Associations between age of menarche, early sexual debut and high-risk sexual behaviour among urban Tanzanian schoolgirls: A cross-sectional study.
adolescent girls
menarche
sexual and reproductive health
sexual behaviour
sexual debut
sub-Saharan Africa
urban
Journal
Tropical medicine & international health : TM & IH
ISSN: 1365-3156
Titre abrégé: Trop Med Int Health
Pays: England
ID NLM: 9610576
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
pubmed:
1
2
2023
medline:
4
3
2023
entrez:
31
1
2023
Statut:
ppublish
Résumé
This cross-sectional survey aimed to explore associations between age of menarche, early sexual debut and high-risk sexual behaviour among urban Tanzanian schoolgirls. Secondary schoolgirls aged 17-18 years from Mwanza, Tanzania, participated in structured face-to-face questionnaire-based interviews, conducted by nurses and clinicians. Age of menarche was evaluated in categories of 11-12, 13-14, 15-16 or ≥17 years. Primary outcome measures were self-reported early sexual debut (first vaginal sex at <16 years) and high-risk sexual behaviour, including non-use of condoms, having sex for gifts/money, having older sexual partners and/or other risky behaviours. Of 401 girls enrolled, 174 (43.4%) reported prior vaginal sex. Prevalence of early sexual debut was 14.2% but pressured/forced sex and risky sexual behaviours were common. Adjusted for potential confounding, younger age at menarche was associated with early sexual debut (adjusted odds ratio for linear trend: 1.88 per category, 95% confidence interval: 1.21-2.92, p = 0.005). This association remained after excluding girls with first sex at <8 years or experiencing pressure or force at first sex. Further, adjusted for potential confounding (including ever experiencing forced sex), early sexual debut was associated with high-risk sexual behaviour (adjusted odds ratio: 2.85, 95% confidence interval: 1.38-5.88, p = 0.004). Among urban Tanzanian school girls, younger age of menarche was associated with early sexual debut, and early sexual debut was associated with high-risk sexual behaviour. Researchers and public health professionals developing and delivering interventions aimed at preventing adverse sexual health outcomes should consider the impact of these early biological and sexual exposures.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
237-246Subventions
Organisme : Medical Research Council
ID : MR/R010161/1
Pays : United Kingdom
Informations de copyright
© 2023 The Authors Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
Références
Melesse DY, Mutua MK, Choudhury A, Wado YD, Faye CM, Neal S, et al. Adolescent sexual and reproductive health in sub-Saharan Africa: who is left behind? BMJ Glob Health. 2020;5(1):e002231.
Stöckl H, Kalra N, Jacobi J, Watts C. Is early sexual debut a risk factor for HIV infection among women in sub-Saharan Africa? A systematic review. Am J Reprod Immunol. 2013;69(Suppl 1):27-40.
Heywood W, Patrick K, Smith AM, Pitts MK. Associations between early first sexual intercourse and later sexual and reproductive outcomes: a systematic review of population-based data. Arch Sex Behav. 2015;44(3):531-69.
Lowry R, Dunville R, Robin L, Kann L. Early sexual debut and associated risk behaviors among sexual minority youth. Am J Prev Med. 2017;52(3):379-84.
Harrison A, Cleland J, Gouws E, Frohlich J. Early sexual debut among young men in rural South Africa: heightened vulnerability to sexual risk? Sex Transm Infect. 2005;81(3):259-61.
Wand H, Ramjee G. The relationship between age of coital debut and HIV seroprevalence among women in Durban, South Africa: a cohort study. BMJ Open. 2012;2(1):e000285.
Pettifor A, O'Brien K, Macphail C, Miller WC, Rees H. Early coital debut and associated HIV risk factors among young women and men in South Africa. Int Perspect Sex Reprod Health. 2009;35(2):82-90.
Boden JM, Fergusson DM, Horwood LJ. Age of menarche and psychosocial outcomes in a New Zealand birth cohort. J Am Acad Child Adolesc Psychiatry. 2011;50(2):132-40.e5.
Copeland W, Shanahan L, Miller S, Costello EJ, Angold A, Maughan B. Outcomes of early pubertal timing in young women: a prospective population-based study. Am J Psychiatry. 2010;167(10):1218-25.
Downing J, Bellis MA. Early pubertal onset and its relationship with sexual risk taking, substance use and anti-social behaviour: a preliminary cross-sectional study. BMC Public Health. 2009;9:446.
Ibitoye M, Choi C, Tai H, Lee G, Sommer M. Early menarche: a systematic review of its effect on sexual and reproductive health in low- and middle-income countries. PLoS One. 2017;12(6):e0178884.
Francis SC, Holm Hansen C, Irani J, Andreasen A, Baisley K, Jespers V, et al. Results from a cross-sectional sexual and reproductive health study among school girls in Tanzania: high prevalence of bacterial vaginosis. Sex Transm Infect. 2019;95(3):219-27.
Baisley KJ, Andreasen A, Irani J, Nnko S, Changalucha J, Crucitti T, et al. HPV prevalence around the time of sexual debut in adolescent girls in Tanzania. Sex Transm Infect. 2020;96(3):211-9.
Francis SC, Crucitti T, Smekens T, Hansen CH, Andreasen A, Jespers V, et al. The vaginal microbiota among adolescent girls in Tanzania around the time of sexual debut. Front Cell Infect Microbiol. 2020;10:305.
