Reproductive health risk and protective factors among youth in Lusaka, Zambia

• Published in: Journal of adolescent health 2002, Vol.30 (1), p.76-86
• Main Authors: Magnani, Robert J, Karim, Ali Mehryar, Weiss, Lisa A, Bond, Katherine C, Lemba, Musonda, Morgan, Gwendolyn T
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Adult; Biological and medical sciences; Child; Data Collection; Female; Gender differences; Health Knowledge, Attitudes, Practice; HIV Infections - ethnology; HIV Infections - prevention & control; HIV/AIDS; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Protective factors; Reproductive health; Reproductive Medicine; Risk and protective factors; Risk behaviour; Risk-Taking; Sexual Behavior - ethnology; Sexual Behavior - statistics & numerical data; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young people; Zambia; Zambia - epidemiology
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/S1054-139X(01)00328-7

Purpose: To: (a) identify risk and protective factors for behaviors that expose Zambian youth to risk of HIV infection and, (b) assess whether research findings from the United States concerning protective factors in “high-risk” environments might apply to other settings. Methods: A community-based sample of 2328 youth ages 10–24 years residing in Lusaka, Zambia was interviewed. Multivariate statistical methods were used to isolate risk and protective factors for selected sexual and contraceptive behaviors. Seven categories of factors were considered: sociodemographic factors, sexual-reproductive health knowledge and perceptions, nonsexual risk behaviors, peer influence, connections with parents and social institutions, and communication with sexual partners. Results: A sizeable number of factors were associated with each outcome. Only two factors, school attendance and knowledge of AIDS, were associated with both lower levels of sexual activity and consistent use of condoms, and only engaging in higher-risk social activities with close friends was a risk factor for both. The effects of the other factors considered varied by outcome and gender. As in prior research, strong influences of peers were observed, but connections with parents and social institutions unexpectedly did not emerge as protective. Conclusion: Because of the number and diverse nature of factors influencing adolescent behaviors, it is unlikely that a single intervention will be found to immediately change sexual risk-taking behaviors in Zambia.