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      Early sexual initiation and multiple sexual partners among Vietnamese women: analysis from the Multiple Indicator Cluster Survey, 2011

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          Abstract

          Introduction

          Under current HIV transmission mechanisms operating in Vietnam, women are seen as victims of their male partners. Having multiple sexual partners is one of the well-known risk factors for HIV infection. However, little is known about women's risky sexual behaviour and their vulnerability to HIV in Vietnam. This study aims to explore association between early sexual initiation and the number of lifetime sexual partners in Vietnamese women. Although the Vietnamese culture is socially conservative in this area, identifying women's risky sexual behaviour is important for the protection of women at risk of HIV and other sexually transmitted diseases.

          Design

          A total of 8,791 women, who reported having had sexual intercourse, were included in this analysis of data from the 2011 Multiple Indicator Cluster Survey in Vietnam. Data were collected using two-stage strata sampling, first at the national level and second across six geographical regions ( n=8,791). Multivariable logistic regressions describe association between early initiation of a sexual activity and lifetime multiple sexual partners.

          Results

          Early sexual intercourse was significantly associated with having lifetime multiple sexual partners. Women who were aged 19 or younger at first sexual intercourse were over five times more likely to have multiple sexual partners, compared with women whose first sexual intercourse was after marriage; aged 10–14 years (OR=5.9; 95% CI=1.9–18.8) at first intercourse; and aged 15–19 years (OR=5.4; 95% CI=4.0–7.2) at first intercourse. There was significant association with having multiple sexual partners for women of lower household wealth and urban residence, but the association with educational attainment was not strong.

          Conclusions

          The study results call for health and education policies to encourage the postponement of early sexual activity in young Vietnamese women as protection against risky sexual behaviour later in life.

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          Most cited references23

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          Long-term health correlates of timing of sexual debut: results from a national US study.

          We explored long-term health consequences of age at sexual initiation and of abstinence until marriage to evaluate empirical support for the claim that postponing sexual initiation has beneficial health effects. We analyzed data from the 1996 National Sexual Health Survey, a cross-sectional study of the US adult population. We compared sexual health outcomes among individuals who had initiated sexual activity at an early or late age versus a normative age. We also compared individuals whose first sexual intercourse had occurred before versus after marriage. Early initiation of sexual intercourse was associated with various sexual risk factors, including increased numbers of sexual partners and recent sexual intercourse under the influence of alcohol, whereas late initiation was associated with fewer risk factors. However, both early and late initiation were associated with sexual problems such as problems with arousal and orgasm, primarily among men. Relationship solidity and sexual relationship satisfaction were not associated with early or late initiation. Early sexual debut is associated with certain long-term negative sexual health outcomes, including increased sexual risk behaviors and problems in sexual functioning. Late initiation was also associated with sexual problems, especially among men. Further research is needed to understand how sexual initiation patterns affect later health outcomes.
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            Concurrent sexual partnerships among men in the United States.

            We sought to determine the prevalence, distribution, and correlates of US men's involvement in concurrent sexual partnerships, a sexual network pattern that speeds population dissemination of HIV. For this analysis, we compared sexual partnership dates of 4928 male respondents in the 2002 National Survey of Family Growth to determine the prevalence of concurrent sexual partnerships and evaluated associations between concurrency and demographic risk characteristics. Approximately 11% of men had concurrent sexual partnerships during the preceding year. Concurrency was associated with being unmarried (odds ratio [OR] = 4.59; 95% confidence interval [CI] = 2.54, 8.29), non-Hispanic Black (OR=2.56; 95% CI=1.61, 4.07) or Hispanic (OR=2.25; 95% CI=1.32, 3.85) race/ethnicity, and incarceration during the past year (OR=2.10; 95% CI=1.18, 3.74). Men with concurrent sexual partnerships were also more likely to report drug or alcohol intoxication during sexual intercourse (OR=2.10; 95% CI=1.37, 3.21), nonmonogamous female sexual partners (OR=6.11; 95% CI=4.10, 9.11), and history of sexual intercourse with a man (OR = 1.93; 95% CI = 1.09, 3.42), than those without concurrent partnerships. The higher concurrency prevalence in various groups, dense sexual networks, and mixing between high-risk subpopulations and the general population may be important factors in the US epidemic of heterosexual HIV infection.
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              Concurrent sexual partnerships among women in the United States.

              The marked racial disparity in sexually transmitted infection (STI) rates in the United States remains inadequately explained. One important factor may be concurrent sexual partnerships (relationships that overlap in time), which can transmit STIs more rapidly through a population than does sequential monogamy. To determine prevalence, distribution, and correlates of U.S. women's involvement in concurrent partnerships, we analyzed sexual partnership data reported by the 10,847 women, age 15-44 years, in the 1995 National Survey of Family Growth. Overlapping sexual partnership dates were determined by computer program and visual review of the data. Prevalence of concurrent partnerships since January 1991 was 12% overall. Prevalence was lowest among currently married respondents (4%) and highest among those who were formerly married (22%), never married (19%), in the lowest income stratum (17%), age 18-24 years when interviewed (23%), or who first had sexual intercourse at age 12 or 13 (35%). Prevalence was 21% among blacks, 11% among whites, 8% among Hispanics, and 6% among Asian American and Pacific Islanders. Multiple logistic analysis substantially weakened the relationship between concurrency and black race (OR = 1.2; 95% CI = 1.1-1.4). Marital status in particular is strongly related to concurrency; thus, lower marriage rates among blacks and the associated higher concurrency of sexual partners may contribute to racial disparities in STI rates.
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                Author and article information

                Journal
                Glob Health Action
                Glob Health Action
                GHA
                Global Health Action
                Co-Action Publishing
                1654-9716
                1654-9880
                29 February 2016
                2016
                : 9
                : 10.3402/gha.v9.29575
                Affiliations
                [1 ]Institute of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
                [2 ]JW LEE Center for Global Medicine, Seoul National University College of Medicine, Seoul, South Korea
                [3 ]Public Health Joint Doctoral Program, San Diego State University and University of California, San Diego, CA, USA
                Author notes
                [* ]Correspondence to: Dinh Thai Son, Institute for Preventive Medicine and Public Health, Hanoi Medical University, No. 1 Ton That Tung street, Hanoi, Vietnam, Email: dinhthaison@gmail.com; Juhwan Oh, JW LEE Center for Global Medicine, Seoul National University College of Medicine, Ihwajang-gil 71, Jongno-gu, Seoul, 110-810, Republic of Korea, Email: oh328@ 123456snu.ac.kr
                [§ ]These authors have contributed equally to this publication.

                Responsible Editor: Jennifer Stewart Williams, Umeå University, Sweden.

                Article
                29575
                10.3402/gha.v9.29575
                4780093
                26950566
                5e0a7cb2-bf9f-4673-a72d-f042e15beed1
                © 2016 Dinh Thai Son et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.

                History
                : 30 August 2015
                : 09 January 2016
                : 09 January 2016
                Categories
                Special Issue: Millennium Development Goals in Vietnam: the Progress and Social Determinants
                Original Article

                Health & Social care
                early sexual initiation,multiple sexual partners,first intercourse,risky sexual behaviours,adolescent sexual behaviour

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