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2016 ; 11
(5
): e0155210
Nephropedia Template TP
gab.com Text
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English Wikipedia
Associations between Forced Sexual Initiation, HIV Status, Sexual Risk Behavior,
Life Stressors, and Coping Strategies among Adolescents in Nigeria
#MMPMID27163436
Folayan MO
; Harrison A
; Brown B
; Odetoyinbo M
; Stockman JK
; Ajuwon AJ
; Cáceres CF
PLoS One
2016[]; 11
(5
): e0155210
PMID27163436
show ga
OBJECTIVES: Some individuals experience their first sexual intercourse through
physically forced sex, which affects the way they experience and cope with
stress. We examined differences in sexual risk behavior, experience of stressors,
and use of stress-coping strategies among adolescents in Nigeria based on their
history of forced sexual initiation and HIV status. METHODS: We analyzed data
from 436 sexually active 10-19-year-old adolescents recruited through a
population-based survey from 12 Nigerian states. Using Lazarus and Folkman's
conceptual framework of stress and coping, we assessed if adolescents who
reported forced sexual initiation were more likely to report HIV sexual risk
practices, to report as stressors events related to social expectations, medical
care and body images, and loss and grief, and to use more avoidance than adaptive
coping strategies to manage stress. We also assessed if HIV status affected
experience of stressors and use of coping strategies. RESULTS: Eighty-one
adolescents (18.6%) reported a history of forced sexual initiation; these
participants were significantly more likely to report anal sex practices (OR:
5.04; 95% CI: 2.14-11.87), and transactional sex (OR: 2.80; 95% CI: 1.56-4.95).
Adolescents with no history of forced sexual initiation were more likely to
identify as stressors, life events related to social expectations (OR: 1.03; 95%
CI: 0.96-1.11) and loss and grief (OR: 1.34; 95% CI: 0.73-2.65), but not those
related to medical care and body images (OR: 0.63; 95% CI: 0.34-1.18). They were
also more likely to use adaptive responses (OR: 1.48; 95% CI: 0.62-3.50) than
avoidance responses (OR: 0.90; 95% CI: 0.49-1.64) to cope with stress, though
these differences were not significant. More adolescents with a history of forced
sexual initiation who were HIV positive identified as stressors, life events
related to medical care and body images (p = 0.03) and loss and grief (p =
0.009). Adolescents reporting forced sexual initiation and HIV-negative status
were significantly less likely to use religion as a coping strategy (OR: 0.28;
95% CI: 0.09-0.83). CONCLUSION: History of forced sexual initiation and HIV
status affected perception of events as stressors and use of specific coping
strategies. Our study findings could inform best practice interventions and
policies to prevent and address forced sexual initiation among adolescents in
Nigeria and other countries.