Individual- and Community-Level Influences on the Timing of Sexual Debut International Perspectives on Sexual and Reproductive Health

International Perspectives on Sexual and Reproductive Health 74 of sources (1.6–2.1) or endorsed a greater number of HIV transmission myths (1.1–1.2); they were reduced among youth with greater knowledge of HIV (0.9 for both). In addition, sexual debut was negatively associated with abstinence self-efficacy among males (0.9), and positively associated with talking to female relatives about HIV and condom-use self-efficacy among females (1.1 for each). At the community level, youth of both sexes who attended schools that received the PSABH program were less likely to report sexual debut than were youth who did not (odds ratios, 0.8–0.9). Males who lived in communities where abstinence was the primary message for avoiding HIV reported delayed sexual debut compared with those in communities where other HIV-prevention messages were delivered (0.9). In contrast, young men in communities where HIV programs were incorporated into festivals were more likely to have had sex than youth in other communities (1.3). Finally, young women in communities where AIDS was publicly acknowledged as a cause of death were less likely to have had sex than were their counterparts in communities where AIDS deaths were not acknowledged (0.4). •Multivariate. Before building multivariate models, we created separate null models for males and females (not shown). The null models suggested that school and community variables are relevant in explaining the timing of sexual debut among youth in Nyanza; the variance components were 0.12 (p<.01) for males and 0.47 (p<.01) for females. The intraclass correlations indicate that 3.5% of the variation in the timing of sexual debut among males and 12.2% of the variation among females is explained by school and community variables. We created three multivariate models for each gender. Model 1 examined associations between components of the IMB model and the timing of sexual debut; the second model added social and demographic variables as controls; and model 3 also added schooland community-level variables. Results showed that even after controlling for social, demographic, and schooland community-level variables, several IMB indicators were associated with the timing of sexual debut (Table 4, page 73, and Table 5). For example, among both males and females, youth had elevated odds of having ever had sex (or of having had sex at an earlier age) if they perceived a small (and among females, a moderate) risk of HIV (odds ratios, 1.2–1.3), knew someone who had died of AIDS (1.1–1.2), had experienced higher levels of sexual pressure (1.3–1.8) or endorsed a greater number of myths about HIV transmission (1.1 for both). Among males, sexual debut was negatively associated with abstinence self-efficacy (0.95), but positively associated with the number of male relatives with whom they had spoken about AIDS (1.03). Young women were less likely to have had sex (or had had sex at a later age) if they were of Kissii (0.8) or other (0.6) ethnicity than if they were Luo. Associations between schooland community-level variables and the timing of first sex were largely consistent with bivariate findings. Among both sexes, sexual TABLE 5. Odds ratios (and standard errors) from discrete-time hazard model of associations between selected characteristics and sexual debut among young women