The influence of gender-equitable attitudes on sexual behaviour among unmarried adolescents in rural Tanzania: a longitudinal study

Figures & data

Table 1. Descriptive characteristics for male & female adolescents 14–19 years old in Tanzania at community level GEM scores

	Mean (SD) or N (%)
	Pooled GEM	Low GEM score	High GEM score	p-value*
Among all participants (n = 2017)
Age	18.1 (1.87)	18.1 (1.77)	18.0 (1.80)	0.843
Sex				0.831
Female	865 (42.9%)	612 (43.0%)	253 (42.5%)
Male	1152 (57.1%)	810 (57.0%)3	342 (57.5%)
Female head of household	1334 (66.1%)	962 (67.7%)	372 (62.5%)	0.026*
Treat	974 (48.3%)	599 (42.1%)	375 (63.0%)	<0.000*
Attending/completed Form IV	1002 (49.7%)	670 (47.1%)	332 (55.8%)	<0.000*
Ever had sex	619 (30.7%)	454 (31.9%)	165 (27.7%)	0.062
Early sexual debut	90 (4.5%)	69 (4.9%)	21 (3.5%)	0.189
Engaged in transactional sex	325 (16.1%)	233 (16.4%)	92 (15.5%)	0.607
HIV testing in last 12 months	858 (42.5%)	582 (40.9%)	276 (46.4%)	0.024*
Among sexually debuted adolescents (n = 619)
Age	18.5 (1.59)	19.1 (1.55)	19.2 (1.73)	0.183
Sex				0.065
Female	281 (45.4%)	196 (43.2%)	85 (51.5%)
Male	338 (54.6%)	258 (56.8%)	80 (48.5%)
Female head of household	422 (68.2%)	318 (70.0%)	104 (63.0%)	0.098
Treat	284 (45.9%)	188 (41.4%)	96 (58.2%)	<0.000*
Attending/completed Form IV	162 (26.2%)	115 (25.3%)	47 (28.5%)	0.430
Early sexual debut	90 (14.5%)	69 (15.2%)	21 (12.7%)	0.441
Engaged in transactional sex	325 (52.5%)	233 (51.3%)	92 (55.8%)	0.328
HIV testing in the last 12 months	414 (66.9%)	298 (65.6%)	116 (70.3%)	0.276
Number of sexual partners in last 12 months	1.40 (1.29)	1.47 (1.39)	1.25 (1.02)	0.891
Modern contraceptive use	404 (65.3%)	303 (66.7%)	101 (61.2%)	0.202
Condom use at last sex	362 (58.5%)	270 (59.5%)	92 (55.8%)	0.407
Concurrency	54 (8.7%)	45 (9.9%)	9 (5.5%)	0.082
Age disparate partner (>5 years)	79 (12.8%)	63 (13.9%)	16 (9.7%)	0.168

*Indicates significance at p < 0.05.

Table 2. Pooled primary outcomes

	Transactional sex		Early sexual debut		HIV testing in the last 12 months
	M1^§	M2	M1^§	M2	M1^§	M2
Community high lag	1.01 (0.73–1.40)	1.01 (0.73–1.39)	0.84 (0.51–1.37)	0.87 (0.53–1.43)	1.29^ (0.99–1.69)	1.31^ (1.00–1.72)
Individual high lag	–	1.02 (0.74–1.43)	–	0.80 (0.46–1.38)		0.92 (0.74–1.15)
Age	1.65*** (1.51–1.80)	1.65*** (1.51–1.80)	0.98 (0.83–1.15)	0.97 (0.83–1.15)	1.37*** (1.29–1.45)	1.37*** (1.29–1.45)
Female	6.67*** (4.88–9.10)	6.70*** (4.84–9.26)	0.97 (0.59–1.61	0.93 (0.56–1.55)	2.41*** (1.93–3.01)	2.37*** (1.90–2.94)
Treat	0.95 (0.68–1.34)	0.95 (0.68–1.34)	0.95 (0.64–1.43)	0.96 (0.64–1.45)	1.32* (1.03–1.68)	1.32* (1.03–1.68)
Attending/Completed Form IV	0.25*** (0.18–0.35)	0.25*** (0.19–0.34)	0.10*** (0.05–0.22)	0.11*** (0.05–0.22)	0.76* (0.60–0.95)	0.76* (0.60–0.96)
Female head of household	1.07 (0.81- 1.41)	1.06 (0.80–1.41)	0.98 (0.63–1.50)	0.98 (0.63–1.50)	1.41*** (1.18–1.69)	1.42*** (1.18–1.69)
Among sexually debuted adolescents (n = 619)
Community high lag	1.00 (0.62–1.61)	1.00 (0.64–1.59)	0.82 (0.48–1.41)	0.87 (0.49–1.53)	1.11 (0.77–1.60)	1.14 (0.79–1.65)
Individual high lag	–	0.98 (0.64–1.50)	–	0.76 (0.41–1.42)	–	0.88 (0.60–1.29)
Age	0.97 (0.87–1.09)	0.97 (0.87–1.09)	0.64*** (0.51–0.79)	0.64*** (0.51–0.79)	1.29*** (1.12–1.50)	1.29*** (1.12–1.50)
Female	8.60*** (5.87–12.61)	8.56*** (5.79–12.64)	0.61 (0.37–1.02)	0.58* (0.35–0.97)	4.55*** (3.01–6.86)	4.42*** (2.90–6.74)
Treat	1.12 (0.75–1.68)	1.12 (0.75–1.68)	0.98 (0.65–1.49)	1.00 (0.65–1.53)	1.23 (0.89–1.71)	1.24 (0.89–1.73)
Attending/Completed Form IV	0.71 (0.46–1.11)	0.71 (0.46–1.11)	0.32** (0.16–0.66)	0.34** (0.16–0.70)	0.87 (0.56–1.35)	0.89 (0.57–1.38)
Female head of household	0.77 (0.53–1.13)	0.77 (0.53–1.13)	0.76 (0.49–1.19)	0.77 (0.49–1.21)	1.22 (0.86–1.73)	1.23 (0.86–1.75)

