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Title
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Factors influencing the risk of becoming sexually active among HIV infected adolescents in Kampala and Kisumu, East Africa
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Author
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Abstract
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| About 2.1 million adolescents aged 10-19years are living with HIV, 80% of them in sub-Saharan Africa. Early sexual activity remains an important risk factor for HIV transmission and potentially result in negative health consequences including onward transmission of sexually transmitted infections. Cross-sectional data of 580 adolescents living with HIV (ALHIV) aged 13-17years (317 girls and 263 boys) from Kenya and Uganda were analyzed to assess factors associated with risk to become sexually active. Factors associated with risk of sexual intercourse were identified using Kaplan-Meier survival curves and Cox regression with gender-stratified bi-and multivariable models. Slightly more females (22%) than males (20%) reported they have had sex. Multivariable models showed that being aware of one's own HIV infection, and receiving antiretroviral treatment were negatively associated with risk of becoming sexually active, while subjective norms conducive to sexuality, and girls' poor health experience increased the risk. In the final multi-variable models, schooling was protective for girls, but not for boys. Being more popular with the opposite sex was negatively associated with the outcome variable only for girls, but not for boys. This study expands the knowledge base on factors associated with onset of sexual activity among ALHIV, potentially informing positive prevention interventions. ResumenAlrededor de 2.1 millones de adolescentes de entre 10 y 19 anos viven con el VIH, el 80% de ellos residen en el africa subsahariana. La actividad sexual precoz sigue siendo un factor de riesgo importante para la transmision del VIH y puede tener consecuencias negativas para la salud, incluida la transmision de infecciones de transmision sexual. Los datos transversales de 580 adolescentes entre los 13-17 anos (317 ninas y 263 ninos) viviendo con el VIH y originarios de Kenia y Uganda fueron analizados para evaluar los factores asociados con el riesgo de volverse sexualmente activos. Los factores asociados con el riesgo de tener relaciones sexuales se identificaron usando las curvas de supervivencia de Kaplan-Meier y la regresion de Cox con modelos bi y multivariables estratificados por genero. Un poco mas de mujeres adolescentes (22%) que de hombres adolescentes (20%) informaron haber tenido relaciones sexuales. Los modelos multivariables mostraron que ser conscientes de la propia infeccion por VIH y recibir tratamiento antiretroviral se asociaron negativamente con el riesgo de volverse sexualmente activos, mientras que las normas subjetivas promoviendo la sexualidad y la mala salud experimentada por las mujeres adolescentes aumentaron el riesgo. En los modelos finales de variables multiples, la escolarizacion resulto ser un factor de proteccion para las mujeres, pero no para los hombres adolescentes. Ser mas popular con el sexo opuesto se asocio negativamente con la variable de resultado pero solo para las mujeres, no para los hombres adolescentes. Este estudio amplia la base de conocimientos sobre los factores asociados con el inicio de la actividad sexual en el VIH lo que podria contribuir a las intervenciones de prevencion positivas. |
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Language
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English
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Source (journal)
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Aids and behavior. - New York, N.Y., 1997, currens
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Publication
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New York, N.Y.
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2019
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ISSN
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1090-7165
[print]
1573-3254
[online]
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DOI
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10.1007/S10461-018-2323-Y
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Volume/pages
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23
:6
(2019)
, p. 1375-1386
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ISI
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000469188400001
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Pubmed ID
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30406334
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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