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APHA Scientific Session and Event Listing

Recorded presentation

Anu Manchikanti, MSc¹, Ilene S. Speizer, PhD, MHS², Heidi Reynolds, PhD, MPH³, Nancy Murray, PhD, MPH⁴, Tania Viala, DDS, MPH⁵, and Harry F. Beauvais, MD, MPH⁵. (1) Family Health International, Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Rosenau Hall, Campus Box 7445, Chapel Hill, NC 27599, 919-969-2097, amanchikanti@unc.edu, (2) SPH - Maternal and Child Health, University of North Carolina at Chapel Hill, MEASURE Evaluation Project, 206 W. Franklin St., Chapel Hill, NC 27516, (3) Health Services Research, Family Health International, PO Box 13950, Research Triangle Park, NC 27709, (4) Futures Group International, 1020 W. 38th St., Baltimore, MD 21211, (5) Foundation for Reproductive Health and Family Education, Rue Débussy # 30, Port-au-Prince, Haiti

Intergenerational sex is a risk factor for adverse reproductive health outcomes among women, particularly in the context of poverty and gender inequality. Unequal power between a young woman and an older man may render sexual negotiation for contraceptive use difficult. This study examines the relationship between sexual debut with an older partner and subsequent reproductive health outcomes among 576 sexually experienced women aged 15-24 who utilized voluntary counseling and testing or reproductive health services in Port-au-Prince, Haiti. 66% of women reported sexual initiation with a partner younger or less than 5 years older, 30% with a partner 5 to 10 years older, and 4% with a partner 10 or more years older. Logistic regression analyses will be conducted to establish, controlling for socioeconomic and demographic factors, whether the age of the partner is significantly associated with risky reproductive health behaviors. Outcomes include: STI diagnosis in the previous 12 months, condom use at first intercourse, condom use at last intercourse, and modern contraceptive use at last intercourse. Preliminary results suggest that first sex with a partner more than 10 years older significantly increases the relative risk of STI diagnosis, while respondents initiating sexual activity with a partner 5-10 years older had a lower risk of using modern contraceptives or condoms at their last sexual intercourse. There was not a significant effect on condom use at first sex. These results indicate that programs focused on delaying sexual debut should also consider age mixing and power relations between young women and older men.

Learning Objectives:

• Describe the occurrence of condom use, contraceptive use, recent STI diagnosis, and sexual debut with an older partner among users of youth VCT and reproductive health services in Port-au-Prince, Haiti.
• Understand the relationship between partner age difference in sexual debut and the risk of adverse reproductive health outcomes among youth.

Keywords: Youth, Reproductive Health

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation