The Importance of Delayed Sexual Debut in Lowering the Risk of HIV/AIDS Infection
Sunday, August 28, 2011 // Blog
In a 2004 study amongst women in Zimbabwe, the average age of sexual debut was 18 years with 11.8% of women reporting sexual debut at 15 or earlier and women with earlier sexual debut having increased HIV risk due to having more sexual partners (Pettifor, van der Straten, Dunbar, Shiboski & Padian, 2004). Of the woman who had had sex at 15 years or younger, 54.6% were infected with HIV compared to 38.2% who had sex when older. In some countries, delay in sexual debut is being advocated as a means to reduce HIV infection in young woman. (Laga, Schwartlander, Pisani, Sow, 2001 in Pettifor et al, 2004.) However delaying sexual debut is often a decision that young woman have very little control over due to gender power imbalances and coercive first sexual experiences (Pettifor et al., 2004)
It is important to note not only women are at increased risk to HIV infection due to early sexual debut. According to research conducted by Harrison, “young men with early sexual debut were 10 times more likely to have had multiple partners…reinforcing evidence that early sexual experiences may determine sexual risk behaviours” (Harrison, Cleland, Gouws, Frolich, 2005). 13.1% of men 15-24 reported their first sexual relationship before 15 (Harrison et al., 2005). Attempts at delaying sexual debut are often undermined by adolescents’ strong need to belong to a social group even if it is a group defined by the fact that the members are sexually active (Selikow et al., 2009) or even perceived to be sexually active. “Prevention programmes that aim to delay the age of first sex are important in Africa and they should target both young men and women” (Pettifor et al., 2004). It is important to note that “risk behaviours once established might be difficult to change.” (Harrison et al., 2005) and for this reason we need to target adolescents early.
Exposing youths to sexuality education before sexual debut is important in allowing them to be able to make informed decisions about sexual intercourse and condoms (Hendriksen, Pettifor, Lee, Coates & Rees, 2007). Both adolescent males and females who used condoms at first sex are more likely to have used condoms at last sex implying that “young men and women who begin their sexual lives safely tend to remain safe.” (Shafi, Stovel, Davis & Holmes, 2004 in Hendriksen et al., 2007). It is encouraging that amongst adolescents, condom use has reached very high levels with 87.4% of males and 73.1% of females reporting condom use at last sex (Shisana et al., 2009). However, since correct and maintained condom use is currently the only way of preventing HIV transmission during sex, adolescents need to be able to make condom use a non-negotiable in all sexual encounters unless they are very certain of the negative status and monogamy of their partners as well as their own status and monogamy.
Image by: m.trevino photography
