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ABSTRACT
Introduction. The HIV infection mainly concerns the young population and is predominantly sexually transmitted in Africa. In most regions of the world, teenagers, girls in particular, are the main vulnerable group of this infection. Our study aimed at identifying factors associated with reporting of sexual initiation and use of condom during the last sexual intercourse in Cameroonian adolescents. Materials and methods. A cross-sectional survey was conducted in 2018 and concerned four regions Cameroon (East, Far North, North and West). In total, 23 secondary schools and 14 youth centers were selected. Adolescents aged 10 to 19 were randomly enrolled. The information was collected on sociodemographic characteristics, knowledge, attitudes and practices towards HIV and AIDS. Results. Among the 1153 adolescents enrolled in this study at a median age of 16 years (IQR: 14-18), a half (51.2%) were boys. In total, 293 (25.4%) adolescents reported sexual initiation. Among these, 200 (69.7%) stated that they had used condoms during the last sexual intercourse. Among sexually active adolescents, those attending youth centers were more likely to report condom use during the last sexual intercourse than those in secondary schools [p=0.035]. Conclusion. More frequent condom use during the last sexual intercourse among adolescents attending youth centers could be explained by better access to sex education and other STD prevention and contraceptive methods, due to the provision of comprehensive sexuality education.
RÉSUMÉ
Contexte. En Afrique, l'infection à VIH concerne majoritairement les jeunes et est principalement transmise sexuellement. Les adolescents, en particulier les filles, constituent le principal groupe vulnérable à cette infection. Cette étude visait à étudier les facteurs associés, d’une part, à l'initiation de l’activité sexuelle telle que déclarée et, d’autre part, à l'usage du préservatif lors du dernier rapport sexuel chez les adolescents camerounais. Matériels et méthodes. Une enquête transversale a été réalisée en 2018 dans quatre régions du Cameroun (Est, Extrême-nord, Nord et Ouest). Au total, 23 établissements d’enseignement secondaire et 14 centres des jeunes ont été sélectionnés. Les adolescents âgés de 10 à 19 ans ont été enrôlés aléatoirement dans l’étude. Les données recueillies comprenaient les caractéristiques sociodémographiques, les connaissances, les attitudes et les pratiques à vis-à-vis du VIH. Résultats. Parmi les 1153 adolescents inclus dans cette étude à un âge médian de 16 ans, la moitié (51,2 %) comprenait des garçons. Au total, 293 (25,4%) adolescents ont déclaré avoir initié l’activité sexuelle. Parmi ceux-ci, 200 (69,7%) ont rapporté l'usage du préservatif lors du dernier rapport sexuel ; ceux qui fréquentaient les centres des jeunes déclaraient plus souvent avoir utilisé le préservatif lors du dernier rapport sexuel que ceux qui fréquentaient les établissements d’enseignement secondaire [p=0,035]. Conclusion. L'usage plus fréquent du préservatif lors des rapports sexuels chez les adolescents fréquentant les centres des jeunes pourrait s'expliquer par l'offre de l'éducation sexuelle complète et un meilleur accès aux méthodes de prévention des infections sexuellement transmissibles.
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References
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- Courtois R, Mullet E, Malvy D. Comparaison des comportements sexuels de lycéens congolais et français dans le contexte du sida. Cah Détudes Rech Francoph Santé. 19 avr 2001;11(1):49‑55.
- Adjahoto EO, Hodonou K a. S, Souza AD de, Tété VK, Baeta S. Information des jeunes en matière de sexualité. Cah Détudes Rech Francoph Santé. 6 oct 2000;10(3):195‑9.
- DiClemente RJ, Wingood GM, Crosby R, Cobb BK, Harrington K, Davies SL. Parent-adolescent communication and sexual risk behaviors among African American adolescent females. J Pediatr. sept 2001;139(3):407‑12.
- Svenson LW, Carmel S, Varnhagen CK. A review of the knowledge, attitudes and behaviours of university students concerning HIV/AIDS. Health Promotion International. Oxford University Press 1997; 12(1).
- Agbèrè ARD, Tchagafou M, Houédji K, Baëta S, Boukari B, Gaba-Amouzou B, et al. [Contraceptive methods used by young women in the township of Lomé (Togo)]. Sante Montrouge Fr. déc 2003;13(4):243‑51.
- Dancy BL, Kaponda CPN, Kachingwe SI, Norr KF. Risky sexual behaviors of adolescents in rural Malawi: evidence from focus groups. J Natl Black Nurses Assoc JNBNA. juill 2006;17(1):22‑8.
- Urassa W, Moshiro C, Chalamilla G, Mhalu F, Sandstrom E. Risky sexual practices among youth attending a sexually transmitted infection clinic in Dar es Salaam, Tanzania. BMC Infect Dis. 19 nov 2008; 159 (8).
- Kelly RJ, Gray RH, Sewankambo NK, Serwadda D, Wabwire-Mangen F, Lutalo T, et al. Age differences in sexual partners and risk of HIV-1 infection in rural Uganda. J Acquir Immune Defic Syndr 1999. 1 avr 2003;32(4):446‑51.
- Longfield K, Glick A, Waithaka M, Berman J. Relationships between older men and younger women: implications for STIs/HIV in Kenya. Stud Fam Plann. juin 2004;35(2):125‑34.