PopulationStat. World statistical data. Mwanza, Tanzania Population. https://populationstat.com/tanzania/mwanza
The United Republic of Tanzania. Basic Demograhic and socio-economic profile. Mwanza Region. National Bureau of Statistics, National Bureau of Statistics, Dar es Salaam. 2016.
Lemme F, Doyle AM, Changalucha J, Andreasen A, Baisley K, Maganja K, et al. HIV infection among young people in northwest Tanzania: the role of biological, behavioural and socio-demographic risk factors. PLoS One. 2013;8(6):e66287.
Francis SC, Ao TT, Vanobberghen FM, Chilongani J, Hashim R, Andreasen A, et al. Epidemiology of curable sexually transmitted infections among women at increased risk for HIV in northwestern Tanzania: inadequacy of syndromic management. PLoS One. 2014;9(7):e101221.
Watson-Jones D, Baisley K, Brown J, Kavishe B, Andreasen A, Changalucha J, et al. High prevalence and incidence of human papillomavirus in a cohort of healthy young African female subjects. Sex Transm Infect. 2013;89(5):358-65.
Tolley EE, Kaaya S, Kaale A, Minja A, Bangapi D, Kalungura H, et al. Comparing patterns of sexual risk among adolescent and young women in a mixed-method study in Tanzania: implications for adolescent participation in HIV prevention trials. J Int AIDS Soc. 2014;17(3 Suppl 2):19149.
Zaba B, Isingo R, Wringe A, Marston M, Slaymaker E, Urassa M. Influence of timing of sexual debut and first marriage on sexual behaviour in later life: findings from four survey rounds in the Kisesa cohort in northern Tanzania. Sex Transm Infect. 2009;85(Suppl 1):i20-6.
Glynn JR, Kayuni N, Floyd S, Banda E, Francis-Chizororo M, Tanton C, et al. Age at menarche, schooling, and sexual debut in northern Malawi. PLoS One. 2010;5(12):e15334.
Pettifor AE, van der Straten A, Dunbar MS, Shiboski SC, Padian NS. Early age of first sex: a risk factor for HIV infection among women in Zimbabwe. Aids. 2004;18(10):1435-42.
Calvert C, Baisley K, Doyle AM, Maganja K, Changalucha J, Watson-Jones D, et al. Risk factors for unplanned pregnancy among young women in Tanzania. J Fam Plann Reprod Health Care. 2013;39(4):e2.
Peltzer K. Early sexual debut and associated factors among in-school adolescents in eight African countries. Acta Paediatr. 2010;99(8):1242-7.
Doyle AM, Plummer ML, Weiss HA, Changalucha J, Watson-Jones D, Hayes RJ, et al. Concurrency and other sexual partnership patterns reported in a survey of young people in rural northern Tanzania. PLoS One. 2017;12(8):e0182567.
Mmbaga EJ, Leonard F, Leyna GH. Incidence and predictors of adolescent's early sexual debut after three decades of HIV interventions in Tanzania: a time to debut analysis. PLoS One. 2012;7(7):e41700.
Glynn JR, Kayuni N, Gondwe L, Price AJ, Crampin AC. Earlier menarche is associated with a higher prevalence of herpes simplex type-2 (HSV-2) in young women in rural Malawi. Elife. 2014;3:e01604.
Ajah LO, Onubogu ES, Anozie OB, Lawani LO, Iyoke CA, Onwe EO, et al. Adolescent reproductive health challenges among schoolgirls in Southeast Nigeria: role of knowledge of menstrual pattern and contraceptive adherence. Patient Prefer Adherence. 2015;9:1219-24.
Emmanuel M, Bokor BR. Tanner stages. StatPearls. Treasure Island (FL): StatPearls Publishing LLC; 2020.
Sunder N. Marriage age, social status, and intergenerational effects in Uganda. Demography. 2019;56(6):2123-46.
Nash K, O'Malley G, Geoffroy E, Schell E, Bvumbwe A, Denno DM. Our girls need to see a path to the future: perspectives on sexual and reproductive health information among adolescent girls, guardians, and initiation counselors in Mulanje district, Malawi. Reprod Health. 2019;16(1):8.
Seff I, Steiner JJ, Stark L. Early sexual debut: a multi-country, sex-stratified analysis in sub-Saharan Africa. Glob Public Health. 2021;16(7):1046-56.
Unicef. Global initiative on out-of-school children: Tanzania country report. March 2018. https://www.unicef.org/tanzania/media/596/file/Tanzania-2018-Global-Initiative-Out-of-School-Children-Country-Report.pdf.
Rutgers. Sexual and reproductive health and rights Alliance. The right to education of pregnant girls and young mothers, Tanzania. Capacity strengthening and advocacy. https://www.rutgers.international/sites/rutgersorg/files/PDF/Advocacy_Tanzania_0.pdf
Rebacz E. Age at menarche in schoolgirls from Tanzania in light of socioeconomic and sociodemographic conditioning. Coll Antropol. 2009;33(1):23-9.
Torrone EA, Morrison CS, Chen PL, Kwok C, Francis SC, Hayes RJ, et al. Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: an individual participant data meta-analysis of 18 HIV prevention studies. PLoS Med. 2018;15(2):e1002511.
Plummer ML, Ross DA, Wight D, Changalucha J, Mshana G, Wamoyi J, et al. “A bit more truthful”: the validity of adolescent sexual behaviour data collected in rural northern Tanzania using five methods. Sex Transm Infect. 2004;80(Suppl 2):ii49-56.