Gender-based differences in early sexual debut among youth in Botswana: implications for risky sexual behaviours and STIs

Age at first sex for young people has implications for prevention of sexually transmitted infections (STIs) and HIV/AIDS. The youth are the most at-risk population group for STIs and HIV/AIDS in Botswana. This paper assesses gender differences in early sexual debut and its implications for risky sexual behaviours and STIs among youth in Botswana.

This paper uses data derived from the fourth Botswana AIDS Impact Survey (BAIS IV). This paper is based on the selection of 458,397 young men and women aged 15–35 years who reported they have ever had sexual intercourse. Descriptive statistics were used to assess age at sexual debut and prevalence of sexual risky behaviours and STIs among youth. Multivariate analysis was conducted to determine the predictors of sexual debut, risky sexual behaviours and STIs among youth. Logistic regression analyses results are presented as odd ratios together wither their confidence intervals. All comparisons were statistically significant at p < 0.05.

More than one-third (36.9%) of the respondents reported they had their first sexual intercourse before the age of 18 years, while 18.9% reported that they were involved with multiple concurrent partners (MCPs), 37.5% used condoms inconsistently and 27.6% indicated that they ever had STIs. Predictors of early sexual debut among male respondents were primary/lower (OR 4.004, CI3.771–4.251) and secondary (OR 2.131, CI 2.056–2.209) education. The odds of early sexual debut were low among young female respondents with high HIV knowledge (OR 0.393, CI 0.374–0.413), those residing in city/town (OR 0.532, CI 0.514–0.551) and urban villages (OR 0.799, CI 0.776–0.822) compared to their counterparts. Male respondents who did not use a condom at first sex were 12 times more likely to be inconsistent condom users (OR 12.011, CI 10.807–13.350) while female respondents who had their first sex before consent age were more likely to be inconsistent condom users (OR 1.992, CI 1.753–2.263). Moreover, young men and women who had first sex before the consent age were more likely to have multiple concurrent partnerships and STIs compared to those who had sexual intercourse after the consent age.

The findings of this study indicate that youth who had sexual debut before the age of consent (18 years) were more likely to report inconsistent condom use, MCPs and STIs, regardless of their gender. The findings of this study show the need to design effective interventions that consider gender differences in early sexual debut to reduce MCPs, inconsistent condom use and STIs among youth in Botswana.