Hostname: page-component-848d4c4894-tn8tq Total loading time: 0 Render date: 2024-07-01T03:12:28.176Z Has data issue: false hasContentIssue false
  • English
  • Français

RELATIONSHIP BETWEEN ORPHANHOOD STATUS, LIVING ARRANGEMENTS AND SEXUAL DEBUT: EVIDENCE FROM FEMALES IN MIDDLE ADOLESCENCE IN SOUTHERN AFRICA

Published online by Cambridge University Press:  11 October 2017

Mercy Shoko ,
Latifat Ibisomi ,
Jonathan Levin  and
Carren Ginsburg
Mercy Shoko*
Affiliation:
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Statistics South Africa, Pretoria, South Africa
Latifat Ibisomi
Affiliation:
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Jonathan Levin
Affiliation:
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Carren Ginsburg
Affiliation:
Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
*
1Corresponding author. Email: mercysh@statssa.gov.za
Get access Rights & Permissions [Opens in a new window]

Summary

This study examined the relationship between orphanhood status, living arrangements and sexual debut. The study is important in the context of southern Africa, where a substantial number of children live apart from their parents because the parent is dead or living elsewhere, and where female adolescents face disproportionate sexual and reproductive health risks. Data for female adolescents were taken from Demographic and Health Surveys conducted in seven southern African countries. Unadjusted and adjusted hazard ratios of sexual debut were estimated using Cox Proportional Hazard models. The results from multivariate analyses showed that non-co-residence with biological parents was significantly associated with higher risk of sexual debut in five of the seven countries. Using pooled data, the results showed that father absence was associated with higher risk of sexual debut – whether the father was deceased or living elsewhere. Interventions to delay sexual debut among female adolescents should seek to promote father–adolescent co-residence and improve access to education.

