Health Research Training Program (HRTP), ICAP at Columbia University, Mbabane, Eswatini.
Faculty of Health Sciences, Department of Community Health Nursing Science, University of Eswatini, Mbabane, Eswatini.
PLoS One. 2023 Mar 10;18(3):e0282828. doi: 10.1371/journal.pone.0282828. eCollection 2023.
Early sexual debut (i.e., sex before the age of 15 years), especially if it is unprotected, may increase the risk of acquiring HIV, sexually transmitted infections, and unwanted pregnancies. We investigated the reasons for early sexual debut among in-school youth in Eswatini, a setting with high HIV incidence among youth.
This was a qualitative, exploratory-descriptive study whereby data were collected from 81 sexually active in-school youth through seven focus group discussions (FGDs) in four purposively selected public high schools (two urban and two rural) in the Manzini region, Eswatini. In each school, except one, two FGDs (one for boys and one for girls) were conducted. Qualitative data were coded and analyzed thematically in Dedoose version 8.2.14.
Nearly 40% of the participants reported having initiated sexual activity before 18 years. Six major themes emerged from the data: i) Intrapersonal factors (feeling mature, religiosity, nutritional or dietary patterns); ii) Parenting and household factors (living arrangement, lack of sexuality education, working parents, negative role-modeling from adults); iii) Peer and partner pressure (pressure from friends, threats from sexual partners, intergenerational sexual partnerships and transactional sex, testing sexual prowess, desire to fit in); iv) Contextual factors (neighborhood, location); v) Mass media (cell phone ownership, social media, and television shows or movies); and vi) Cultural factors (attending traditional ceremonies, loss of cultural norms, values, and traditions, and dress code).
The poor monitoring and negative role-modeling by elders highlight the importance of involving parents or guardians as key stakeholders when designing interventions targeting risky sexual behavior among youth. The multifaceted nature of the cited reasons for early sexual debut calls for interventions aimed at curbing risky sexual behavior to be culturally sensitive and responsive to the themes identified in this study.
性初体验（即 15 岁之前发生性行为），尤其是无保护的性行为，可能会增加感染艾滋病毒、性传播感染和意外怀孕的风险。我们调查了斯威士兰在校青少年性初体验的原因，该地区青年艾滋病毒感染率较高。
这是一项定性、探索性描述研究，通过在斯威士兰曼齐尼地区的四所公立高中（两所城市和两所农村）进行的 7 次焦点小组讨论（FGD），从 81 名有性活跃的在校青少年中收集数据。除了一所学校外，每所学校都进行了两次 FGD（一次针对男孩，一次针对女孩）。在 Dedoose 版本 8.2.14 中对定性数据进行编码和主题分析。
近 40%的参与者报告在 18 岁之前开始了性行为。数据中出现了 6 个主要主题：i）个体因素（感觉成熟、宗教信仰、营养或饮食模式）；ii）父母和家庭因素（生活安排、缺乏性教育、父母工作、成年人的负面榜样）；iii）同伴和伴侣的压力（来自朋友的压力、性伴侣的威胁、代际性关系和交易性性行为、测试性能力、融入群体的愿望）；iv）背景因素（邻里、位置）；v）大众媒体（手机拥有情况、社交媒体、电视节目或电影）；vi）文化因素（参加传统仪式、失去文化规范、价值观和传统以及着装规范）。
长辈对青少年的不良监督和负面榜样作用突出了在设计针对青年危险性行为的干预措施时，将父母或监护人作为关键利益相关者的重要性。性初体验的原因具有多面性，这呼吁采取文化敏感和针对本研究中确定的主题的干预措施来遏制危险的性行为。
