Sexual behaviour among Kenyan adolescents enrolled in an efficacy trial of a smartphone game to prevent HIV: a cross-sectional analysis of baseline data

Sexual behaviour of adolescents is contextual, with various determinants affecting sexual activity and age of sexual debut. Insight into sexual activity among young adolescents has the potential to influence appropriate sexual and reproductive health interventions. For this analysis, adolescents wer...

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Main Authors: Victor Mudhune, Kate Winskell, Robert A. Bednarczyk, Ken Ondenge, Calvin Mbeda, Emily Kerubo, Richard Ndivo, Judith Arego, Marissa Morales, Brianna Halliburton, Gaëlle Sabben
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:SAHARA-J
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Online Access:https://www.tandfonline.com/doi/10.1080/17290376.2024.2320188
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author Victor Mudhune
Kate Winskell
Robert A. Bednarczyk
Ken Ondenge
Calvin Mbeda
Emily Kerubo
Richard Ndivo
Judith Arego
Marissa Morales
Brianna Halliburton
Gaëlle Sabben
author_facet Victor Mudhune
Kate Winskell
Robert A. Bednarczyk
Ken Ondenge
Calvin Mbeda
Emily Kerubo
Richard Ndivo
Judith Arego
Marissa Morales
Brianna Halliburton
Gaëlle Sabben
author_sort Victor Mudhune
collection DOAJ
description Sexual behaviour of adolescents is contextual, with various determinants affecting sexual activity and age of sexual debut. Insight into sexual activity among young adolescents has the potential to influence appropriate sexual and reproductive health interventions. For this analysis, adolescents were recruited as part of the Tumaini smartphone game efficacy trial. Data collection included a self-administered behavioural survey and blood test for HIV and HSV-2. Descriptive statistics were calculated for demographics and measures of sexual behaviour and behavioural intent based on gender and sexual experience, with associations assessed using chi-square tests, t-tests and Wilcoxon rank sum tests as appropriate. We enrolled 996 adolescents, mean age 14 years and 2.2% HSV-2 positivity. Overall, 15% of the adolescents were sexually experienced, this being associated with lower socio-economic status (p = 0.01), household food insecurity (p = 0.008), a living situation without both parents (p < 0.01), substance use (p = 0.02), no adult conversation about future goals (p = 0.003), conversations about condoms (p = 0.01), with some gender disparity within these factors. Among those sexually experienced, 21.7% reported unwilling sex; 17.5% had engaged in transactional sex; 57.8% had willing first sex, of whom 60.9% reported no condom use. Among those abstaining, female adolescents were less likely to contemplate condom use at first sex (p = 0.006). Our findings determine that young sexually active adolescents are likely engaging in unprotected sex and having unwilling sexual experiences. Socio-economic status, living situation and parental monitoring remain significant factors associated with sexual experience among young adolescents. In this context, early adolescence is an opportunity to provide age- and developmentally appropriate education about safer sex practices.Trial registration: ClinicalTrials.gov identifier: NCT04437667.
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spelling doaj-art-86dc906d096f489687d12f2a352837222025-08-20T01:53:26ZengTaylor & Francis GroupSAHARA-J1729-03761813-44242024-12-0121110.1080/17290376.2024.2320188Sexual behaviour among Kenyan adolescents enrolled in an efficacy trial of a smartphone game to prevent HIV: a cross-sectional analysis of baseline dataVictor Mudhune0Kate Winskell1Robert A. Bednarczyk2Ken Ondenge3Calvin Mbeda4Emily Kerubo5Richard Ndivo6Judith Arego7Marissa Morales8Brianna Halliburton9Gaëlle Sabben10HIV Research Division, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, KenyaHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USAHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USAHIV Research Division, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, KenyaHIV Research Division, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, KenyaHIV Research Division, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, KenyaHIV Research Division, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, KenyaHIV Research Division, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, KenyaHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USADepartment of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USAHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USASexual behaviour of adolescents is contextual, with various determinants affecting sexual activity and age of sexual debut. Insight into sexual activity among young adolescents has the potential to influence appropriate sexual and reproductive health interventions. For this analysis, adolescents were recruited as part of the Tumaini smartphone game efficacy trial. Data collection included a self-administered behavioural survey and blood test for HIV and HSV-2. Descriptive statistics were calculated for demographics and measures of sexual behaviour and behavioural intent based on gender and sexual experience, with associations assessed using chi-square tests, t-tests and Wilcoxon rank sum tests as appropriate. We enrolled 996 adolescents, mean age 14 years and 2.2% HSV-2 positivity. Overall, 15% of the adolescents were sexually experienced, this being associated with lower socio-economic status (p = 0.01), household food insecurity (p = 0.008), a living situation without both parents (p < 0.01), substance use (p = 0.02), no adult conversation about future goals (p = 0.003), conversations about condoms (p = 0.01), with some gender disparity within these factors. Among those sexually experienced, 21.7% reported unwilling sex; 17.5% had engaged in transactional sex; 57.8% had willing first sex, of whom 60.9% reported no condom use. Among those abstaining, female adolescents were less likely to contemplate condom use at first sex (p = 0.006). Our findings determine that young sexually active adolescents are likely engaging in unprotected sex and having unwilling sexual experiences. Socio-economic status, living situation and parental monitoring remain significant factors associated with sexual experience among young adolescents. In this context, early adolescence is an opportunity to provide age- and developmentally appropriate education about safer sex practices.Trial registration: ClinicalTrials.gov identifier: NCT04437667.https://www.tandfonline.com/doi/10.1080/17290376.2024.2320188Kenyayoung adolescentsexual behavioursexual activitysexual debut
spellingShingle Victor Mudhune
Kate Winskell
Robert A. Bednarczyk
Ken Ondenge
Calvin Mbeda
Emily Kerubo
Richard Ndivo
Judith Arego
Marissa Morales
Brianna Halliburton
Gaëlle Sabben
Sexual behaviour among Kenyan adolescents enrolled in an efficacy trial of a smartphone game to prevent HIV: a cross-sectional analysis of baseline data
SAHARA-J
Kenya
young adolescent
sexual behaviour
sexual activity
sexual debut
title Sexual behaviour among Kenyan adolescents enrolled in an efficacy trial of a smartphone game to prevent HIV: a cross-sectional analysis of baseline data
title_full Sexual behaviour among Kenyan adolescents enrolled in an efficacy trial of a smartphone game to prevent HIV: a cross-sectional analysis of baseline data
title_fullStr Sexual behaviour among Kenyan adolescents enrolled in an efficacy trial of a smartphone game to prevent HIV: a cross-sectional analysis of baseline data
title_full_unstemmed Sexual behaviour among Kenyan adolescents enrolled in an efficacy trial of a smartphone game to prevent HIV: a cross-sectional analysis of baseline data
title_short Sexual behaviour among Kenyan adolescents enrolled in an efficacy trial of a smartphone game to prevent HIV: a cross-sectional analysis of baseline data
title_sort sexual behaviour among kenyan adolescents enrolled in an efficacy trial of a smartphone game to prevent hiv a cross sectional analysis of baseline data
topic Kenya
young adolescent
sexual behaviour
sexual activity
sexual debut
url https://www.tandfonline.com/doi/10.1080/17290376.2024.2320188
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