Type
Research Article
Information
Journal of Biosocial Science , Volume 50 , Issue 3 , May 2018 , pp. 380 - 396
Copyright
Copyright © Cambridge University Press, 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bryan, M. I. & Jenkins, S. P. (2016) Multilevel modelling of country effects: a cautionary tale. European Sociological Review 32(1), 3–22.Google Scholar
Case, A., Paxson, C. & Ableidinger, J. (2004) Orphans in Africa: parental death, poverty, and school enrollment. Demography 41(3), 483–508.CrossRefGoogle ScholarPubMed
Chae, S. (2013) Timing of orphanhood, early sexual debut, and early marriage in four sub-Saharan African countries. Studies in Family Planning 44(2), 123–146.Google Scholar
Chandra-Mouli, V., McCarraher, D. R., Phillips, S. J., Williamson, N. E. & Hainsworth, G. (2014) Contraception for adolescents in low and middle income countries: needs, barriers, and access. Reproductive Health 11(1), 1–8.Google Scholar
Chandra-Mouli, V., Svanemyr, J., Amin, A., Fogstad, H., Say, L., Girard, F. & Temmerman, M. (2015) Twenty years after international conference on population and development: where are we with adolescent sexual and reproductive health and rights? Journal of Adolescent Health 56 (Supplement 1), s1–s6.Google Scholar
Corsi, D. J., Neuman, M., Finlay, J. E. & Subramanian, S. V. (2012) Demographic and health surveys: a profile. International Journal of Epidemiology 41(6), 1602–1613.Google Scholar
Dixon-Mueller, R. (2008) How young is ‘too young’? Comparative perspectives on adolescent sexual, marital, and reproductive transitions. Studies in Family Planning 39(4), 247–262.Google Scholar
Eaton, J. W., Garnett, G. P., Takavarasha, F. R., Mason, P. R., Robertson, L., Schumacher, C. M. et al. (2013) Increasing adolescent HIV prevalence in eastern Zimbabwe – evidence of long-term survivors of mother-to-child transmission? PloS One 8(8), e70447.Google Scholar
Embleton, L., Nyandat, J., Ayuku, D., Sang, E., Kamanda, A., Ayaya, S. et al. (2017) Sexual behavior among orphaned adolescents in western Kenya: a comparison of institutional- and family-based care settings. Journal of Adolescent Health 60(4), 417–424.Google Scholar
Fathalla, M. (1998) Issues in reproductive health. Presented at the Expert Group Meeting on Women and Health Mainstreaming the Gender Perspective into the Health Sector, Tunis (Tunisia), 28th September to 2nd October 1998. URL: http://www.un.org/womenwatch/daw/csw/issues.htm (accessed November 2016).Google Scholar
Fisher, J. (1950) Orphans in the United States: number and living arrangements. Social Security Bulletin 13(8), 13–18.Google Scholar
Foster, G. (2004) Safety needs for children affected by HIV/AIDS in Southern Africa. In Pharaoh, R., Richter L. & Killian, B., (eds) A Generation at Risk?’ HIV/AIDS, Vulnerable Children and Security in Southern Africa. Monograph No. 109. Institute for Security Studies, Pretoria, South Africa.Google Scholar
Gaydosh, L. (2015) Childhood risk of parental absence in Tanzania. Demography 52(4), 1121–1146.Google Scholar
Ghebremichael, M., Larsen, U. & Paintsil, E. (2009) Association of age at first sex with HIV-1, HSV-2, and other sexual transmitted infections among women in northern Tanzania. Sexually Transmitted Diseases 36(9), 570–576.CrossRefGoogle ScholarPubMed
Hosegood, V., Floyd, S., Marston, M., Hill, C. & McGrath, N. (2007) The effects of high HIV prevalence on orphanhood and living arrangements of children in Malawi, Tanzania and South Africa. Population Studies 61(3), 327–336.Google Scholar
Hillis, S. D., Zapata, L., Robbins, C. L., Kissin, D. M., Skipalska, H., Yorick, R. et al. (2012) HIV seroprevalence among orphaned and homeless youth: no place like home. AIDS 26(1), 105–110.Google Scholar
Juma, M., Askew, I. & Ferguson, A. (2007) Situation Analysis of the Sexual and Reproductive Health and HIV Risks and Prevention Needs of Older Orphaned and Vulnerable Children in Nyanza Province. Population Council, Constella Futures, Nairobi, Kenya.Google Scholar
Louie, K. S., de Sanjose, S., Diaz, M., Castellsague, X., Herrero, R., Meijer, C. J. et al. (2009) Early age at first sexual intercourse and early pregnancy are risk factors for cervical cancer in developing countries. British Journal of Cancer 100(7), 1191–1197.Google Scholar
Magadi, M. & Uchudi, J. (2015) Onset of sexual activity among adolescents in HIV/AIDS-affected households in sub-Saharan Africa. Journal of Biosocial Science 47(2), 238–257.Google Scholar
Makumbi, F. E., Nakigozi, G., Sekasanvu, J., Lukabwe, I., Kagaayi, J., Lutalo, T. et al. (2012) Incidence of orphanhood before and after implementation of a HIV CARE program in Rakai, Uganda. Tropical Medicine & International Health 17(8), e94–e102.Google Scholar
Mann, G. (2002) Family Matters: The Care and Protection of Children Affected by HIV/AIDS in Malawi. Save the Children, Sweden.Google Scholar
Martin, F. S. & Zulaika, G. (2016) Who cares for children? A descriptive study of care-related data available through global household surveys and how these could be better mined to inform policies and services to strengthen family care. Global Social Welfare 3(2), 51–74.Google Scholar
McGrath, N., Nyirenda, M., Hosegood, V. & Newell, M. L. (2009) Age at first sex in rural South Africa. Sex Transmission Infection 85 (Supplement 1), i49–i55.Google Scholar
Meintjes, H., Hall, K., Marera, D. H. & Boulle, A. (2010) Orphans of the AIDS epidemic? The extent, nature and circumstances of child-headed households in South Africa. AIDS Care 22(1), 40–49.Google Scholar
Mkandawire, P., Tenkorang, E. & Luginaah, I. N. (2013) Orphan status and time to first sex among adolescents in northern Malawi. AIDS Behavior 17(3), 939–950.Google Scholar