- Brown LK, Diclemente RJ, Park T. Predictors of condom use in sexually active adolescents. J Adolesc Health Off Publ Soc Adolesc Med. déc 1992;13(8):651‑7.
- Tavares CM, Schor N, França Junior I, Diniz SG. Factors associated with sexual initiation and condom use among adolescents on Santiago Island, Cape Verde, West Africa. Cad Saúde Pública. sept 2009;25(9):1969‑80.
- Adhikari R, Tamang J. Premarital Sexual Behavior among male college students of Kathmandu, Nepal. BMC Public Health. 15 juill 2009;9(1):241.
- Wong LP. Qualitative inquiry into premarital sexual behaviours and contraceptive use among multiethnic young women: implications for education and future research. PloS One. 2012;7(12):e51745.
- Rwenge Mburano J-R. Les différences ethniques des comportements sexuels au Cameroun : l’exemple des Bamiléké et Bëti. Union for African Population Studies. Aug-2004; 19(2).
- Cates W, Steiner MJ. Dual protection against unintended pregnancy and sexually transmitted infections: what is the best contraceptive approach? Sex Transm Dis. mars 2002;29(3):168 - 74.
References
Cissoko Y, Traoré A, Sidibé LN, Maiga YI, Coulibaly M, Maiga Z, Diamoye S, Ly AB, Sidibé AF, Dao S, Diarra D. Knowledge attitude and practice toward STI, HIV/AIDS among high school students in Gao (Northen-Mali in West Africa). Revue Malienne d’Infectiologie et de Microbiologie 2014; (4).
B. Touré, K. Koffi, V. Kouassi-Gohou, E. Kokoun, O. Angbo-Effi, N. Koffi, A. J. Diarra-Nam. Awareness, attitudes, and practices of secondary school students in relation to HIV/aids in Abidjan, Ivory Coast. Medecine Tropicale 2005; 65(4): 346-8.
Courtois R, Mullet E, Malvy D. Comparaison des comportements sexuels de lycéens congolais et français dans le contexte du sida. Cah Détudes Rech Francoph Santé. 19 avr 2001;11(1):49‑55.
Adjahoto EO, Hodonou K a. S, Souza AD de, Tété VK, Baeta S. Information des jeunes en matière de sexualité. Cah Détudes Rech Francoph Santé. 6 oct 2000;10(3):195‑9.
DiClemente RJ, Wingood GM, Crosby R, Cobb BK, Harrington K, Davies SL. Parent-adolescent communication and sexual risk behaviors among African American adolescent females. J Pediatr. sept 2001;139(3):407‑12.
Svenson LW, Carmel S, Varnhagen CK. A review of the knowledge, attitudes and behaviours of university students concerning HIV/AIDS. Health Promotion International. Oxford University Press 1997; 12(1).
Agbèrè ARD, Tchagafou M, Houédji K, Baëta S, Boukari B, Gaba-Amouzou B, et al. [Contraceptive methods used by young women in the township of Lomé (Togo)]. Sante Montrouge Fr. déc 2003;13(4):243‑51.
Dancy BL, Kaponda CPN, Kachingwe SI, Norr KF. Risky sexual behaviors of adolescents in rural Malawi: evidence from focus groups. J Natl Black Nurses Assoc JNBNA. juill 2006;17(1):22‑8.
Urassa W, Moshiro C, Chalamilla G, Mhalu F, Sandstrom E. Risky sexual practices among youth attending a sexually transmitted infection clinic in Dar es Salaam, Tanzania. BMC Infect Dis. 19 nov 2008; 159 (8).
Kelly RJ, Gray RH, Sewankambo NK, Serwadda D, Wabwire-Mangen F, Lutalo T, et al. Age differences in sexual partners and risk of HIV-1 infection in rural Uganda. J Acquir Immune Defic Syndr 1999. 1 avr 2003;32(4):446‑51.
Longfield K, Glick A, Waithaka M, Berman J. Relationships between older men and younger women: implications for STIs/HIV in Kenya. Stud Fam Plann. juin 2004;35(2):125‑34.
Brown LK, Diclemente RJ, Park T. Predictors of condom use in sexually active adolescents. J Adolesc Health Off Publ Soc Adolesc Med. déc 1992;13(8):651‑7.
Tavares CM, Schor N, França Junior I, Diniz SG. Factors associated with sexual initiation and condom use among adolescents on Santiago Island, Cape Verde, West Africa. Cad Saúde Pública. sept 2009;25(9):1969‑80.
Adhikari R, Tamang J. Premarital Sexual Behavior among male college students of Kathmandu, Nepal. BMC Public Health. 15 juill 2009;9(1):241.
Wong LP. Qualitative inquiry into premarital sexual behaviours and contraceptive use among multiethnic young women: implications for education and future research. PloS One. 2012;7(12):e51745.
Rwenge Mburano J-R. Les différences ethniques des comportements sexuels au Cameroun : l’exemple des Bamiléké et Bëti. Union for African Population Studies. Aug-2004; 19(2).
Cates W, Steiner MJ. Dual protection against unintended pregnancy and sexually transmitted infections: what is the best contraceptive approach? Sex Transm Dis. mars 2002;29(3):168 - 74.