SRTB data for <b>Disordered eating behaviour is not associated with sexual risk taking behaviour amongst emerging adults attending a tertiary education institution in Coastal Kenya: a latent class analysis approach</b>

BackgroundSexual risk-taking behavior is a well-documented pathway to HIV acquisition in emerging adults and remains common amongst African emerging adults. We aimed to describe the relationship between disordered eating behavior and sexual risk-taking behavior amongst emerging adults attending a tertiary educational institution at the Kenyan Coast.MethodsWe applied a cross-sectional design nested in a young adults’ cohort study. Eligibility included sexually active emerging adults aged 18-24 years. Three disordered eating behaviors (emotional, restrained and external eating) were assessed using the Dutch Eating Behavior Questionnaire and analyzed using exploratory factor analysis. Seven sexual risk-taking behavior indicators were assessed: non-condom use, casual sex, multiple sex partners, transactional sex, group sex, age-disparate relationship and anal sex, and grouped into low vs. high sexual risk-taking behavior using latent class analysis. Logistic regression was used to assess the association between disordered eating behavior and sexual risk-taking behavior.ResultsOf 273 eligible participants (female, n =110 [40.3%]), the mean [SD] of emotional, restrained and external eating was 1.9 [0.6], 2.0 [0.6] and 3.0 [0.5] respectively. Overall, 57 (20.9%) were grouped into the latent high sexual risk-taking behavior class. Emotional (Adjusted odds ratio {AOR [95% confidence interval, CI]: 1.0 [0.9 – 1.0], p = 0.398), restrained (AOR, 1.0 [CI: 0.9 – 1.1], p = 0.301) and External (AOR, 1.0 [CI: 0.8 – 1.2], p = 0.523) eating were not independently associated with latent high sexual risk-taking behavior.ConclusionThere was no significant association between disordered eating behavior and sexual risk-taking behavior. More studies in different African settings are needed to assess this association in order to lay a strong evidence base for public health interventions on sexual risk-taking behavior and to prevent disordered eating behavior in this and similar settings.</p

Common forms of SRTB.

BackgroundIt is known from previous studies that university students in sub-Saharan Africa (sSA) engage in sexual risk-taking behaviour (SRTB). However, there is paucity of data on factors contributing to SRTB among university students (emerging adults) at the Kenyan Coast thus hindering intervention planning. This study seeks to provide an in-depth qualitative understanding of the factors contributing to SRTB and their interconnectedness among university students at the Kenyan Coast combining qualitative research with a systems thinking approach.MethodsUsing the ecological model, and employing in-depth interviews, we explored the perceptions of twenty-six key informants (twenty-one emerging adults and five other stakeholders) on what constitutes and influences SRTB among emerging adults at a tertiary institution of learning in Coastal Kenya. Data were analysed using a thematic framework approach. A causal loop diagram (CLD) was developed to map the interconnectedness of the correlates of SRTB.ResultsOur findings show that unprotected sex, transactional sex, cross-generational sex, multiple sex partnerships, gender-based violence, sex under influence of alcohol/drugs, early sex debut, and sharing sex toys were common SRTBs. Based on the ecological model and CLD, most of the reported risk factors were interconnected and operated at the individual level.ConclusionOur study shows that emerging adults are frequently engaging in unprotected sex. Enhancing sexuality education programs for students in Kenyan universities and strengthening support systems including counselling for those using alcohol/drugs may help reduce SRTB among emerging adults in Kenyan universities.</div

Characteristics of emerging adults at a tertiary education institution in Coastal Kenya.

Characteristics of emerging adults at a tertiary education institution in Coastal Kenya.</p

A diagram of emerging adults’ and other stakeholders’ perceived risk and protective factors for sexual risk taking behaviour among emerging adults at a tertiary education institution in Coastal Kenya.

A diagram of emerging adults’ and other stakeholders’ perceived risk and protective factors for sexual risk taking behaviour among emerging adults at a tertiary education institution in Coastal Kenya.</p

STROBE statement—checklist of items that should be included in reports of observational studies.

STROBE statement—checklist of items that should be included in reports of observational studies.</p

Interview guide.

BackgroundIt is known from previous studies that university students in sub-Saharan Africa (sSA) engage in sexual risk-taking behaviour (SRTB). However, there is paucity of data on factors contributing to SRTB among university students (emerging adults) at the Kenyan Coast thus hindering intervention planning. This study seeks to provide an in-depth qualitative understanding of the factors contributing to SRTB and their interconnectedness among university students at the Kenyan Coast combining qualitative research with a systems thinking approach.MethodsUsing the ecological model, and employing in-depth interviews, we explored the perceptions of twenty-six key informants (twenty-one emerging adults and five other stakeholders) on what constitutes and influences SRTB among emerging adults at a tertiary institution of learning in Coastal Kenya. Data were analysed using a thematic framework approach. A causal loop diagram (CLD) was developed to map the interconnectedness of the correlates of SRTB.ResultsOur findings show that unprotected sex, transactional sex, cross-generational sex, multiple sex partnerships, gender-based violence, sex under influence of alcohol/drugs, early sex debut, and sharing sex toys were common SRTBs. Based on the ecological model and CLD, most of the reported risk factors were interconnected and operated at the individual level.ConclusionOur study shows that emerging adults are frequently engaging in unprotected sex. Enhancing sexuality education programs for students in Kenyan universities and strengthening support systems including counselling for those using alcohol/drugs may help reduce SRTB among emerging adults in Kenyan universities.</div

Causal structure diagram.

BackgroundIt is known from previous studies that university students in sub-Saharan Africa (sSA) engage in sexual risk-taking behaviour (SRTB). However, there is paucity of data on factors contributing to SRTB among university students (emerging adults) at the Kenyan Coast thus hindering intervention planning. This study seeks to provide an in-depth qualitative understanding of the factors contributing to SRTB and their interconnectedness among university students at the Kenyan Coast combining qualitative research with a systems thinking approach.MethodsUsing the ecological model, and employing in-depth interviews, we explored the perceptions of twenty-six key informants (twenty-one emerging adults and five other stakeholders) on what constitutes and influences SRTB among emerging adults at a tertiary institution of learning in Coastal Kenya. Data were analysed using a thematic framework approach. A causal loop diagram (CLD) was developed to map the interconnectedness of the correlates of SRTB.ResultsOur findings show that unprotected sex, transactional sex, cross-generational sex, multiple sex partnerships, gender-based violence, sex under influence of alcohol/drugs, early sex debut, and sharing sex toys were common SRTBs. Based on the ecological model and CLD, most of the reported risk factors were interconnected and operated at the individual level.ConclusionOur study shows that emerging adults are frequently engaging in unprotected sex. Enhancing sexuality education programs for students in Kenyan universities and strengthening support systems including counselling for those using alcohol/drugs may help reduce SRTB among emerging adults in Kenyan universities.</div

A causal loop diagram showing risk and protective factors that impact sexual risk-taking behaviour among emerging adults at a tertiary education institution in Coastal Kenya.

Arrows and variables in red have been added based on literature to make the causal loop diagram complete. R- Reinforcing loop.</p

Risk and protective factors of sexual risk-taking behaviour and exemplifying statements.

Risk and protective factors of sexual risk-taking behaviour and exemplifying statements.</p