Kawai Kosuke, Kaaya Sylvia F, Kajula Lusajo, Mbwambo Jessie, Kilonzo Gad P, Fawzi Wafaie W
Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
Scand J Public Health. 2008 Nov;36(8):879-88. doi: 10.1177/1403494808094243.
Early sexual debut is associated with increased HIV risk among young adolescents in sub-Saharan Africa. Our study examines parents' and teachers' communication about sexual matters in relation to the timing of sexual initiation among students aged 12-14 years old in Dar es Salaam, Tanzania.
Virgin primary school students were followed prospectively for 6 months to assess sexual initiation. Socio-demographic, psychosocial, and behavioural factors were assessed with a structured questionnaire. Univariate and multivariate logistic regression analyses were performed.
Of 2477 adolescents, 26.9% of students reported communicating about HIV and sex with parents and 35.6% communicated with teachers. Communication with teachers about HIV and sex was associated with delayed sexual initiation among adolescents after adjusting for potential confounding factors (OR=0.59, 95%CI=0.40-0.89, p=0.01). However, parental communication was not associated with the timing of sexual initiation. The perception that most peers are sexually active was a significant predictor of early sexual debut (test for linear trend, p=0.002). Students who do not live with a biological mother were marginally more likely to initiate sex compared to those who live with a biological mother (OR=1.39, 95%CI=0.97-1.99, p=0.08).
Teachers can play an effective role in discussing HIV and sex with young adolescents. Our study highlights the necessity of responsible adults discussing sexual matters with young adolescents in sub-Saharan Africa. More research is required to better understand the role of parental communication about sexual matters and strategies for improving the quality of parental communication.
在撒哈拉以南非洲地区，青少年过早开始性行为会增加感染艾滋病毒的风险。我们的研究调查了坦桑尼亚达累斯萨拉姆12至14岁学生的父母和教师在性问题上的沟通情况与首次性行为时间的关系。
对小学处女学生进行为期6个月的前瞻性跟踪，以评估首次性行为情况。通过结构化问卷评估社会人口统计学、心理社会和行为因素。进行单变量和多变量逻辑回归分析。
在2477名青少年中，26.9%的学生报告与父母交流过艾滋病毒和性方面的问题，35.6%的学生与教师交流过。在调整潜在混杂因素后，与教师就艾滋病毒和性进行交流与青少年性行为开始时间延迟有关（比值比=0.59，95%置信区间=0.40-0.89，p=0.01）。然而，父母的沟通与首次性行为时间无关。认为大多数同龄人有性行为是过早开始性行为的一个重要预测因素（线性趋势检验，p=0.002）。与与生母同住的学生相比，不住在生母身边的学生开始性行为的可能性略高（比值比=1.39，95%置信区间=0.97-1.99，p=0.08）。
教师在与青少年讨论艾滋病毒和性方面可以发挥有效作用。我们的研究强调了在撒哈拉以南非洲地区，负责任的成年人与青少年讨论性问题的必要性。需要更多研究来更好地理解父母在性问题上沟通的作用以及提高父母沟通质量的策略。
