years (range; 14 - 19). North West and North East had the highest proportion of women who had reported early sexual debut (61% - 78%). The spatial distribution of age of initiation of sexual intercourse was nonrandom and clustered with a Moran's I = 0.635 (p = .001). There was significant positive spatial relationship between median age of marriage and spatial lag of median age of sexual debut (Bivariate Moran's I = 0.646, (p = .001). After adjusting for both individual-level and contextual factors, the probability of starting sex at an earlier age was associated with respondents' current age, education attainment, ethnicity, region, and community median age of marriage.

Conclusion: The study found that individual-level and community contextual characteristics were independently associated with early sexual debut, suggesting that interventions to reduce adolescent high-risk sexual behaviour should focus on high-risk places as well as high-risk groups of people.

Show MeSH
Related in: MedlinePlus