| Literature DB >> 35895697 |
Oluwaseyi Dolapo Somefun1, Emmanuel Olamijuwon2,3,4.
Abstract
Studies have linked the timing of sexual debut to unplanned pregnancies and sexually transmissible infections, including HIV. Current understandings of sexual debut among Nigerian adolescents focused on the roles of individual and familial characteristics. We leveraged the 2018 Nigeria Demographic and Health Survey data to examine how community features like affluence, ethnic diversity, and women empowerment may be associated with the timing of sexual debut among adolescent girls. The sample comprised 7449 adolescent girls who were usual residents in 6,505 households and 1,352 clusters or communities. Statistical associations between community characteristics and the onset of sexual debut were assessed using a two-level mixed-effects parametric survival model with Weibull distribution. We found that community affluence [aHR:0.43, 95%CI: 0.30-0.62] and community ethnic diversity [aHR: 0.63, 95%CI: 0.42-0.94] are associated with a lower hazard of sexual debut among adolescent girls. We also observed that women that married within the observation period had an earlier sexual initiation than those who were unmarried. The results disaggregated by marital status further shows that higher community level of women's employment [aHR: 2.45, 95%CI: 1.38-4.38] and women's education [aHR:1.85, 95%CI: 1.03-3.33] were associated with a higher hazard of sexual debut among unmarried adolescent girls but not married adolescent girls. Higher community affluence [aHR:0.40, 95%CI: 0.27-0.60] was also associated with a lower hazard of sexual debut among unmarried adolescent girls but not married adolescent girls. Our results illuminate the associated factors of the timing of sexual debut among adolescent girls that moves beyond individual characteristics to community characteristics.Entities:
Mesh:
Year: 2022 PMID: 35895697 PMCID: PMC9328553 DOI: 10.1371/journal.pone.0269168
Source DB: PubMed Journal: PLoS One ISSN: 1932-6203 Impact factor: 3.752
Descriptive characteristics of adolescents girls in the sample.
| Frequency Distribution | Percentages | |
|---|---|---|
| Educational Attainment | ||
| < Secondary | 2,512 | 34.43% |
| Secondary + | 4,937 | 65.57% |
| Place of Residence | ||
| Urban | 3,070 | 46.54% |
| Rural | 4,379 | 53.46% |
| Region of Residence | ||
| North Central | 1,388 | 13.60% |
| North East | 1,458 | 17.80% |
| North West | 2,013 | 32.43% |
| South East | 922 | 10.61% |
| South South | 838 | 10.57% |
| South West | 830 | 14.99% |
| Marital Status | ||
| Ever Married | 1,243 | 17.98% |
| Never Married | 6,206 | 82.02 |
| Ethnicity | ||
| Yoruba | 846 | 13.85% |
| Igbo | 1,100 | 13.61% |
| Hausa | 2,179 | 33.78% |
| Fulani | 472 | 5.54% |
| Ijaw | 203 | 1.77% |
| Others | 2,649 | 31.46% |
| Religious Affiliation | ||
| Christian | 3,436 | 41.78% |
| Muslim | 3,956 | 57.71% |
| Others | 57 | 0.51% |
Distribution of adolescent girls in the sample by community characteristics.
| Median [min—max] | Mean ± Standard deviation | |
|---|---|---|
| Community Affluence | 0.31 [0–1] | 0.409 ± 0.378 |
| Community Level of Women’s Education | 0.38 [0–1] | 0.413 ± 0.335 |
| Community Level of Women’s Employment | 0.65 [0–1] | 0.631 ± 0.192 |
| Ethnic Diversity | 0.11 [0–1] | 0.186 ± 0.202 |
Fig 1Survival probabilities of not being sexually experienced among adolescent girls in Nigeria.
