Exploratory analysis of the ecological variables associated with sexual health profiles in high-risk, sexually-active female learners in rural KwaZulu-Natal

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Authors
Humphries, Hilton
Osman, Farzana
Karim, Quarraisha Abdool
Knight, Lucia
Issue Date
2018-04-05
Type
Article
Language
en_US
Keywords
Exploratory Analysis , Ecological Variables , Sexual Health Profiles , High-Risk , Sexually-Active Female Learners , KwaZulu-Natal
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Abstract
Purpose: Young women are at high risk for negative sexual health outcomes. Despite their high risk, many sexually-active women never experience negative sexual health outcomes. This study explored the ecological risk factors associated with the risk profiles of sexually-active female high school-learners in rural KwaZulu-Natal, South Africa. Methods: Using baseline data from N = 596 sexually-active school-going women, we explored the ecological factors associated with being sexually-active and managing risk successfully [SARS] or unsuccessfully [SARU]. Generalised estimated equations (GEE) were applied to data collected at multiple levels while adjusting for school and other included variables. GEE were used to calculate probability of being SARU. Results: Amongst SARU learners, 21.9% had HIV, 38.6% had HSV-2, 12.5% were pregnant, 28.7% self-reported STI symptoms and 51.9% reported a previous pregnancy. Individual-level factors had the greatest impact on being SARU. Univariate and multivariate analysis highlighted several important partner factors associated with SARU. Age was significantly associated with the risk profiles (p<0.0001), a greater proportion of SARU learners were 18 or older compared to the SARS learners. The odds of being SARU decreased when ≥18 years (aOR = 0.2577, 95% CI 0.1462–0.4542) or if not falling pregnant was important (aOR = 0.6343, 95% CI 0.4218–0.9538). Having >1 HIV test (aOR = 2.2161, 95% CI 1.3964–3.5169) increased the odds a SARU profile. Conclusion: Individual and partner level factors are important for the sexual health profile of an adolescent female. While the exploratory findings require further research; managing multiple sexual health outcomes, tailoring responses around a risk profile and including partners is essential for successful interventions.
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Humphries, H., Osman, F., Knight, L., & Abdool Karim, Q. (2018). Exploratory analysis of the ecological variables associated with sexual health profiles in high-risk, sexually-active female learners in rural KwaZulu-Natal. PloS one, 13(4), e0195107. https://doi.org/10.1371/journal.pone.0195107
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PloS One
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