AGE AT FIRST SEXUAL INITIATION AND HIV RISK PERCEPTION AMONG NIGERIAN YOUTHS

Abstract

Many young people do not receive adequate preparation about the dangers associated with early sexual initiation which leaves them vulnerable to coercion, abuse, exploitation, unintended pregnancy and sexually transmitted infections, including HIV/AIDS. Therefore, the aim of this study was to examine the age pattern of youth sexual initiation and its predictors among a nationally representative sample. This study was a secondary analysis of data from National HIV/AIDS and Reproductive Health Survey (NARHS). A total of 4366 records of youth aged 15-24 years were extracted. Kaplan Meier survival analysis and Log rank test was used to identify factors associated with sexual initiation, Cox proportional hazards models to identify the predictors of sexual initiation and multinomial logistic regression was used to examine youth HIV self-risk perceptions. There were 2359 (50.9%) males and 2274 (49.1 %) females with male: female ratio of 1.03: 1. The mean age of the respondents was 17 .01±2.7 yrs.The cumulative rate of sexual initiation was 76.2% at 24 years of age. The risk of sexual initiation was lower for youths in South East (HR = 0.44; 95% CI= 0.37 - 0.52, p<0.05) compared to the South South. The risk of sexual initiation was lower in male respondents (HR = 0.49; 95% C.1= 0.45 - 0.53 , p<0.05) compared with female respondents. Urban respondents (HR = 0.809; 95% C.I= 0.735 - 0.891. p<0.05) commenced sexual intercourse later than rural counterparts. A higher proportion of the respondents 2632(63.2%) perceived no risk of HIV infection, 34.1% perceived low risk and 2.6% perceived high risk. HIV risk perception was about 2 times higher among the respondent with primary level of education (OR =2.44; 95% C.I= 1.10 5.43, p<0.05) compared with those with no formal level of education. Also, the odds of high HIV risk perception is lowest in the North West (OR =0.12; 95% C.l= 0.05 - 0.30, p<0.05) and highest in the North East region (OR = 0.94; 95% C.I= 0.50 - 1.76, p<0.05) compared with South South. The odds of low HIV -risk perception reduced by 3.6%. Also, the odd of low risk perception is about 1.6 times higher among respondents with higher level of education (OR = 1.61; 95% C.I= 1.16 - 2.23, p<0.05) compared with respondents with no formal education. The North West (OR=0.42: 95% C.I 0.33 - 0.54, p<0.05) respondents were about 58.1 % less likely to perceive low HIV risk. The findings from this study showed that substantial geographical variation exists in the rate of first sexual initiation within Nigeria. Also, majority of Nigerian youths perceived themselves as having low risk for HIV infection. There is strong evidence that the risk of early intercourse was associated with respondents' sex, education attainment, residence and geopolitical zone.