Multivariate multi-level mixed effect parametric analysis of timing of sexual debut among adolescents in Nigeria.
| Hazard Ratios [95% Confidence Interval] | ||||
|---|---|---|---|---|
| Model I | Full Model | Sub-group analysis | ||
| Married Adolescents | Never Married Adolescents | |||
| Community Affluence | 0.23 | 0.43 | 0.87 [0.41,1.85] | 0.40 |
| Community Level of Women’s Education | 0.56 | 1.64 [0.98,2.74] | 0.52 [0.21,1.33] | 2.45 |
| Community Level of Women’s Employment | 0.84 [0.57,1.25] | 0.97 [0.66,1.43] | 0.82 [0.48,1.40] | 1.85 |
| Ethnic Diversity | 0.84 [0.57,1.23] | 0.63 | 0.68 [0.39,1.19] | 0.56 [0.30,1.05] |
| Highest Level of Education | ||||
| < Secondary | Reference | Reference | Reference | |
| Secondary + | 0.60 | 0.65 | 0.66 | |
| Place of Residence | ||||
| Urban | Reference | Reference | Reference | |
| Rural | 1.13 [0.94,1.35] | 1.15 [0.83,1.60] | 1.03 [0.83,1.27] | |
| Marital Status | ||||
| Ever Married | Reference | |||
| Never Married | 0.05 | |||
| Ethnicity | ||||
| Yoruba | Reference | Reference | Reference | |
| Igbo | 1.33 [0.65,2.69] | 1.18 [0.47,3.00] | 1.45 [0.69,3.05] | |
| Hausa | 0.99 [0.34,2.90] | 1.47 [0.75,2.87] | 0.63 [0.06,7.11] | |
| Fulani | 1.31 [0.48,3.59] | 1.95 [0.95,3.99] | 0.81 [0.21,3.13] | |
| Ijaw | 0.95 [0.40,2.26] | 1.56 [0.55,4.46] | 1.23 [0.50,3.03] | |
| others | 1.07 [0.48,2.36] | 1.26 [0.66,2.41] | 1.53 [0.68,3.48] | |
| Region of Residence | ||||
| North central | Reference | Reference | Reference | |
| North-East | 0.59 | 0.96 [0.66,1.42] | 0.45 | |
| North-West | 0.60 | 1.08 [0.71,1.64] | 0.17 | |
| South-East | 0.57 | 1.12 [0.41,3.05] | 0.49 | |
| South South | 1.54 | 1.79 [0.88,3.63] | 1.13 [0.86,1.48] | |
| South-West | 1.27 [0.68,2.37] | 1.97 | 1.03 [0.55,1.91] | |
| Religious Affiliation | ||||
| Christian | 1.65 | 1.66* [1.04,2.64] | 1.42 | |
| Muslim | Reference | Reference | Reference | |
| Others | 0.82 [0.43,1.57] | 0.85 [0.51,1.40] | 0.93 [0.36,2.37] | |
* p<0.05
** p<0.01
*** p<0.001.
Summary of random effect and model comparison.
| Null model | Model I | Full Model | Sub-group analysis | ||
|---|---|---|---|---|---|
| Married Adolescents | Never Married Adolescents | ||||
| Measures of variation | |||||
| Neighbourhood Variance | 1.34 [1.14, 1.57] | 0.83 [0.70–0.99] | 0.42 [0.33, 0.54] | 0.50 [0.36, 0.68] | 0.50 [0.30, 0.83] |
| ICC | 0.990 [0.988, 0.992 | 0.984 [0.981, 0.988] | 0.976 [0.969, 0.983] | 0.985 [0.979, 0.991] | 0.972 [0.958, 0.987] |
| PCV | Reference | 0.381 | 0.687 | ||
| Model fit | |||||
| AIC | 2050.07 | 1730.9 | -655.96 | -2679.41 | 1699.62 |
| BIC | 2070.82 | 1779.31 | -503.81 | -2576.9 | 1841.02 |
| Adolescent girls | 7449 | 7449 | 7449 | 1243 | 6206 |
| Households | 6505 | 6505 | 6505 | 1228 | 5323 |
| Neighbourhoods | 1352 | 1352 | 1352 | 520 | 1291 |
ICC = Interclass Correlation, PCV = Proportional Change in Variance, AIC = Akaike Information Criterion, BIC = Bayesian Information Criterion.