采用地理加性离散时间生存方法对津巴布韦女性首次性行为的时间进行建模。

Modeling timing of sexual debut among women in Zimbabwe using a Geoadditive Discrete-Time survival approach.

作者信息

Bere Alphonce, Maposa Innocent, Matsena-Zingoni Zvifadzo, Twabi Halima S, Batidzirai Jesca M, Singini Geoffrey C, Mchunu Nobuhle, Nasejje Justine B, Moyo-Chilufya Maureen, Ojifinni Oludoyinmola, Nevhungoni Portia, Musekiwa Alfred

机构信息

Department of Mathematical and Computational Sciences, University of Venda, Thohoyandou, South Africa.

Division of Epidemiology & Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

出版信息

BMC Womens Health. 2025 Mar 24;25(1):137. doi: 10.1186/s12905-025-03590-w.

DOI:10.1186/s12905-025-03590-w

PMID:40128696

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11931742/

Abstract

BACKGROUND

Early sexual debut has undesirable health consequences such as an increased risk of contracting sexually transmitted infections (STIs) including HIV, mental health problems, pregnancy-related complications and death including abortion-related deaths. Despite a global decline in adolescent birth rates, Zimbabwe continues to face a high prevalence of underage pregnancies, highlighting significant early sexual debut among Zimbabwean adolescents. This study examined the spatial variation and the demographic and socio-economic determinants of the timing of early sexual debut among Zimbabwean women.

METHODS

Data for 9,882 Zimbabwean women of reproductive age were drawn from the 2015 Zimbabwe Demographic and Health Survey (ZDHS). We defined early sexual debut as having first sexual intercourse before the 18 years of age. A fully Bayesian geoadditive discrete-time survival model was used. Adjustments for unequal sampling probabilities were done using the provided survey weights.

RESULTS

Our findings show that women with primary education (aOR = 0.62,95% Crl:0.47-0.81), secondary education (aOR = 0.25,95% Crl:0.19-0.33) and higher education (aOR = 0.06,95% Crl:0.04-0.09) had lower odds of early sexual debut than those with no education. In comparison to those with middle household wealth index, women with higher household wealth index (aOR = 0.83, 95% CrI: 0.71-0.98) had lower odds of early sexual initiation. On the other hand, women with lower household wealth index had higher likelihood of early sexual debut (aOR = 1.13, 95% CrI: 1.03-1.26) than those with middle household wealth index. The type of place of residence and birth year cohort did not have a significant association with the odds of early sexual debut. The hotspots of early sexual debut were in Matabeleland North and Matabeleland South provinces.

CONCLUSION

To mitigate early sexual debut in Zimbabwe, targeted interventions are essential in Matabeleland North and Matabeleland South provinces as well as in the identified high-risk groups.

摘要

背景

过早开始性行为会带来不良健康后果，如感染包括艾滋病毒在内的性传播感染的风险增加、心理健康问题、与怀孕相关的并发症以及死亡，包括与堕胎相关的死亡。尽管全球青少年生育率有所下降，但津巴布韦仍面临未成年怀孕的高流行率，这凸显了津巴布韦青少年中过早开始性行为的情况严重。本研究调查了津巴布韦女性过早开始性行为时间的空间差异以及人口和社会经济决定因素。

方法

从2015年津巴布韦人口与健康调查（ZDHS）中提取了9882名育龄津巴布韦女性的数据。我们将过早开始性行为定义为在18岁之前首次发生性行为。使用了一个完全贝叶斯地理加性离散时间生存模型。使用提供的调查权重对不等抽样概率进行了调整。

结果

我们的研究结果表明，接受小学教育的女性（调整后比值比[aOR]=0.62，95%可信区间[CrI]：0.47 - 0.81）、接受中学教育的女性（aOR = 0.25，95% CrI：0.19 - 0.33）和接受高等教育的女性（aOR = 0.06，95% CrI：0.04 - 0.09）过早开始性行为的几率低于未接受教育的女性。与中等家庭财富指数的女性相比，家庭财富指数较高的女性（aOR = 0.83，95% CrI：0.71 - 0.98）过早开始性行为的几率较低。另一方面，家庭财富指数较低的女性过早开始性行为的可能性（aOR = 1.13，95% CrI：1.03 - 1.26）高于中等家庭财富指数的女性。居住地点类型和出生年份队列与过早开始性行为的几率没有显著关联。过早开始性行为的热点地区位于北马塔贝莱兰省和南马塔贝莱兰省。