Measuring sexual behavior among in-school youth in Rwanda: A cross-sectional analysis of self-reported timing of first sex and correlates of early sexual debut1

Elsevier

Available online 14 April 2023

Annals of EpidemiologyAuthor links open overlay panel, , , , , , , AbstractIntroduction

Understanding the timing of sexual debut is critical for informing sexual and reproductive health (SRH) interventions. We investigated sexual behavior and early sexual debut among Rwandan youth.

Methods

We conducted a cross-sectional analysis of data from a cluster-randomized trial with 6,079 students ages 12-19 years in Rwanda. We examined timing of first sex using Cox models to estimate adjusted hazard ratios (aHR) and predictors of early sexual debut (<15 years) using logistic regression to estimate adjusted odds ratios (aOR). Interpretations of sex were also explored.

Results

Participants were 15 years and 51.5% female on average; 1,723 (28.3%) reported sexual activity. Among 1,320 who provided an age of sexual debut, 51.4% reported sex at 12 years and 75.7% at <15 years. Males were more likely to report early sexual debut (aOR: 2.48; 95% CI: 2.05, 2.98) and younger age at first sex than females (aHR: 1.92; 95% CI: 1.19, 1.51). One-third of participants considered “sexual intercourse” to include kissing/touching, or masturbation.

Conclusions

Sex at 12 years was frequently reported, indicating that interventions facilitating access to youth-friendly SRH services are necessary before age 12. Validation studies are needed to evaluate how interpretations of sexual intercourse influence assessment of sexual activity.

AbbreviationsSRH

sexual and reproductive health

aOR

adjusted odds ratio(s)

aHR

adjusted hazard ratio(s)

FP/RH

family planning and reproductive health

S1

school level secondary 1

S2

school level secondary 2

PD

prevalence difference(s)

USAID

United States Agency for International Development

Keywords

Sexual debut

first sex

youth sexual health

© 2023 The Author(s). Published by Elsevier Inc.

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