Early sexual debut: voluntary or coerced? Evidence from longitudinal data in South Africa - the Birth to Twenty Plus study

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BACKGROUND: Early sexual debut, voluntary or coerced, increases risks to sexual and reproductive health. Sexual coercion is increasingly receiving attention as an important public health issue owing to its association with adverse health and social outcomes OBJECTIVE: To describe voluntary and coerced experience at sexual debut METHODS: A longitudinal perspective among 2 216 adolescents (1 149 females, 1 067 males) in a birth cohort study in South Africa, analysing data collected on six occasions between 11 and 18 years RESULTS: The median age of sexual debut was 16 years for females and 15 for males. Reported coerced sexual debut included children <11 years of age. Males reported earlier sexual debut, with both voluntary and coerced sexual experience, than females (p<0.0001). Sexual coercion at early sexual debut among both male and female adolescents occurred mostly through sexual intercourse with older adolescents and partners of the same age CONCLUSION: The identified time periods and age groups need to be targeted for interventions to delay sexual debut and prevent sexual coercion among young people. More research is needed to understand underlying predisposing risk factors for sexual coercion at sexual debut, both early and not early

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The epidemiology of rape and sexual coercion in South Africa: an overview.

Rachel Jewkes, N Abrahams (2002)

During 1999 the issue of rape in South Africa was debated at the highest levels. The epidemiology of rape has become an issue of considerable political importance and sensitivity, with President Mbeki demanding an answer to the question: how much rape is there in South Africa? The purpose of this paper is both to summarise and synthesise the findings of research to provide an overview of the epidemiology of rape of women in South Africa and to show how difficult it is to answer the President's question. The review begins by considering why rape is so difficult to research. Data available shows that rape reported to the police (240 incidents of rape and attempted rape per 100,000 women each year) represents the tip of an ice berg of sexual coercion. Representative community-based surveys have found, for example, that in the 17-48 age group there are 2070 such incidents per 100,000 women per year. Non-consensual sex in marriage and dating relationships is believed to be very common but is usually not well reported in surveys. Forced sexual initiation is reported by almost a third of adolescent girls. In addition coerced consensual sex is a common problem in schools, workplaces and amongst peers. Knowledge of causal and contributory factors influencing the high levels of rape are also discussed. We conclude that the rape statistic for the country is currently elusive but levels of non-consensual and coerced sex are clearly very high. International comparison needs to be approached with caution because most developing countries lack the infrastructure for accurate crime reporting and do not have such a substantial body of survey data.

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Secretive females or swaggering males? An assessment of the quality of sexual partnership reporting in rural Tanzania.

Egge J. Boerma, Soori Nnko, Basia Zaba … (2004)

In population-based surveys on sexual behaviour, men consistently report higher numbers of sexual partners than women, which may be associated with male exaggeration or female under-reporting or with issues related to sampling, such as exclusion of female sex workers. This paper presents an analysis of data collected in the context of a longitudinal study in rural Tanzania, where a sexual partnership module was applied to all participating men and women in the study population. Since the study design included all men and women of reproductive ages and did not involve sampling, these data provide a unique opportunity to compare the consistency of aggregate measures of sexual behaviour between men and women living in the same villages. The analysis shows that non-marital partnerships were common amongst single people of both sexes--around 70% of unmarried men and women report at least one sexual partner in the last year. However, 40% of married men also report having non-marital partners, but only 3% of married women did so. Single women reported about half as many multiple partnerships in the last year as men. Under-reporting of non-marital partnerships was much more common among single women than among married women and men. Furthermore, women were more likely to report longer duration partnerships and partnership with urban men or more educated men than with others. If a woman reports multiple partners, biological data indicate that she is at high risk of contracting HIV. For men, however, there is only a weak association between number of partnerships and the risk of HIV, and it cannot be excluded that men, especially single men, exaggerate the number of sexual partners.

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Is early sexual debut a risk factor for HIV infection among women in sub-Saharan Africa? A systematic review.

Charlotte Watts, Jantine Jacobi, Heidi Stöckl … (2013)

In Africa, adolescent girls have high HIV risk. Early sexual debut may be a risk factor, although evidence has not been systematically compiled. A systematic review was conducted. Quantitative studies from sub-Saharan Africa with biologically confirmed HIV infection measures were included. A total of 128 full texts were screened. Twenty-five met the inclusion criteria, most cross-sectional. Half of studies, and all with large sample sizes, reported significant bivariate associations. These remained significant in all three studies controlling for socio-demographic factors; both studies controlling for sexual activity duration and four of eight studies controlling for subsequent risk behaviour. Higher-quality studies consistently find significant bivariate associations between early sexual debut and HIV. In some studies, the increase in women's HIV infection risk seems to result from women's later engagement in risky sexual behaviours, rather than being directly related to early onset of sexual debut. In other studies, the increase in risk did not seem to be due to specific behavioural risk characteristics of the respondents or their sexual partners, suggesting that the risk may relate more to the potential for biological factors, for example, genital trauma, or other factors that have not been captured by the studies in this review. © 2012 John Wiley & Sons A/S.

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Author and article information

Contributors

L Richter: Role: ND

M Mabaso: Role: ND

J Ramjith: Role: ND

S A Norris: Role: ND

Journal

Journal ID (publisher): samj

Title: SAMJ: South African Medical Journal

Abbreviated Title: SAMJ, S. Afr. med. j.

Publisher: Health and Medical Publishing Group (Cape Town )

ISSN: 2078-5135

Publication date (Print): April 2015

Volume: 105

Issue: 4

Pages: 304-307

Affiliations

[1 ] University of the Witwatersrand South Africa

[2 ] Human Sciences Research Council South Africa

[3 ] Human Sciences Research Council South Africa

[4 ] University of Cape Town South Africa

[5 ] University of the Witwatersrand South Africa

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Publisher ID: S0256-95742015000300029

DOI: 10.7196/SAMJ.8925

PubMed ID: 26294851

SO-VID: 6895c91b-4688-4031-a25b-88045ea823f5

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http://creativecommons.org/licenses/by/4.0/

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SciELO South Africa

Self URI (journal page): http://www.scielo.org.za/scielo.php?script=sci_serial&pid=0256-9574&lng=en

Early sexual debut: voluntary or coerced? Evidence from longitudinal data in South Africa - the Birth to Twenty Plus study

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Most cited references 34

The epidemiology of rape and sexual coercion in South Africa: an overview.

Secretive females or swaggering males? An assessment of the quality of sexual partnership reporting in rural Tanzania.

Is early sexual debut a risk factor for HIV infection among women in sub-Saharan Africa? A systematic review.

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