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UNESCO HIV and Health Education Clearinghouse

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  1. How reliable are reports of early adolescent reproductive and sexual health events in demographic and health surveys?

    CONTEXT: Age at sexual debut, age at first marriage or first union and age at first birth are among the most widely used indicators of health and well-being for female adolescents. However, the accuracy of estimates for these indicators, particularly for younger adolescents, is poorly understood. METHODS: For each of nine countries in Africa and Latin America, Demographic and Health Survey (DHS) data from two surveys conducted five years apart were used to examine women’s reports of age at sexual debut, marriage or first union, and first birth. …

  2. Minimum marriage age laws and the prevalence of child marriage and adolescent birth: evidence from Sub-Saharan Africa

    CONTEXT: The relationship of national laws that prohibit child marriage with the prevalence of child marriage and adolescent birth is not well understood. METHODS: Data from Demographic and Health Surveys and from the Child Marriage Database created by the MACHEquity program at McGill University were used to examine the relationship between laws that consistently set the age for marriage for girls at 18 or older and the prevalence of child marriage and teenage childbearing in 12 Sub-Saharan African countries. …

  3. On the impact of early marriage on schooling outcomes in Sub-Saharan Africa and South West Asia

    This paper examines the effect of age of marriage on women’s schooling outcomes for 36 countries from Sub-Saharan Africa and South West Asia. We employ an instrumental variable approach to account for the endogeneity of early marriage driven by socio-economic and cultural factors. Our results show that delaying early marriage by one year is associated with an increase of half a year of education in Sub- Saharan Africa and nearly one third of a year of education in South West Asia as well as a lower likelihood of dropping out from secondary school of 5.5% in South West Asia.

  4. Let’s talk about sex: A qualitative study of Rwandan adolescents’ views on sex and HIV

    Objective: This qualitative study explored the views and experiences of adolescents with perinatally acquired HIV in Kigali, Rwanda, regarding sex, love, marriage, children and hope for the future. Design: The study enrolled 42 adolescents who had received combination antiretroviral therapy for at least 12 months, and a selection of their primary caregivers. Study methods included 3 multiple day workshops consisting of role-playing and focus group discussions (FGDs) with adolescents, 8 in-depth interviews with adolescents, and one FGD with caregivers. …

  5. Does Education Affect HIV Status? Evidence from five African Countries

    Data from the first five Demographic and Health Surveys to include HIV testing for a representative sample of the adult population are used to analyze the socioeconomic correlates of HIV infection and associated sexual behavior. Emerging from a wealth of country relevant results, some important findings can be generalized. First, successive marriages are a significant risk factor. Second, contrary to prima facie evidence, education is not positively associated with HIV status. …

  6. Individual and community-level tolerance of spouse abuse and the association with the circumstances of first sex among youth from six sub-Saharan African countries

    Youth who engage in early and premarital sex are at risk of HIV and sexually transmitted infections. Most prevention programs ignore the mediating influence of the threat and experience of violence on these outcomes. Using nationally representative data from Lesotho, Malawi, Zimbabwe, Kenya, Tanzania, and Uganda, the autors used multivariate analyses to examine the association between individual- and community-level tolerance of spouse abuse on the age and circumstances of sexual debut among female youth. The youth sample sizes ranged from a high of 5007 in Malawi to a low of 3050 in Lesotho. …

  7. Programs to address child marriage: Framing the problem

    Child marriage violates girls’ human rights and adversely affects their health and well-being. While age at marriage is increasing in most regions of the developing world, early marriage persists for large populations. Worldwide, it is estimated that more than one out of three women aged 20–24 were married before age 18, and one out of seven were married before age 15. There is great variation in child marriage practices across and within regions and between ethnic and religious groups. Eradicating child marriage has long been on the agenda of the United Nations and of individual countries. …

  8. Addressing sexual violence and HIV risk among married adolescent girls in rural Nyanza, Kenya

    HIV infection is much higher among adolescent girls in sub-Saharan Africa than among boys. In settings such as Nyanza Province, Kenya, rates of HIV infection are extremely high, and evidence is increasing in some settings that girls who are married are much more likely to be infected with HIV, compared with their unmarried sexually active counterparts. This brief describes a program addressing the problem of sexual violence and the risk of HIV transmission within marriage in Kenya's Nyanza Province. …

  9. Fostering accurate HIV/AIDS knowledge among unmarried youths in Cameroon: Do family environment and peers matter?

    This report investigates the linkages between family structure, family and peer communication about sexuality and accurate knowledge of transmission and prevention strategies. Data from the Cameroon Family Life and Health Survey, conducted in 2002 were used. Respondents were aged 10 years and over and sampled 765 households from the 75 localities forming the administrative prefecture of Bandjoun. Details questionnaires were used to gather data for the survey and it had a 97% response rate. …

  10. Influence of religious affiliation and education on HIV knowledge and HIV-related sexual behaviors among unmarried youth in rural central Mozambique

    The interactions among religious affiliation, education, HIV knowledge, and HIV-related sexual behaviors among African church youth are poorly understood. In this sociodemographic study, 522 unmarried youth 12-28 years old in rural central Mozambique were surveyed with a structured questionnaire. Using binary logistic regression analysis, the authors used religious affiliation and education to measure influence on (1) HIV transmission and prevention knowledge and attitudes and (2) HIV-related sexual behaviors among youth. …

  11. In the absence of marriage: long-term concurrent partnerships, pregnancy, and HIV risk dynamics among South African young adults

    In KwaZulu/Natal, South Africa, where HIV prevalence is among the world's highest, a longitudinal qualitative study of partnership dynamics and HIV preventive behaviors was conducted. 47 young adults aged 18-24 participated in in-depth interviews, and 29 were re-interviewed 2 years later. Five analytical domains emerged: primary partnerships, love and romance; secondary partnerships; pregnancy/parenthood; condom use/prevention; and contextual influences, including schooling and future aspirations. …

  12. Delaying sexual debut amongst out-of-school youth in rural southwest Uganda

    This paper focuses on sexual debut among out-of-school youth in Masaka District, Uganda; factors influencing its timing; and assistance young people feel they need to delay sexual initiation. Data were drawn from a needs assessment using applied anthropological techniques with young people ages 13-19 years. Parents, guardians, and community leaders were also consulted. All participants felt that young people begin their sexual lives too early. Young men feel under pressure from friends and older men to prove their masculinity. …

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