Pettifor Audrey, O'Brien Katie, Macphail Catherine, Miller William C, Rees Helen
Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC, USA.
Int Perspect Sex Reprod Health. 2009 Jun;35(2):82-90. doi: 10.1363/ifpp.35.082.09.
Young people in South Africa are at high risk of HIV infection. Because first sexual experiences may influence a young person's HIV risk, a better understanding of coital debut is needed.
Data from a nationally representative survey that included 7,692 sexually active South African youth aged 15-24 were used to assess characteristics related to sexual debut and to respondents' first sexual partner. Poisson regression analyses were conducted to identify relationships among these characteristics and partner age differences, early coital debut (i.e., before age 15), forced sex with one's first partner and nonuse of condoms at first sex.
Eighteen percent of young men and 8% of young women reported early coital debut. The likelihood of early debut was elevated among females and males who had had an older first partner (adjusted prevalence ratio, 1.1 per year) and among females who had had forced sex (2.5). Lack of condom use at first sex was associated with early coital debut (1.5) and forced sex (1.6) for males. Among females, the likelihood of nonuse was elevated for respondents who had had an early debut but had not had forced sex (1.3), and among those who had had both a later debut and forced sex (1.4).
Early coital debut is associated with factors that may increase a young person's risk for HIV infection, such as forced sex and having older partners. Intervention efforts should encourage youth to delay coital debut and promote strategies to make young people's first sexual experience safer.
南非的年轻人面临着较高的艾滋病毒感染风险。由于首次性行为可能会影响年轻人感染艾滋病毒的风险，因此需要更好地了解初次性交情况。
利用一项具有全国代表性的调查数据，该调查涵盖了7692名年龄在15 - 24岁之间有性行为的南非青年，以评估与初次性行为及受访者的首个性伴侣相关的特征。进行泊松回归分析，以确定这些特征与伴侣年龄差异、初次性交过早（即15岁之前）、与首个伴侣的强迫性行为以及初次性行为时未使用避孕套之间的关系。
18%的年轻男性和8%的年轻女性报告初次性交过早。首个伴侣年龄较大的女性和男性（调整后的患病率比值为每年1.1）以及遭受过强迫性行为的女性（2.5）初次性交过早的可能性更高。男性初次性行为时未使用避孕套与初次性交过早（1.5）和强迫性行为（1.6）有关。在女性中，初次性交过早但未遭受强迫性行为的受访者（1.3）以及初次性交较晚且遭受过强迫性行为的受访者（1.4）未使用避孕套的可能性更高。
初次性交过早与可能增加年轻人感染艾滋病毒风险的因素有关，如强迫性行为和拥有年龄较大的伴侣。干预措施应鼓励年轻人推迟初次性交，并推广使年轻人的首次性经历更安全的策略。
