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BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2015 | Research article

What are the characteristics of ‘sexually ready’ adolescents? Exploring the sexual readiness of youth in urban poor Accra

Authors: Adriana A. E. Biney, F. Nii-Amoo Dodoo

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

Adolescent sexual activity, especially among the urban poor, remains a challenge. Despite numerous interventions and programs to address the negative consequences arising from early and frequent sexual activity among youth in sub-Saharan Africa, including Ghana, only slight progress has been made. A plausible explanation is that our understanding of what adolescents think about sex and about their own sexuality is poor. In that sense, examining how adolescents in urban poor communities think about their sexual readiness, and identifying characteristics associated with that sexual self-concept dimension, should deepen our understanding of this topical issue.

Methods

A total of 196 male and female adolescents, ages 12 to 19, were surveyed in the 2011 RIPS Urban Health and Poverty Project in Accra, Ghana. The youth responded to three statements which determined their levels of sexual readiness. Other background characteristics were also obtained enabling the assessment of the correlates of their preparedness to engage in sex. The data were analyzed using ordered logistic regression models.

Results

Overall, the majority of respondents did not consider themselves ready for sex. Multivariate analyses indicated that sexual experience, exposure to pornographic movies, gender, ethnicity and household wealth were significantly linked to their readiness for sex.

Conclusion

Sexual readiness is related to sexual activity as well as other characteristics of the adolescents, suggesting the need to consider these factors in the design of programs and interventions to curb early sex. The subject of sexual readiness has to be investigated further to ensure adolescents do not identify with any negative effects of this sexual self-view.
Footnotes
1
Buzwell and Rosenthal [22] determined five clusters representing five distinct sexual self-concept dimensions/styles of adolescents. They were categorized into sexually naïve, sexually unassured, sexually adventurous, sexually competent and sexually driven groups. They styles were a reflection of their responses on the sexual self-esteem, sexual self-efficacy and sexual attitude scales. For example, the sexually naïve adolescents exhibited low sexual self-esteem, low sexual self-efficacy, and high sexual commitment and anxiety attitudes, while the sexually adventurous youth exhibited the opposite.
 
2
These data are from the second of three waves of a project conducted by the Regional Institute for Population Studies (RIPS), on urban poverty, population and health issues. Two of the localities (James Town and Ussher Town) are considered urban poor settings with indigenous Ga residents, while Agbogbloshie is more of an informal (slum) settlement consisting of more transient dwellers.
 
3
Adolescents between ages 12 and 14 were not interviewed in Agbogbloshie, hence the 15 to 19 year olds that were interviewed were also not included in this sample.
 
4
Items 2 and 3 were reverse coded into ‘I do not think I am too young to have sex’ and ‘I do not think it is wrong for me to have sex’. This was done to suggest that agreement meant adolescents “owned” their sexuality.
 
5
Further analyses show that a significantly higher proportion of girls state their first sexual encounter was with a boyfriend who was older than them. In addition, with the exception of males engaging in sex with more casual partners, females were more likely to exhibit risky sexual behavior which was largely characterized by their non- or inconsistent use of condoms with sexual partners.
 
