Division of Epidemiology, School of Public Health, University of California, Berkeley, California.
Youth Development Labs (YLabs), Atelier, Kimihurura, Rwanda.
Ann Epidemiol. 2023 Jul;83:35-39.e1. doi: 10.1016/j.annepidem.2023.04.005. Epub 2023 Apr 14.
Understanding the timing of sexual debut is critical for informing sexual and reproductive health interventions. We investigated sexual behavior and early sexual debut among Rwandan youth.
We conducted a cross-sectional analysis of data from a cluster-randomized trial with 6079 students ages 12-19 years in Rwanda. We examined predictors of early sexual debut (<15 years) using logistic regression to estimate odds ratios and factors associated with the timing of first sex using Cox models to estimate hazard ratios. Interpretations of sex were also explored.
Participants were 15 years and 51.5% female on average; 1723 (28.3%) reported sexual activity. Among the 1320 participants who provided an age of sexual debut, 51.4% reported sex at ≤12 years and 75.7% at<15 years. Males had a higher odds of early sexual debut (adjusted odds ratio: 2.40; 95% CI: 1.99, 2.90) and a higher hazard of sex occuring at an earlier age than females (adjusted hazard ratio: 1.91; 95% CI: 1.67, 2.20). One-third of participants considered "sexual intercourse" to include kissing, touching, or masturbation.
Sex at ≤12 years was frequently reported, indicating that interventions facilitating access to youth-friendly sexual and reproductive health services are necessary before age 12. Validation studies are needed to evaluate how interpretations of sexual intercourse influence the assessment of sexual activity.
NCT04198272.
了解性初体验的时间对于告知性和生殖健康干预措施至关重要。我们调查了卢旺达青年的性行为和早期性初体验。
我们对卢旺达一项包含 6079 名 12-19 岁学生的随机对照试验数据进行了横断面分析。我们使用逻辑回归分析来评估早期性初体验（<15 岁）的预测因素，以估计优势比；使用 Cox 模型来评估首次性行为的时间相关因素，以估计风险比。还探讨了对性的理解。
参与者的平均年龄为 15 岁，51.5%为女性；1723 人（28.3%）报告有性行为。在 1320 名提供性初体验年龄的参与者中，51.4%报告在≤12 岁时发生性行为，75.7%报告在<15 岁时发生性行为。男性发生早期性初体验的可能性更高（调整后的优势比：2.40；95%置信区间：1.99，2.90），发生性行为的年龄也更早（调整后的风险比：1.91；95%置信区间：1.67，2.20）。三分之一的参与者认为“性交”包括亲吻、触摸或自慰。
经常报告在≤12 岁时发生性行为，这表明在 12 岁之前需要促进青少年友好的性和生殖健康服务的干预措施。需要进行验证研究来评估对性交的理解如何影响对性行为的评估。
NCT04198272。
