Modelling Factors influencing the timing of first sexual intercourse among female youth aged 15-24 years in Uganda.

Abstract

The burden of early sexual engagement among young people is enormous, raising the risk of sexually transmitted infections (STIs) such as HIV/AIDS, unintended pregnancy, unsafe abortion, premature childbirth, and psychosocial issues. The aim of this study was to model factors influencing the timing of first sexual intercourse following menarche among female youth aged 15-24 years in Uganda. The study utilized data from the 2016 Uganda Demographic and Health Survey. The estimated average age of menarche in Uganda is 12; therefore, a sample of 8,056 females (15-24 years) was considered. All females who had their debut before 12 years were excluded, resulting in a study sample of 7,964 females (15-24 years). The analysis employed a time-to-event approach using life-table estimates, a generalized Wilcoxon test, Kaplan-Meier survival curves, log-rank tests for survival functions, and a discrete-time logit model. The results revealed that female youth in the Northern region were less likely to have their first sexual intercourse than those in the Central region (OR=0.877; 95% CI=0.79-0.97; p=0.012). Additionally, female youth with higher levels of education were less likely to start sexual intercourse than those with no education (OR=0.724; 95% CI=0.59-0.89; p=0.003). Females who could not read and write were more likely to have their first sexual intercourse than those who could (OR=1.155; 95% CI=1.07-1.25; p<0.001). Finally, working female youth were more likely to have their first sexual debut than those who were not working (OR=1.085; 95% CI=1.01-1.16; p=0.021). Therefore, the time to sexual debut given menarche is associated with the region of residence, level of education, occupation status, and literacy status of the female youth. The study recommends that in regions where female youth are more likely to engage in early sexual intercourse, targeted educational programs and awareness campaigns should be implemented to delay the onset of sexual activity. These programs can address region-specific factors and provide information on sexual health and relationships. It is crucial to promote and prioritize education among female youth, considering that higher levels of education are associated with delayed sexual debut. Efforts should be directed towards ensuring girls have access to quality education, including addressing barriers and providing opportunities for continued learning. Additionally, there should be a focus on improving literacy and life skills among female youth, particularly those who cannot read and write. Literacy programs can empower girls with knowledge and skills that may contribute to delayed sexual initiation and better decision-making.