Literature
1.
Meekers D. Sexual Initiation and Premarital Sexual Initiation Childbearing Africa in Sub-Saharan. Popul Stud (NY). 1994;48(1):47–64.CrossRef
2.
Glover EK, Bannerman A, Pence BW, Jones H, Miller R, Weiss E, et al. Sexual health experiences of adolescents in three Ghanaian towns. Int Fam Plan Perspect. 2003;29(1):32–40.PubMedCrossRef
3.
4.
Manzini N. Sexual initiation and childbearing among adolescent girls in KwaZulu Natal, Reprod Health Matters. 2001;9:44–52.PubMedCrossRef
5.
Gupta N, Mahy M. Sexual Initiation among Adolescent Girls and Boys: Trends and Differentials in Sub-Saharan Africa. Arch Sex Behav. 2003;32(1):41–53.PubMedCrossRef
6.
7.
Butler TH, Miller KS, Holtgrave DR, Forehand R, Long N. Stages of sexual readiness and six‐month stage progression among African American pre‐teens. J Sex Res Taylor & Francis. 2006;43(4):378–86.CrossRef
8.
Biddlecom A, Gregory R, Lloyd CB, Mensch BS. Associations Between Premarital Sex and Leaving School in Four Sub‐Saharan African Countries. Stud Fam Plann Wiley Online Library. 2008;39(4):337–50.CrossRef
9.
10.
Meekers D, Gage A, Zhan L. Preparing adolescents for adulthood. Popul Res Policy Rev Springer. 1995;14(1):91–110.CrossRef
11.
Zulu EM, Dodoo FN-A, Ezeh AC. Sexual risk-taking in the slums of Nairobi, Kenya, 1993–8. Popul Stud (NY). 2002;56(3):311–23.CrossRef
12.
Dodoo FN-A, Zulu EM, Ezeh AC. Urban–rural differences in the socioeconomic deprivation-Sexual behavior link in Kenya. Soc Sci Med. 2007;64:1019–31.PubMedPubMedCentralCrossRef
13.
Morrison-Beedy D, Jones SH, Xia Y, Tu X, Crean HF, Carey MP. Reducing sexual risk behavior in adolescent girls: results from a randomized controlled trial. J Adolesc Heal Elsevier. 2013;52(3):314–21.CrossRef
14.
Brahmbhatt H, Kågesten A, Emerson M, Decker MR, Olumide AO, Ojengbede O, et al. Prevalence and Determinants of Adolescent Pregnancy in Urban Disadvantaged Settings Across Five Cities. J Adolesc Heal Elsevier. 2014;55(6):S48–57.CrossRef
15.
16.
Ngom P, Magadi MA, Owuor T. Parental presence and adolescent reproductive health among the Nairobi urban poor. J Adolesc Heal Elsevier. 2003;33(5):369–77.CrossRef
17.
Ghana Statistical Service (GSS), Ghana Health Service (GHS). ICF International. Ghana Demographic and Health Survey 2014 [Internet]. Rockville, Maryland, USA: GSS, GHS, and ICF International; 2015. Available from: http://​dhsprogram.​com/​pubs/​pdf/​FR307/​FR307.​pdf.​
18.
19.
Sundaram A, Juarez F, Bankole A, Singh S. Factors Associated with Abortion-Seeking and Obtaining a Safe Abortion in Ghana. Stud Fam Plann. 2012;43(4):273–86.PubMedCrossRef
20.
Biney AAE. Developing a Sexual Self-Concept Scale for Adolescents in Accra. University of Ghana, Legon: Ghana. Unpublished doctoral dissertation; 2013.
21.
Winter L. The role of sexual self-concept in the use of contraceptives. Fam Plann Perspect. 1988;20(3):123–7.PubMedCrossRef
22.
Buzwell S, Rosenthal D. Constructing a sexual self: Adolescents’ sexual self-perceptions and sexual risk-taking. J Res Adolesc. 1996;64(4):489–513.
23.
24.
Vickberg SMJ, Deaux K. Measuring the dimensions of women’s sexuality: The women's sexual self-concept scale. Sex Roles. 2005;53(5–6):361–9.CrossRef
25.
O’Sullivan LF, Mckeague IW, Dudley C, Hearn KD, Varela Y, Miller K, et al. The development of the sexual self-concept inventory for adolescent girls. Psychol Women Q. 2006;30:139–49.CrossRef
26.
Rostosky SS, Dekhtyar O, Cupp PK, Anderman EM. Sexual self-concept and sexual self-efficacy in adolescents: a possible clue to promoting sexual health? J Sex Res. 2008;45(3):277–86.PubMedCrossRef
27.
Miller KS, Fasula AM, Lin CY, Levin ML, Wyckoff SC, Forehand R. Ready, set, go African American preadolescents’ sexual thoughts, intentions, and behaviors. J Early Adolesc SAGE Publications. 2012;32(2):293–307.CrossRef
28.
