Stark Lindsay, Tan Timothy M, Muldoon Katherine A, King Dora, Lamin David F M, Lilley Sarah, Wessells Michael G
a Mailman School of Public Health , Columbia University , New York , NY , USA.
b School of Population and Public Health , University of British Columbia , Vancouver , BC , Canada.
Glob Public Health. 2016 Mar;11(3):309-321. doi: 10.1080/17441692.2015.1031155. Epub 2015 Apr 16.
Orphanhood is common in sub-Saharan Africa, and is a critical issue shaping global assistance for children. Care arrangements for children are often fluid, and many 'orphaned' children have a surviving biological parent. This study examines the protective effects of family-level factors on early sex and pregnancy in rural Sierra Leone. A survey of 530 adolescents in 2 districts in Sierra Leone was analysed to evaluate associations between living arrangement and orphanhood on recent sexual activity and pregnancies out of wedlock. After controlling for confounders, living with one's mother (AOR = 0.46, 95% CI: 0.22-1.00) and living with both parents (AOR = 0.36, 95% CI: 0.17-0.73) were protective against recent sexual activity. Orphan status was not significantly associated with recent sexual activity. Among 164 sexually active adolescents, neither living arrangement nor orphanhood was associated with pregnancy. This study demonstrates the protective effect of living with a surviving biological parent to delay early sexual debut. Once an adolescent becomes sexually active; however, living arrangement is not associated with the risk of pregnancy out of wedlock. The findings suggest that supporting family connectedness and preventing unnecessary family separation may benefit at least some aspects of adolescent sexual and reproductive health in Sierra Leone.
孤儿现象在撒哈拉以南非洲地区很常见，并且是影响全球儿童援助的一个关键问题。儿童的照料安排往往不稳定，许多“孤儿”有健在的亲生父母。本研究考察了家庭层面因素对塞拉利昂农村地区青少年过早性行为和怀孕的保护作用。对塞拉利昂两个地区的530名青少年进行了一项调查分析，以评估生活安排和孤儿身份与近期性活动及非婚怀孕之间的关联。在控制混杂因素后，与母亲同住（调整后比值比[AOR]=0.46，95%置信区间[CI]：0.22 - 1.00）和与父母双方同住（AOR = 0.36，95% CI：0.17 - 0.73）可预防近期性活动。孤儿身份与近期性活动无显著关联。在164名有性活动的青少年中，生活安排和孤儿身份均与怀孕无关。本研究证明了与健在的亲生父母同住对推迟初次性行为的保护作用。然而，一旦青少年开始有性活动，生活安排与非婚怀孕风险无关。研究结果表明，支持家庭联系并防止不必要的家庭分离可能至少在塞拉利昂青少年性与生殖健康的某些方面有益。