Mmari, K. (2011) Exploring the relationship between caregiving and health: perceptions among orphaned and non–orphaned adolescents in Tanzania. Journal of Adolescence 34(2), 301–309.Google Scholar
Mmari, K., Kalamar, A. M., Brahmbhatt, H. & Venables, E. (2016) The influence of the family on adolescent sexual experience: a comparison between Baltimore and Johannesburg. PLoS One 11(11), e0166032.Google Scholar
Mofenson, L. M. & Cotton, M. F. (2013) The challenges of success, adolescents with perinatal HIV infection. Journal of the International AIDS Society 16, 18650.Google Scholar
Mojola, S. A. (2011) Multiple transitions and HIV risk among orphaned Kenyan schoolgirls. Studies in Family Planning 42(1), 29–40.CrossRefGoogle ScholarPubMed
Monasch, R. & Boerma, J. T. (2004) Orphanhood and childcare patterns in sub-Saharan Africa: an analysis of national surveys from 40 countries. AIDS 18, S55–S65.Google Scholar
Ngom, P., Magadi, M. A. & Owuor, T. (2003) Parental presence and adolescent reproductive health among the Nairobi urban poor. Journal of Adolescent Health 33, 369–377.Google Scholar
Operario, D., Underhill, K., Chuong, C. & Cluver, L. (2011) HIV infection and sexual risk behaviour among youth who have experienced orphanhood: systematic review and meta-analysis. Journal of the International AIDS Society 14(1), 1–11.Google Scholar
Palermo, T. & Peterman, A. (2009) Are female orphans at risk for early marriage, early sexual debut, and teen pregnancy? Evidence from sub-Saharan Africa. Studies in Family Planning 40(2), 101–112.Google Scholar
Palloni, A. & Lee, Y. J. (1992) Some aspects of the social HIV and its effects on women, children and families. Population Bulletin of the United Nations 33, 64–87.Google Scholar
Pilgrim, N. A., Ahmed, S., Gray, R. H, Sekasanvu, J., Lutalo, T., Nalugoda, F. et al. (2014) Family structure effects on early sexual debut among adolescent girls in Rakai, Uganda. Vulnerable Children Youth Studies 9(3), 193–205.Google Scholar
Puffer, E. S., Drabkin, A. S., Stashko, A. I., Broverman, S. A., Ogwang-Odhiambo, R. A. & Sikkema, K. J. (2012) Orphan status, HIV risk behavior, and mental health among adolescents in rural Kenya. Journal of Pediatric Psychology 37(8), 868–878.Google Scholar
Rathod, S. D., Chi, B. H., Kusanthan, T., Chilopa, B., Levy, J., Sikazwe, I. et al. (2014) Trends in all-cause mortality during the scale-up of an antiretroviral therapy programme: a cross-sectional study in Lusaka, Zambia. Bulletin of the World Health Organization 92(10), 734–741.Google Scholar
Reniers, G., Blom, S., Calvert, C., Martin-Onraet, A., Herbst, A. J., Eaton, J. W. et al. (2016) Trends in the burden of HIV mortality after roll-out of antiretroviral therapy in KwaZulu-Natal, South Africa: an observational community cohort study. Lancet HIV 9(16), 30225–30229.Google Scholar
Robertson, L., Gregson, S. & Garnett, G. P. (2010) Sexual risk among orphaned adolescents: is country-level HIV prevalance an important factor? AIDS Care 22(8), 927–938.Google Scholar
Rutstein, S. O. & Staveteig, S. (2014) Making the Demographic and Health Surveys wealth index comparable. DHS Methodological Reports No. 9. ICF International, Rockville, MD, USA.Google Scholar
Sedgh, G., Singh, S., Shah, I. H., Åhman, E., Henshaw, S. K. & Bankole, A. (2012) Induced abortion, incidence and trends worldwide from 1995 to 2008. The Lancet 379(9816), 625–632.Google Scholar
Shoko, M. & Ibisomi, L. (2016) Orphanhood prevalence, living arrangements and orphanhood reporting in Lesotho, Malawi and Zimbabwe. Child Indicators Research, 1–15.Google Scholar
Shtarkshall, R. A., Santelli, J. S. & Hirsch, J. S. (2007) Sex education and sexual socialization: roles for educators and parents. Perspectives on Sexual and Reproductive Health 39(2), 116–119.Google Scholar
Stark, L., Tan, T. M., Muldoon, K. A., King, D., Lamin, D. F. M. et al. (2015) Family structure and sexual and reproductive health outcomes among adolescents in rural Sierra Leone. Global Public Health 16, 1–13.Google Scholar
Stockl, H., Kalra, N., Jacobi, J. & Watts, C. (2013) Is early sexual debut a risk factor for HIV infection among women in sub-Saharan Africa? A systematic review. American Journal of Reproductive Immunology 1, 27–40.Google Scholar
UN (1994) Report of the International Conference on Population and Development, Cairo (Egypt), 5–13th September 1994. URL: http://www.un.org/popin/icpd/conference/offeng/poa.html (accessed November 2016).Google Scholar
UNAIDS (2002) Monitoring the Declaration of Commitment on HIV/AIDS: Guidelines on Construction of Core Indicators. UNAIDS, Geneva.Google Scholar
UNAIDS (2016) UNAIDS Indicators. URL: http://aidsinfo.unaids.org/#data-details (accessed May 2017).Google Scholar
UNAIDS, UNICEF & USAID (2004) Children On The Brink. A Joint Report of New Orphan Estimates and a Framework for Action . UNAIDS, UNICEF and USAID, New York.Google Scholar
UNDESA (no date) Definition of Youth. URL: http://www.un.org/esa/socdev/documents/youth/fact-sheets/youth-definition.pdf (accessed May 2017).Google Scholar
UNFPA (2012) Marrying Too Young: End Child Marriage. UNFPA, New York.Google Scholar
UNICEF (2012) Progress For Children: A Report Card on Adolescents. UNICEF, New York.Google Scholar
UNICEF (2015) The State of the World’s Children 2015. UNICEF, New York.Google Scholar
Van Rossem, R., Berten, H. & Van Tuyckom, C. (2010) AIDS knowledge and sexual activity among Flemish secondary school students: a multilevel analysis of the effects of type of education. BMC Public Health 10(1), 1–10.Google Scholar
WHO (2001) Second Decade: Improving Adolescent Health and Development. WHO, Geneva.Google Scholar
Zaba, B., Boerma, T. J., Pisani, E. & Baptiste, N. (2002) Estimation of levels and trends in age at first sex from surveys using survival analysis. Measure Evaluation Working Paper. University of North Carolina.Google Scholar