Health risk behaviors among youth: Effects of Early Sexual Debut on HIV incidence among Rwandan youth.

Abstract

Abstract Background: Youth engagement in health-risk behaviors, exposes them to Human Immunodeficiency Virus (HIV) which propagates disabilities and a decline in the economic growth. This work is aimed at understanding the determinants of health-risk behaviors among the youth, and how limiting early sexual debut could contribute in minimizing disease incidence among Rwandan youth for the attainment of sexual and reproductive health. Methodology: Using the Rwanda Demographic Health Survey data of 2014-15. A total of 1,528 youths aged 15-24 who met the eligibility criteria for this study were included by the main investigator. The extracted health-risk behaviors of youth, were categorized. STATA version 13.0, was used to compute proportions, Chi square test, bivariate, and multivariate logistic regressions for signal categories and the final model combined for all categories at a significant level of 95%. Adjusted Odd Ratio, was used in calculating Population Attributable Fraction for the youth in the total study population, and to examine the proportions of HIV infections among them. Ethical clearance for this study was approved by the ethics committee of the University of Rwanda, college of medicine and health sciences. Data were officially provided by DHS program. Results: The study found that 2.62% (n=40) of youth is HIV infected where 2.06% (n=26) currently not living with a partner were HIV infection, p-value=0.003. The bivariate analysis revealed that being a female, was more likely to be infected by HIV than males (OR = 3.81, 95% CI = 1.80 – 8.07, p= 0.000). The final model revealed that youth who had sexual debut at ages 6- 14 were less associated with HIV infection but highly significant (OR = 0.13, 95% CI = 0.02 – 0.94, p = 0.044) compared to those aged 15 - 17 who are highly associated to HIV though not significant (OR = 1.45, 95% CI = 0.76-2.77, p=0.256) during the past 12 months. The results also showed that about 3 % of HIV infection can be avoided among youths in Rwanda if they increase their age of sexual debut. Conclusions: Health risk behaviors are still a risk to HIV infection among youths in Rwanda and are sparsely distributed between gender. This leads to significant influence in the prevalence of HIV infection that could be avoidable if prudent interventions are put in place. Public health programs that are population based considering contextual and structural factors need to be strengthened to avert these risk factors that increase HIV infection among youths in Rwanda.