Curtin School of Population Health, Curtin University, Perth, Australia.
Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Arch Sex Behav. 2023 Aug;52(6):2491-2502. doi: 10.1007/s10508-023-02591-w. Epub 2023 Apr 17.
Early sexual debut is associated with increased risk of several sexual and reproductive health problems, including unwanted pregnancies and sexually transmitted infections. Hence, determining factors that promote early sexual initiation is significant to guide policy and inform interventions aimed to promote the health of young people through to adulthood. This study examined the prevalence of early sexual debut and its associated factors among young women in Mali. Using cross-sectional nationally representative data from the 2018 Mali Demographic and Health Survey, a total of 4063 young women aged 15-24 were included in the study. Multilevel binary logistic regression analysis was done to determine the factors associated with early sexual debut. The results were presented using adjusted odds ratios (aOR) and 95% confidence intervals (CIs). The prevalence of early sexual debut in Mali was 17.8% (95% CI; 16-19.7%). Young women who attended higher school had lower odds of early sexual debut (aOR = 0.10, 95% CI; 0.01-0.82) compared to young women who had no formal education. Young women from richest households had lower odds of early sexual debut compared to those from the poorest households (aOR = 0.48, 95% CI; 0.27-0.82). Young women from households with large family size also had lower odds of experiencing early sexual debut compared to those in small family size (aOR = 0.81, 95% CI; 0.66-0.99). Furthermore, the odds of early sexual debut were lower among young women in Koulikoro (aOR = 0.59, 95% CI; 0.39-0.90), Sikasso (aOR = 0.35, 95% CI; 0.21-0.56), Segou (aOR = 0.40, 95% CI; 0.25-0.64), and Mopti (aOR = 0.44, 95% CI; 0.23-0.82) regions compared to young women in Kayes region. Higher odds of early sexual debut were found among currently employed compared to not currently employed young women (aOR = 1.74, 95% CI; 1.42-2.12) and currently married compared to not currently married young women (aOR = 4.64, 95% CI; 3.64-5.92). Young women from the Peulh ethnic groups compared to those from the Bambara ethnic groups were at a higher odds of early sexual debut (aOR = 1.43, 95% CI; 1.03-1.99). The findings suggest the need for interventions aimed at addressing early sexual debut among young women. These can include emphasizing the promotion and importance of female education, addressing the cultural practices that promote negative sexual norms/practices such as child marriages, and ensuring social change through efforts such as creating employment or economic opportunities for families.
早期性行为与多种性健康和生殖健康问题的风险增加有关，包括意外怀孕和性传播感染。因此，确定促进早期性行为的因素对于指导政策和提供信息干预措施以促进年轻人的健康至关重要。本研究调查了马里年轻女性中早期性行为的流行情况及其相关因素。本研究使用了来自 2018 年马里人口与健康调查的全国代表性横断面数据，共纳入了 4063 名年龄在 15-24 岁的年轻女性。使用多水平二项逻辑回归分析确定与早期性行为相关的因素。结果以调整后的优势比（aOR）和 95%置信区间（CI）表示。马里的早期性行为流行率为 17.8%（95%CI；16-19.7%）。与没有正规教育的年轻女性相比，接受过高等教育的年轻女性发生早期性行为的可能性较小（aOR=0.10，95%CI；0.01-0.82）。与来自最贫困家庭的年轻女性相比，来自最富裕家庭的年轻女性发生早期性行为的可能性较低（aOR=0.48，95%CI；0.27-0.82）。与来自大家庭的年轻女性相比，来自小家庭的年轻女性发生早期性行为的可能性也较低（aOR=0.81，95%CI；0.66-0.99）。此外，与来自卡伊泽地区的年轻女性相比，来自库里克罗、锡卡索、塞古和莫普提地区的年轻女性发生早期性行为的可能性较低（aOR=0.59，95%CI；0.39-0.90）。与未婚的年轻女性相比，目前已婚的年轻女性发生早期性行为的可能性更高（aOR=4.64，95%CI；3.64-5.92）。与未就业的年轻女性相比，目前就业的年轻女性发生早期性行为的可能性更高（aOR=1.74，95%CI；1.42-2.12）。与班巴拉族的年轻女性相比，属于颇尔族的年轻女性发生早期性行为的可能性更高（aOR=1.43，95%CI；1.03-1.99）。研究结果表明，需要针对年轻女性开展早期性行为干预措施。这些措施包括强调促进和重视女性教育，解决促进负面性规范/做法的文化习俗，例如童婚，以及通过创造就业或经济机会等努力实现社会变革。
