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AJPH First Look, published online ahead of print Nov 13, 2008
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January 2009, Vol 99, No. 1 | American Journal of Public Health 102-109
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2007.126904

RESEARCH AND PRACTICE

Community Influences on Young People's Sexual Behavior in 3 African Countries

Rob Stephenson, PhD

Rob Stephenson is with the Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA.

Correspondence: Requests for reprints should be sent to Rob Stephenson, PhD, Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322 (e-mail: rbsteph{at}sph.emory.edu).

Objectives. I examined the role of community-level factors in the reporting of risky sexual behaviors among young people aged 15 to 24 years in 3 African countries with varying HIV prevalence rates.

Methods. I analyzed demographic and health survey data from Burkina Faso, Ghana, and Zambia during the period 2001 through 2003 to identify individual, household, and community factors associated with reports of risky sexual behaviors.

Results. The mechanisms through which the community environment shaped sexual behaviors varied among young men and young women. Community demographic profiles were not associated with reports of risky sexual behavior among young women but were influential in shaping the behavior of young men. Prevailing economic conditions and the behaviors and attitudes of adults in the community were strong influences on young people's sexual behaviors.

Conclusions. These results provide strong support for a focus on community-level influences as an intervention point for behavioral change. Such interventions, however, should recognize specific cultural settings and the different pathways through which the community can shape the sexual behaviors of young men and women.






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