The Factors Influencing the Sexual Practices of Adolescents in Three African Nations
Presently, 3,280,000 youth in sub-Saharan Africa between the ages of 15-24 are living with HIV (UNAIDS, 2008a). Ghana, Malawi, and Uganda are three sub-Saharan African nations that have started examining the sexual practices of adolescents via population-based studies. These three nations are similar in that each falls into the last quartile on the Human Development Index (HDI) signifying the lowest levels of human development in the world. The study explores how knowledge and persuasion dimensions influence choices in condom use or sexual abstinence among adolescents from Ghana, Malawi, and Uganda. Further, the study examines whether differences exist in adoption of condoms between nations. In testing the three hypotheses of this study on adoption of condom use and sexual abstinence by adolescents, binary logistic regression and analysis of covariance were utilized. Scale development and instrument reliability were examined through Cronbach alphas and item deletion. The first binary logistic regression model demonstrated that when controlling for background variables, family planning, condom knowledge and efficacy, and media intervention on family planning and HIV prevention increased the likelihood of condom use. In the second binary logistic regression model, family planning, AIDS knowledge, and pressure from family to remain sexually abstinent were statistically significant in the odds on sexual abstinence when controlling for background variables. The testing of the third hypothesis showed that Uganda had a higher mean for condom utilization compared to Ghana and Malawi but only the mean difference between Uganda and Ghana was statistically significant. Implications for macro, mezzo, and micro-level social work practice are discussed. Additional attention was given to macro-level social work practice due to international social development modeling which is most appropriately practiced at the macro-level involving both social policy and community practice. There are four main areas of social policy that the findings from this study can influence: AIDS, family, education, and labor. Implications for community practice in addressing HIV prevention and intervention among adolescents involve community development and community organizing. Implications for social work groupwork were explored as much community organization involves mezzo-level social work practice through the use of small groups.
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