Self-reported risky sexual practices among adolescents and young adults in Botswana

Unoda Chakalisa, Kathleen Wirth, Kara Bennett, Etienne Kadima, Kutlo Manyake, Tendani Gaolathe, Pam Bachanas, Tafireyi Marukutira, Refeletswe Lebelonyane, Scott Dryden-Peterson, Lisa Butler, Mompati Mmalane, Joseph Makhema, Michelle E Roland, Molly Pretorius-Holme, Max Essex, Shahin Lockman, Kathleen M Powis, Unoda Chakalisa, Kathleen Wirth, Kara Bennett, Etienne Kadima, Kutlo Manyake, Tendani Gaolathe, Pam Bachanas, Tafireyi Marukutira, Refeletswe Lebelonyane, Scott Dryden-Peterson, Lisa Butler, Mompati Mmalane, Joseph Makhema, Michelle E Roland, Molly Pretorius-Holme, Max Essex, Shahin Lockman, Kathleen M Powis

Abstract

Background: Adolescents and young adults account for more than one-third of incident Human Immunodeficiency Virus (HIV) infections globally. Understanding sexual practices of this high-risk group is critical in designing HIV targeted prevention programming.

Objectives: To describe self-reported risky sexual practices of adolescents and young adults aged 16-24 years from 30 Botswana communities.

Methods: Cross-sectional, self-reported age at sexual debut; number of sexual partners; condom and alcohol use during sex; intergenerational sex; and transactional sex data were collected. Modified Poisson estimating equations were used to obtain univariate and multivariate-adjusted prevalence ratios (PR) and 95% confidence intervals (CI) comparing engagement in different sexual practices according to gender, accounting for the clustered design of the study.

Results: Among the 3380 participants, 2311 reported being sexually active with more females reporting being sexually active compared to males (65% vs. 35%, respectively; p < 0.0001). In univariate analyses, female participants were more likely to report inconsistent condom use (PR 1.61; 95% CI 1.44-1.80), intergenerational sex (PR 9.00; 95% CI 5.84-13.88) and transactional sex (PR 3.46; 95% CI 2.07-5.77) than males, yet less likely to report engaging in sex before age 15 years (PR 0.59; 95% CI: 0.41-0.85), using alcohol around the time of intercourse (PR: 0.59; 95% CI 0.45-0.76) or having ≥ two partners in the last 12 months (PR 0.65; 95% CI 0.57-0.74).

Conclusions: Self-reported risky sexual practices of adolescents and young adults in Botswana differed significantly between males and females. Gender-specific risky sexual practices highlight the importance of developing tailored HIV prevention programming.

Keywords: Adolescents; Gender-specific risky sexual practices; HIV; Risky sexual practices; Self-reported risky sexual practices; Young adults.

Conflict of interest statement

The authors declare that this article is not under publication consideration elsewhere and that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

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Source: PubMed

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