Heron J, Low N, Lewis G, Macleod J, Ness A, Waylen A. Social factors associated with readiness for sexual activity in adolescents: a population-based cohort study. Arch Sex Behav Springer. 2013;44(3):669–78.CrossRef
29.
Holmes MC. Mental health and sexual self-concept discrepancies in a sample of young black women. J Black Psychol. 2002;28:347–70.CrossRef
30.
Salazar LF, Diclemente RJ, Wingood GM, Crosby RA, Harrington K, Davies S, et al. Self-concept and adolescents’ refusal of unprotected sex: A test of mediating mechanisms among African American girls. Prev Sci. 2004;5(3):137–49.PubMedCrossRef
31.
Lou J, Chen S, Li R, Yu H. Relationships among sexual self‐concept, sexual risk cognition and sexual communication in adolescents: a structural equation model. J Clin Nurs Wiley Online Library. 2011;20(11–12):1696–704.
32.
Pai H-C, Lee S, Chang T. Sexual self-concept and intended sexual behavior of young adolescent Taiwanese girls. Nurs Res LWW. 2010;59(6):433–40.CrossRef
33.
Pai H, Lee S. Sexual self‐concept as influencing intended sexual health behaviour of young adolescent Taiwanese girls. J Clin Nurs Wiley Online Library. 2012;21(13–14):1988–97.
34.
35.
Marston C, King E. Factors that shape young people’s sexual behaviour: a systematic review. Lancet. 2006;368:1581–6.PubMedCrossRef
36.
Shavelson RJ, Hubner JJ, Stanton GC. Self-Concept: Validation of Construct Interpretations. Rev Educ Res. 1976;46(3):407–41.CrossRef
37.
Wagner J, Rehfuss M. Self-injury, sexual self-concept, and a conservative Christian upbringing: An exploratory study of three young women’s perspective. J Ment Heal Couns. 2008;30:173–88.CrossRef
38.
Abbott DA, Dalla RL. “It”s a choice, simple as that’: youth reasoning for sexual abstinence or activity. J Youth Stud. 2008;11(6):629–49.CrossRef
39.
Bingenheimer JB, Asante EA, Ahiadeke C. Reliability, Validity, and Associations With Sexual Behavior Among Ghanaian Teenagers of Scales Measuring Four Dimensions of Relationships With Parents and Other Adults. J Fam Issues. 2015;36(5):647–68.PubMedPubMedCentralCrossRef
40.
Ott MA, Pfeiffer EJ, Fortenberry JD. Perceptions of Sexual Abstinence among High-Risk Early and Middle Adolescents. J Adolesc Heal. 2006;39:192–8.CrossRef
41.
Long-Middleton ER, Burke PJ, Lawrence CAC, Blanchard LB, Amudala NH, Rankin SH. Understanding motivations for abstinence among adolescent young women: Insights into effective sexual risk reduction strategies. J Pediatr Heal Care Elsevier. 2013;27(5):342–50.CrossRef
42.
Ott MA, Pfeiffer EJ. “That’s nasty” to curiosity: Early adolescent cognitions about sexual abstinence. J Adolesc Heal. Elsevier. 2009;44(6):575–81.
43.
Atwood KA, Zimmerman R, Cupp PK, Fongkaew W, Miller BA, Byrnes HF, et al. Correlates of Precoital Behaviors, Intentions, and Sexual Initiation Among Thai Adolescents. J Early Adolesc. 2012;32:364–86.CrossRef
44.
Aubrey JS. Does television exposure influence college-aged women’s sexual self-concept? Media Psychol. 2007;10:157–81.CrossRef
45.
Djamba YK. Financial capital and premarital sexual activity: The case of Zambia. Popul Res Policy Rev. 1997;16(3):243–57.CrossRef
46.
Tolman DL. Femininity as a barrier to positive sexual health for adolescent girls. J Am Med Womens Assoc. 1999;54:133–8.PubMed
47.
Muhanguzi FK. Gender and sexual vulnerability of young women in Africa: experiences of young girls in secondary schools in Uganda. Cult Health Sex Taylor & Francis. 2011;13(06):713–25.CrossRef
48.
Biddle BJ, Bank BJ, Marlin MM. Parental and Peer Influence on Adolescents. Soc Forces. 1980;58(4):1057–79.CrossRef
Metadata
Title
What are the characteristics of ‘sexually ready’ adolescents? Exploring the sexual readiness of youth in urban poor Accra
Authors
Adriana A. E. Biney
F. Nii-Amoo Dodoo
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2620-6

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