Shrestha Grishu, Piya Reecha, Kakchapati Sampurna, Sapkota Parash Mani, Joshi Deepak, Baral Sushil Chandra
Health Research and Social Development Forum (HERD) International, Lalitpur, Nepal.
PLoS One. 2025 Jan 3;20(1):e0315495. doi: 10.1371/journal.pone.0315495. eCollection 2025.
Sexual behavior among youth is a public health concern, particularly in contexts where cultural norms, socio-economic factors, and access to comprehensive sexual education play pivotal roles. This paper aims to examine the determinants of sexual behavior among Nepali youths.
This study analyzed data from 7,122 individuals aged 15-24 years from the Nepal Demographic and Health Survey (NDHS) 2022, focusing on a nationally representative sample. This study assessed the prevalence of sexual behaviors, including premarital sex, recent sexual activity, and multiple sexual partners. Determinants examined included socio-demographic characteristics, media use, smoking, and alcohol consumption. Bivariate and multivariate logistic regression analysis were conducted to determine the associations between social determinants and sexual behaviors.
The prevalence of premarital sex among the youth was 10.4%, with 15% of male youths reporting recent sexual activity and 2.8% having sexual intercourse with multiple partners. Variables significantly associated with premarital sex included older age groups (AOR = 2.81; 95% CI: 1.98-3.99), male (AOR = 7.87; 95% CI: 5.00-12.39), sales occupations (AOR = 2; 95% CI:1.12-3.57), smoking (AOR = 2.71; 95% CI:1.74-4.23), smokeless tobacco products (AOR = 1.94; 95% CI:1.12-3.34), and alcohol consumption (AOR = 2.97; 95% CI:2-4.41). Variables significantly associated with recent sexual activity included older age groups (AOR = 2.1; 95% CI:1.46, 3.03), being unmarried (AOR = 9.34; 95% CI:5.19-16.82), smoking (AOR = 2.01; 95% CI:1.33-3.05), use of smokeless products (AOR = 1.7; 95% CI:1.98-3.67), and alcohol consumption (AOR = 1.91; 95% CI:1.30-2.82). Youths using smokeless products had higher odds (AOR = 3.33; 95% CI:1.75-6.35) of having multiple sexual partners compared to those youths not using smokeless products.
Social determinants, along with smoking and alcohol consumption, were associated with sexual behaviors among youth. This study highlights the need for multicomponent health promotion (new public health) interventions which consider multi-level strategies, including culturally tailored sexual health programs, drug use behaviors, healthy lifestyle choices, comprehensive sexual health education for evidence-based interventions.
青少年的性行为是一个公共卫生问题，在文化规范、社会经济因素以及获得全面性教育发挥关键作用的背景下尤其如此。本文旨在研究尼泊尔青少年性行为的决定因素。
本研究分析了2022年尼泊尔人口与健康调查（NDHS）中7122名年龄在15至24岁之间的个体的数据，重点是具有全国代表性的样本。本研究评估了性行为的发生率，包括婚前性行为、近期性活动以及多个性伴侣。所考察的决定因素包括社会人口学特征、媒体使用、吸烟和饮酒情况。进行了双变量和多变量逻辑回归分析，以确定社会决定因素与性行为之间的关联。
青少年中婚前性行为的发生率为10.4%，15%的男性青少年报告近期有性活动，2.8%的人有多个性伴侣。与婚前性行为显著相关的变量包括年龄较大的年龄组（调整后比值比[AOR]=2.81；95%置信区间[CI]：1.98 - 3.99）、男性（AOR = 7.87；95% CI：5.00 - 12.39）、销售职业（AOR = 2；95% CI：1.12 - 3.57）、吸烟（AOR = 2.71；95% CI：1.74 - 4.23）、无烟烟草制品（AOR = 1.94；95% CI：1.12 - 3.34）以及饮酒（AOR = 2.97；95% CI：2 - 4.41）。与近期性活动显著相关的变量包括年龄较大的年龄组（AOR = 2.1；95% CI：1.46，3.03）、未婚（AOR = 9.34；95% CI：5.19 - 16.82）、吸烟（AOR = 2.01；95% CI：1.33 - 3.05）、使用无烟制品（AOR = 1.7；95% CI：1.98 - 3.67）以及饮酒（AOR = 1.91；95% CI：1.30 - 2.82）。与不使用无烟制品的青少年相比，使用无烟制品的青少年有多个性伴侣的几率更高（AOR = 3.33；95% CI：1.75 - 6.35）。
社会决定因素以及吸烟和饮酒与青少年的性行为有关。本研究强调需要采取多成分的健康促进（新公共卫生）干预措施，这些措施应考虑多层次策略，包括针对文化特点的性健康项目、药物使用行为、健康的生活方式选择以及基于证据的干预措施的全面性健康教育。