Odds ratios and 95% confidence intervals by community high GEM scores (M1) and individual (M2) high GEM scores for primary outcomes among all adolescents (n = 2017)

95% confidence intervals in parentheses | *** p < 0.001, ** p < 0.01, *p < 0.05 ^p < .10 | ^§ indicates best model fit.

Model 1 (M1) included community gender equitable attitudes only.

Model 2 (M2) included both high community gender equitable attitudes and high individual gender equitable attitudes.

Table 3. Pooled secondary outcomes

	Modern contraceptive use		Condom use at last sex		# of sexual partners in last 12 months		Concurrent sexual partners		Age-disparate partnership
	M1^§	M2	M1^§	M2	M1^§	M2	M1^§	M2	M1^§	M2
Community high lag	0.83 (0.53–1.30)	0.77 (0.49–1.22)	0.95 (0.61–1.47)	0.90 (0.58–1.39)	0.89 (0.77–1.03)	0.90 (0.77–1.04)	0.58 (0.28–1.24)	0.59 (0.28–1.27)	0.52* (0.30–0.88)	0.52* (0.30–0.93)
Individual high lag	–	1.41 (0.94–2.11)	–	1.30 (0.89–1.91)	–	0.97 (0.82–1.14)	–	0.92 (0.49–1.73)	–	0.93 (0.45–1.93)
Age	1.08 (0.97–1.21)	1.08 (0.97–1.21)	1.01 (0.90–1.12)	1.01 (0.90–1.13)	1.00 (0.97–1.04)	1.00 (0.97–1.04)	1.01 (0.81–1.26)	1.01 (0.81–1.25)	0.95 (0.81–1.12)	0.95 (0.81–1.12)
Female	0.44** (0.31–0.62)	0.47** (0.33–0.67)	0.28*** (0.19–0.40)	0.29*** (0.20–0.42)	0.64*** (0.58–0.72)	0.64*** (0.57–0.72)	0.15*** (0.06–0.39)	0.14*** (0.0 5- 0.39)	47.64*** (14.37–157.98)	46.89*** (14.39–152.84)
Treat	1.02 (0.67–1.54)	1.01 (0.67–1.54)	0.97 (0.64–1.47)	0.97 (0.64–1.46)	0.99 (0.84–1.16)	0.99 (0.84–1.16)	0.99 (0.51–1.90)	1.00 (0.52–1.91)	0.99 (0.57–1.71)	0.99 (0.57–1.71)
Attending/Completed Form IV	0.78 (0.52–1.15)	0.74 (0.50–1.11)	1.23 (0.83–1.82)	1.18 (0.80–1.75)	0.80* (0.68–0.95)	0.81* (0.68–0.96)	0.41* (0.18–0.95)	0.42* (0.18–0.97)	0.55 (0.30–1.01)	0.55* (0.30–1.00)
Female head of household	0.82 (0.59–1.15)	0.82 (0.59–1.13)	0.83 (0.59–1.18)	0.82 (0.58–1.17)	1.03 (0.90–1.18)	1.03 (0.90–1.18)	0.93 (0.54–1.60)	0.93 (0.53–1.63)	1.15 (0.65–2.04)	1.15 (0.65–2.04)

Odds ratios and 95% confidence intervals by community high GEM scores and individual and community high GEM scores for secondary outcomes among sexually debuted adolescents (n = 619)

95% confidence intervals in parentheses | *** p < 0.001, ** p < 0.01, *p < 0.05 | ^§ indicates best model fit.

Model 1 (M1) included community gender equitable attitudes only.

Model 2 (M2) included both high community gender equitable attitudes and high individual gender equitable attitudes.