Exploratory analysis of the ecological variables associated with sexual health profiles in high-risk, sexually-active female learners in rural KwaZulu-Natal
PURPOSE
Young women are at high risk for negative sexual health outcomes. Despite their high risk,
many sexually-active women never experience negative sexual health outcomes. This
study explored the ecological risk factors associated with the risk profiles of sexually-active
female high school-learners in rural KwaZulu-Natal, South Africa.
METHODS
Using baseline data from N = 596 sexually-active school-going women, we explored the
ecological factors associated with being sexually-active and managing risk successfully
[SARS] or unsuccessfully [SARU]. Generalised estimated equations (GEE) were applied to
data collected at multiple levels while adjusting for school and other included variables. GEE
were used to calculate probability of being SARU.
RESULTS
Amongst SARU learners, 21.9% had HIV, 38.6% had HSV-2, 12.5% were pregnant, 28.7%
self-reported STI symptoms and 51.9% reported a previous pregnancy. Individual-level
factors had the greatest impact on being SARU. Univariate and multivariate analysis
highlighted several important partner factors associated with SARU. Age was significantly
associated with the risk profiles (p<0.0001), a greater proportion of SARU learners were 18
or older compared to the SARS learners. The odds of being SARU decreased when 18
years (aOR = 0.2577, 95% CI 0.1462±0.4542) or if not falling pregnant was important
(aOR = 0.6343, 95% CI 0.4218±0.9538). Having >1 HIV test (aOR = 2.2161, 95% CI
1.3964±3.5169) increased the odds a SARU profile.
CONCLUSION
Individual and partner level factors are important for the sexual health profile of an adolescent
female. While the exploratory findings require further research; managing multiple sexual
health outcomes, tailoring responses around a risk profile and including partners is
essential for successful interventions
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