Department of Biological Sciences, School of Environmental Sciences, Njala University, PMB, Freetown, Sierra Leone.
Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana.
PLoS One. 2024 Aug 22;19(8):e0309200. doi: 10.1371/journal.pone.0309200. eCollection 2024.
Premarital sexual intercourse has essential implications for the sexual and reproductive health and rights of young women. These include increased sexual pleasure and satisfaction as well as exposure to the risks of unintended pregnancy and sexually transmitted infections, including HIV/AIDS. This study examined the trends, patterns, and associations of premarital sexual intercourse among young women aged 15-24 in Sierra Leone.
Nationally representative cross-sectional data from the 2008, 2013, and 2019 Demographic and Health Surveys in Sierra Leone were used for the study. A weighted sample of 9,675 never-married young women was used to estimate the pooled prevalence of premarital sexual intercourse in Sierra Leone. Percentages were used to present the results of the trends and patterns of premarital sexual intercourse. We employed a multilevel binary logistic regression modelling technique to examine the associations of premarital sexual intercourse. The results were presented using adjusted odds ratio with their respective 95% confidence interval.
The pooled prevalence of premarital sexual intercourse among the young women in Sierra Leone was 62.9%. Over the survey years, premarital sexual intercourse increased from 59.8% in 2008 to 65.1% in 2013. However, it declined by 3.5% to 61.6% in 2019. Young women aged 20-24 (aOR = 12.47, 95% CI = 10.54-14.76) had higher odds of engaging in premarital sexual intercourse than those aged 15-19. Young women with higher educational levels (aOR = 1.87, 95% CI = 1.17-2.99), those who were working (aOR = 1.60, 95% CI = 1.44-1.78), those who listened to the radio (aOR = 1.33, 95% CI = 1.29-1.60), and those who lived in the Northwestern (aOR = 2.19, 95% CI = 1.68-2.84), Eastern (aOR = 1.47, 95% CI = 1.23-1.760, Northern (aOR = 1.48, 95% CI = 1.25 -, 1.76), and Southern (aOR = 1.63, 95% CI = 1.36-1.94) regions were more likely to engage in premarital sexual intercourse compared to those with no formal education, those not working, those who did not listen to the radio, and those who lived in the Western region, respectively. Young women in the richest wealth category (aOR = 0.62, 95% CI = 0.49-0.78), and residing in rural areas (aOR = 0.84, 95% CI = 0.72-0.98) had lower odds of engaging in premarital sexual intercourse relative to those from the poorest wealth quintile and those living in urban areas.
Our study found a high prevalence of premarital sexual intercourse among young women in Sierra Leone. Premarital sexual intercourse was associated with age, educational level, wealth, employment, and region. This necessitates providing them with comprehensive information regarding sexual and reproductive health behaviours, specifically emphasising the benefits and adverse consequences of engaging in sexual experimentation. Additionally, it is crucial to promote the adoption of abstinence, injections, implants, and condom usage through consistent advocacy for youth-risk communication.
婚前性行为对年轻女性的性健康和生殖健康权利至关重要。这些权利包括增加性愉悦和满足感，以及接触意外怀孕和性传播感染的风险，包括艾滋病毒/艾滋病。本研究调查了塞拉利昂 15-24 岁年轻女性婚前性行为的趋势、模式和关联。
本研究使用了塞拉利昂 2008、2013 和 2019 年人口与健康调查的全国代表性横断面数据。使用从未结婚的年轻女性加权样本估计塞拉利昂婚前性行为的总流行率。百分比用于呈现婚前性行为趋势和模式的结果。我们采用多水平二项逻辑回归模型技术来研究婚前性行为的关联。结果以调整后的优势比及其相应的 95%置信区间呈现。
塞拉利昂年轻女性婚前性行为的总流行率为 62.9%。在调查年份中，婚前性行为从 2008 年的 59.8%增加到 2013 年的 65.1%。然而，在 2019 年，它下降了 3.5%，至 61.6%。20-24 岁的年轻女性（调整后的优势比为 12.47，95%置信区间为 10.54-14.76）与 15-19 岁的年轻女性相比，发生婚前性行为的可能性更高。教育程度较高的年轻女性（调整后的优势比为 1.87，95%置信区间为 1.17-2.99）、有工作的年轻女性（调整后的优势比为 1.60，95%置信区间为 1.44-1.78）、听广播的年轻女性（调整后的优势比为 1.33，95%置信区间为 1.29-1.60）和居住在西北（调整后的优势比为 2.19，95%置信区间为 1.68-2.84）、东部（调整后的优势比为 1.47，95%置信区间为 1.23-1.760）、北部（调整后的优势比为 1.48，95%置信区间为 1.25-1.76）和南部（调整后的优势比为 1.63，95%置信区间为 1.36-1.94）地区的年轻女性比没有正规教育、没有工作、不听广播和居住在西部地区的年轻女性更有可能发生婚前性行为。最富有财富阶层的年轻女性（调整后的优势比为 0.62，95%置信区间为 0.49-0.78）和居住在农村地区的年轻女性（调整后的优势比为 0.84，95%置信区间为 0.72-0.98）与最贫穷财富五分位数的年轻女性和居住在城市地区的年轻女性相比，发生婚前性行为的可能性较低。
我们的研究发现，塞拉利昂年轻女性婚前性行为的流行率很高。婚前性行为与年龄、教育程度、财富、就业和地区有关。这就需要为她们提供有关性行为和生殖健康行为的全面信息，特别是强调性实验的好处和不良后果。此外，必须通过持续倡导青年风险沟通，促进采用禁欲、注射、植入物和避孕套的使用。
