Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111937

Jessica Greene, MPH, John Berman, and Neha Suchak, MS. AIDSMark, Population Services International, 1120 19th St NW, Suite 600, Washington, DC 20036, 202-572-4586, jgreene@psi.org

Understanding Barriers to Delayed Debut Among African Youth

Background: Early sexual debut puts youth at increased risk of HIV acquisition by lengthening exposure period and resulting in more lifetime sexual partners. Abstinence is recognized as a crucial component of HIV prevention, however, sustained behavior change is difficult to achieve. This study explores how barriers to delayed sexual debut impact sexual behavior.

Methods: 74 focus groups were conducted with male and female, sexually and non-sexually active youth, ages 14-19 in Botswana, DRC, Mali, Rwanda, Tanzania, Togo, Uganda, and Zambia. Constant comparative analysis highlighted common and divergent themes. Results informed the design of a regional communications campaign targeting youth in peri-urban and urban areas in sixteen countries.

Results: Sexual intercourse was a rite of passage from childhood to adulthood. Desire to be “a man” or “a woman” influenced sexual decision-making. Among males, peer pressure to fit in with friends emphasized proving one's manhood. Among females, fitting in with friends, acquiring money and material goods influenced decision-making. Sexual violence and coercion was pervasive and tolerated. More parental communication and sex education was desired.

Conclusion: Addressing contextual issues inhibiting delayed debut includes providing youth with sex education, life skills to negotiate peer and partner pressure, and increasing acceptance of abstinence and challenging social norms associating sex with adulthood. A regional mass media campaign was developed; messages focused on altering the definition of adulthood from sexual activity to responsibility, respect, and future goals. Supporting IPC material will facilitate communication on sexuality between parents and children.

Learning Objectives:

• Describe how early sexual debut puts youth at increased risk of HIV acquisition.
• List 3 barriers to delayed sexual debut among youth ages 14-19 that were identified in focus group discussions in Botswana, DRC, Mali, Rwanda, Tanzania, Togo, Uganda, and Zambia. Articulate how the transition from childhood to adulthood influences sexual decision-making in the described groups.
• List three interventions that can address the contextual issues inhibiting delayed debut.

Keywords: HIV/AIDS, Sexual Behavior

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation