Individual and community-level tolerance of spouse abuse and the association with the circumstances of first sex among youth from six sub-Saharan African countries

Abstract

Youth who engage in early and premarital sex are at risk of HIV and sexually transmitted infections. Most prevention programs ignore the mediating influence of the threat and experience of violence on these outcomes. Using nationally representative data from Lesotho, Malawi, Zimbabwe, Kenya, Tanzania, and Uganda, multivariate analyses examined the association between individual- and community-level tolerance of spouse abuse on the age and circumstances of sexual debut among female youth. The youth sample sizes ranged from a high of 5007 in Malawi to a low of 3050 in Lesotho. In the study countries, there were between 521 and 367 communities included in the analysis. Youth who approved of spouse abuse were more likely to have sexually debuted at each age. In Kenya, youth from communities with high female spouse abuse tolerance were more likely to have initiated sex at each age. In Malawi and Zimbabwe, youth from high tolerance communities were less likely to have sexually debuted at each age or to have had premarital sex; the same effect on premarital sex was found for men's tolerance in Kenya and Tanzania. Programs are needed to reduce violence risk and increase youth negotiating power and delayed sexual debut, with the objective of reducing young people's risk of negative outcomes.

Keywords:

• spouse abuse
• sexual debut
• HIV
• youth
• sub-Saharan Africa

Acknowledgements

The author would like to thank Anu Manchikanti Gómez for her valuable insights into this paper. This study was supported by Grant Number 1R03HD05511101A1 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. This research was also supported by grant, 5 R24 HD050924, Carolina Population Center, awarded to the Carolina Population Center at The University of North Carolina at Chapel Hill by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute of Child Health and Human Development.