IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0064881.html
   My bibliography  Save this article

Decline in Sexual Risk Behaviours among Young People in Zambia (2000–2009): Do Neighbourhood Contextual Effects Play a Role?

Author

Listed:
  • Nkomba Kayeyi
  • Knut Fylkesnes
  • Nora Wiium
  • Ingvild F Sandøy

Abstract

Objective: This study examined trends in premarital sex, multiple partnership and condom use among young people (15–24 years) in Zambia from 2000 to 2009, and assessed the effects of individual and neighbourhood variables on these sexual behaviour indicators in 2000 and 2009. Methodology: We analysed data from the Zambia Sexual Behaviour Survey, conducted in 2000, 2003, 2005 and 2009. Multi-stage cluster sampling was used to select 385 neighbourhoods, giving a population sample of 6,500 young people. Using linear-by-linear trend test, trends in the three indicators were examined. Multilevel logistic regression was used to assess the effects of individual and neighbourhood variables on the indicators. Results: Premarital sex among young people decreased significantly from 51 to 42% between 2000 and 2009. Multiple partnerships of men also decreased from 26 to 14% during the same period. The use of condoms by young people remained stable during this period. Full multilevel regression models explained 29 and 34% of the neighbourhood variance of premarital sex in 2000 and 2009. For multiple partnerships and condom use, the explained variance was 29 and 18% in 2000; whereas in 2009 it was extremely low. Urban residence and living in neighbourhood with higher average duration of residence were associated with low premarital sex and higher condom use. Living in a neighbourhood with higher average level of comprehensive knowledge of HIV was associated with less risky sexual behaviour. Conclusion: Declining trends in premarital sex and multiple partnerships are among the factors that might explain the decrease in HIV incidence in Zambia among young people. However, condom use among young people has remained low and stable over the years. The results also suggest that behaviour change interventions should take stock of the social context when introducing individual-level programmes because neighbourhood factors play a considerable role in influencing sexual behaviour.

