Self-reported risky sexual practices among adolescents and young adults in Botswana

• Main Authors: Unoda Chakalisa (Author), Kathleen Wirth (Author), Kara Bennett (Author), Etienne Kadima (Author), Kutlo Manyake (Author), Tendani Gaolathe (Author), Pam Bachanas (Author), Tafireyi Marukutira (Author), Refeletswe Lebelonyane (Author), Scott Dryden-Peterson (Author), Lisa Butler (Author), Mompati Mmalane (Author), Joseph Makhema (Author), Michelle E. Roland (Author), Molly Pretorius-Holme (Author), Max Essex (Author), Shahin Lockman (Author), Kathleen M. Powis (Author)
• Format: Book
• Published: AOSIS, 2019-06-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 1608-9693; 2078-6751; 10.4102/sajhivmed.v20i1.899
• Keywords: Adolescents; Young adults; Risky sexual practices; HIV; Self-reported risky sexual practices; Gender-specific risky sexual practices; Public aspects of medicine; RA1-1270; Infectious and parasitic diseases; RC109-216
• Source: Southern African Journal of HIV Medicine, Vol 20, Iss 1, Pp e1-e8 (2019)

Background: Adolescents and young adults account for more than one-third of incident Human Immunodeficiency Virus (HIV) infections globally. Understanding sexual practices of this high-risk group is critical in designing HIV targeted prevention programming. Objectives: To describe self-reported risky sexual practices of adolescents and young adults aged 16-24 years from 30 Botswana communities. Methods: Cross-sectional, self-reported age at sexual debut; number of sexual partners; condom and alcohol use during sex; intergenerational sex; and transactional sex data were collected. Modified Poisson estimating equations were used to obtain univariate and multivariate-adjusted prevalence ratios (PR) and 95% confidence intervals (CI) comparing engagement in different sexual practices according to gender, accounting for the clustered design of the study. Results: Among the 3380 participants, 2311 reported being sexually active with more females reporting being sexually active compared to males (65% vs. 35%, respectively; p < 0.0001). In univariate analyses, female participants were more likely to report inconsistent condom use (PR 1.61; 95% CI 1.44-1.80), intergenerational sex (PR 9.00; 95% CI 5.84-13.88) and transactional sex (PR 3.46; 95% CI 2.07-5.77) than males, yet less likely to report engaging in sex before age 15 years (PR 0.59; 95% CI: 0.41-0.85), using alcohol around the time of intercourse (PR: 0.59; 95% CI 0.45-0.76) or having ≥ two partners in the last 12 months (PR 0.65; 95% CI 0.57-0.74). Conclusions: Self-reported risky sexual practices of adolescents and young adults in Botswana differed significantly between males and females. Gender-specific risky sexual practices highlight the importance of developing tailored HIV prevention programming.