Email updates

Keep up to date with the latest news and content from BMC Public Health and BioMed Central.

Open Access Research article

Associations between sexual behaviour change in young people and decline in HIV prevalence in Zambia

Ingvild F Sandøy1*, Charles Michelo2, Seter Siziya3 and Knut Fylkesnes4

Author Affiliations

1 Centre for International Health, University of Bergen, Armauer Hansen building, N-5021 Bergen, Norway

2 Centre for International Health, University of Bergen and Department of Community Medicine, University of Zambia, Zambia

3 Department of Community Medicine, University of Zambia, Zambia

4 Centre for International Health, University of Bergen, Bergen, Norway

For all author emails, please log on.

BMC Public Health 2007, 7:60  doi:10.1186/1471-2458-7-60

Published: 23 April 2007

Abstract

Background

Evidence suggests that HIV prevalence amongst young Zambians has declined recently, especially in higher-education groups. We studied trends in key sexual behaviour indicators among 15–24 year-olds from 1995 to 2003, including the associations between sexual behaviour change and education.

Methods

The data stem from a series of three population-based surveys conducted in 1995 (n = 1720), 1999 (n = 1946) and 2003 (n = 2637). Logistic regression and Extended Mantel Haenszel Chi Square for linear trends were used to compare the three surveys.

Results

Men and lower-education groups reported more than one sexual partner in the year immediately prior to the survey more frequently than did women and higher-education groups (p < 0.01), but these proportions declined regardless of sex and residence. Substantial delays in child-bearing were observed, particularly among higher-education and urban respondents. Condom use at least for casual sexual intercourse increased from 1995 to 2003; the level was highest among urban and higher-education groups. The number of women reporting frequent dry sex using traditional agents fell during the period. Participants from the rural area and those with less education reported more sexual experience than urban and higher-education participants in 2003. The reported number of sexual partners during the year immediately prior to the survey was a factor that reduced the association between HIV and survey times among sexually active young urban men and women.

Conclusion

High risk behaviours clearly decreased, especially in higher-educated and urban groups, and there is a probable association here with the decline in HIV prevalence in the study population. Fewer sexual partners and condom use were among the core factors involved for both sexes; and for women a further factor was delayed child-bearing.