Suggested Citation

  • Nkomba Kayeyi & Knut Fylkesnes & Nora Wiium & Ingvild F Sandøy, 2013. "Decline in Sexual Risk Behaviours among Young People in Zambia (2000–2009): Do Neighbourhood Contextual Effects Play a Role?," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-15, May.
    • Handle: RePEc:plo:pone00:0064881
    DOI: 10.1371/journal.pone.0064881
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0064881
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0064881&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0064881?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Karin Brewster, 1994. "Neighborhood context and the transition to sexual activity among young black women," Demography, Springer;Population Association of America (PAA), vol. 31(4), pages 603-614, November.
    2. Stephenson, R., 2009. "Community influences on young people's sexual behavior in 3 African countries," American Journal of Public Health, American Public Health Association, vol. 99(1), pages 102-109.
    3. Diez-Roux, A.V., 1998. "Bringing context back into epidemiology: Variables and fallacies in multilevel analysis," American Journal of Public Health, American Public Health Association, vol. 88(2), pages 216-222.
    4. Christopher Browning & Tama Leventhal & Jeanne Brooks-Gunn, 2004. "Neighborhood context and racial differences in early adolescent sexual activity," Demography, Springer;Population Association of America (PAA), vol. 41(4), pages 697-720, November.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Tom W. Smith & Jibum Kim, 2013. "An Assessment of the Multi-level Integrated Database Approach," The ANNALS of the American Academy of Political and Social Science, , vol. 645(1), pages 185-221, January.
    2. Yasamin Kusunoki & Jennifer S. Barber & Elizabeth J. Ela & Amelia Bucek, 2016. "Black-White Differences in Sex and Contraceptive Use Among Young Women," Demography, Springer;Population Association of America (PAA), vol. 53(5), pages 1399-1428, October.
    3. Bolte, Gabriele, 2018. "Epidemiologische Methoden und Erkenntnisse als eine Grundlage für Stadtplanung und gesundheitsfördernde Stadtentwicklung," Forschungsberichte der ARL: Aufsätze, in: Baumgart, Sabine & Köckler, Heike & Ritzinger, Anne & Rüdiger, Andrea (ed.), Planung für gesundheitsfördernde Städte, volume 8, pages 118-134, ARL – Akademie für Raumentwicklung in der Leibniz-Gemeinschaft.
    4. Spielman, Seth E. & Yoo, Eun-hye, 2009. "The spatial dimensions of neighborhood effects," Social Science & Medicine, Elsevier, vol. 68(6), pages 1098-1105, March.
    5. Orna Braun-Lewensohn, 2016. "Sense of Coherence, Values, Youth Involvement, Civic Efficacy and Hope: Adolescents During Social Protest," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 128(2), pages 661-673, September.
    6. Linda Loury, 2006. "Teen Childbearing and Conservative Religious Communities," Discussion Papers Series, Department of Economics, Tufts University 0619, Department of Economics, Tufts University.
    7. Bisakha Sen, 2006. "Frequency Of Sexual Activity Among Unmarried Adolescent Girls: Do State Policies Pertaining To Abortion Access Matter?," Eastern Economic Journal, Eastern Economic Association, vol. 32(2), pages 313-330, Spring.
    8. Dusan Paredes Araya & Tomothy M Komarek, 2013. "Spatial Income Inequality in Chile and the Rol of Spatial Labor Sorting," Documentos de Trabajo en Economia y Ciencia Regional 46, Universidad Catolica del Norte, Chile, Department of Economics, revised Apr 2013.
    9. Seth E Spielman & Eun-Hye Yoo & Crystal Linkletter, 2013. "Neighborhood Contexts, Health, and Behavior: Understanding the Role of Scale and Residential Sorting," Environment and Planning B, , vol. 40(3), pages 489-506, June.
    10. Zanetta Gant & Larry Gant & Ruiguang Song & Leigh Willis & Anna Satcher Johnson, 2014. "A Census Tract–Level Examination of Social Determinants of Health among Black/African American Men with Diagnosed HIV Infection, 2005–2009—17 US Areas," PLOS ONE, Public Library of Science, vol. 9(9), pages 1-7, September.
    11. Miller, Charlotte E. & Vasan, Ramachandran S., 2021. "The southern rural health and mortality penalty: A review of regional health inequities in the United States," Social Science & Medicine, Elsevier, vol. 268(C).
    12. Dodoo, F. Nii-Amoo & Zulu, Eliya M. & Ezeh, Alex C., 2007. "Urban-rural differences in the socioeconomic deprivation-Sexual behavior link in Kenya," Social Science & Medicine, Elsevier, vol. 64(5), pages 1019-1031, March.
    13. Akers, Aletha Y. & Muhammad, Melvin R. & Corbie-Smith, Giselle, 2011. ""When you got nothing to do, you do somebody": A community's perceptions of neighborhood effects on adolescent sexual behaviors," Social Science & Medicine, Elsevier, vol. 72(1), pages 91-99, January.
    14. Myers, Douglas J. & Kriebel, David & Karasek, Robert & Punnett, Laura & Wegman, David H., 2007. "The social distribution of risk at work: Acute injuries and physical assaults among healthcare workers working in a long-term care facility," Social Science & Medicine, Elsevier, vol. 64(4), pages 794-806, February.
    15. infocede, 2001. "Desnutrición infantil en Colombia: inequidades y determinantes," Documentos CEDE 20100, Universidad de los Andes, Facultad de Economía, CEDE.
    16. Martin Gaechter & Peter Schwazer & Engelbert Theurl, 2012. "Stronger Sex but Earlier Death: A Multi-level Socioeconomic Analysis of Gender Differences in Mortality in Austria," DANUBE: Law and Economics Review, European Association Comenius - EACO, issue 1, pages 1-23, March.
    17. De Clercq, B. & Vyncke, V. & Hublet, A. & Elgar, F.J. & Ravens-Sieberer, U. & Currie, C. & Hooghe, M. & Ieven, A. & Maes, L., 2012. "Social capital and social inequality in adolescents’ health in 601 Flemish communities: A multilevel analysis," Social Science & Medicine, Elsevier, vol. 74(2), pages 202-210.
    18. Kuang-Tsu Yang & Chun-Hao Yin & Yao-Min Hung & Shih-Ju Huang & Ching-Chih Lee & Tsu-Jen Kuo, 2020. "Continuity of Care Is Associated with Medical Costs and Inpatient Days in Children with Cerebral Palsy," IJERPH, MDPI, vol. 17(8), pages 1-15, April.
    19. Steffen Andreas Schüle & Gabriele Bolte, 2015. "Interactive and Independent Associations between the Socioeconomic and Objective Built Environment on the Neighbourhood Level and Individual Health: A Systematic Review of Multilevel Studies," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-31, April.
    20. Win Wah & Arul Earnest & Charumathi Sabanayagam & Ching-Yu Cheng & Marcus Eng Hock Ong & Tien Y Wong & Ecosse L Lamoureux, 2015. "Composite Measures of Individual and Area-Level Socio-Economic Status Are Associated with Visual Impairment in Singapore," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-12, November.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0064881. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.