Page 148 - SAHCS HIVMed Journal Vol 20 No 1 2019

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 8 Original Research

Self-reported risky sexual practices among

adolescents and young adults in Botswana

Authors: Background: Adolescents and young adults account for more than one-third of incident
Unoda Chakalisa Human Immunodeficiency Virus (HIV) infections globally. Understanding sexual practices of
1
Kathleen Wirth 2
Kara Bennett 3 this high-risk group is critical in designing HIV targeted prevention programming.
Etienne Kadima
1
Kutlo Manyake 1 Objectives: To describe self-reported risky sexual practices of adolescents and young adults
Tendani Gaolathe 1 aged 16–24 years from 30 Botswana communities.
Pam Bachanas 4
Tafireyi Marukutira 5 Methods: Cross-sectional, self-reported age at sexual debut; number of sexual partners;
Refeletswe Lebelonyane 6 condom and alcohol use during sex; intergenerational sex; and transactional sex data were
Scott Dryden-Peterson 7 collected. Modified Poisson estimating equations were used to obtain univariate and
Lisa Butler 8 multivariate-adjusted prevalence ratios (PR) and 95% confidence intervals (CI) comparing
Mompati Mmalane
1
Joseph Makhema 1 engagement in different sexual practices according to gender, accounting for the clustered
Michelle E. Roland 5 design of the study.
Molly Pretorius-Holme 2
Max Essex 2 Results: Among the 3380 participants, 2311 reported being sexually active with more females
Shahin Lockman 7 reporting being sexually active compared to males (65% vs. 35%, respectively; p < 0.0001). In
Kathleen M. Powis 9 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
Affiliations:
1 Botswana Harvard AIDS sex (PR 3.46; 95% CI 2.07–5.77) than males, yet less likely to report engaging in sex before age
Institute Partnership, 15 years (PR 0.59; 95% CI: 0.41–0.85), using alcohol around the time of intercourse (PR: 0.59;
Gaborone, Botswana 95% CI 0.45–0.76) or having ≥ two partners in the last 12 months (PR 0.65; 95% CI 0.57–0.74).
2 Harvard T.H. Chan School Conclusions: Self-reported risky sexual practices of adolescents and young adults in Botswana
of Public Health, Boston, differed significantly between males and females. Gender-specific risky sexual practices
United States highlight the importance of developing tailored HIV prevention programming.
3 Bennett Statistical Keywords: Adolescents; Young adults; Risky sexual practices; HIV; Self-reported risky sexual
Consulting, Ballston Lake, practices; Gender-specific risky sexual practices.
United States
4 Centers for Disease Control
and Prevention, Division of Introduction
Global HIV/AIDS and TB,
Atlanta, United States According to the United Nations International Children’s Emergency Fund (UNICEF), every
2 minutes an adolescent aged 15–19 years is infected with Human Immunodeficiency Virus (HIV),
5 Centers for Disease Control with female adolescents and young adults aged 15–24 years in sub-Saharan Africa at the greatest
and Prevention, Gaborone, risk. The World Health Organization (WHO) estimates that 20% of women living with HIV
1,2
Botswana
worldwide are aged 15–24 years, of whom 80% live in sub-Saharan Africa. AIDS remains one of the
2,3
6 Botswana Ministry of Health leading causes of death among adolescents worldwide, with sub-Saharan Africa the most affected. 1,4
and Wellness, Gaborone,
Botswana Human immunodeficiency virus prevention programming represents a critical component of
HIV epidemic eradication. However, prevention programme designs and offerings need to reflect
7 Brigham and Women’s
Hospital, Boston, United States the dynamics of the epidemic. For example, females acquire HIV approximately 5–7 years earlier
than their male counterparts in sub-Saharan Africa. Factors contributing to this gender disparity
5
8 Institute for Collaboration include behavioural differences, such as challenges around the ability to negotiate condom use, or
on Health, Intervention vulnerability to incidents of forced sex, as well as structural differences, including poverty,
and Policy, University of
6,7
Connecticut, Storrs, differential livelihood opportunities, and unequal access to higher education. Therefore,
United States contextually and age-appropriate prevention programming that effectively reaches adolescents
and young adults in sub-Saharan Africa (especially women) is urgently needed.
Read online: 9 Massachusetts General Hospital, Boston, United States
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Scan this QR Corresponding author: Unoda Chakalisa, [email protected]
code with your Dates: Received: 14 Aug. 2018 | Accepted: 25 Mar. 2019 | Published: 26 June 2019
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mobile device How to cite this article: Chakalisa U, Wirth K, Bennett K, et al. Self-reported risky sexual practices among adolescents and young adults
to read online. in Botswana. S Afr J HIV Med. 2019;20(1), a899. https://doi.org/10.4102/sajhivmed.v20i1.899
to read online.
Copyright: © 2019. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
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