Uthman, Olalekan A. (2008) Geographical variations and contextual effects on age of initiation of sexual intercourse among women in Nigeria : a multilevel and spatial analysis. International Journal of Health Geographics, Volume 7 (Number 1). Article no. 27. doi:10.1186/1476-072X-7-27 ISSN 1476-072X.

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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.

Item Type:	Journal Article
Subjects:	G Geography. Anthropology. Recreation > GN Anthropology H Social Sciences > HQ The family. Marriage. Woman Q Science > QA Mathematics
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Sex customs -- Nigeria -- Research, Women -- Sexual behavior -- Nigeria -- Research, Multilevel models (Statistics), Spatial analysis (Statistics)
Journal or Publication Title:	International Journal of Health Geographics
Publisher:	BioMed Central Ltd.
ISSN:	1476-072X
Official Date:	2008
Dates:	Date Event 2008 UNSPECIFIED
Volume:	Volume 7
Number:	Number 1
Page Range:	Article no. 27
DOI:	10.1186/1476-072X-7-27
Status:	Peer Reviewed
Publication Status:	Published
Date of first compliant deposit:	24 December 2015
Date of first compliant Open Access:	24 December 2015

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