Determinants of Adolescent Sexual Behavior in Sub-Saharan Africa: A Systematic Review of In-School and Out-of-School Adolescents.

Abstract

Objectives: This review aims to identify the main determinants of various sexual behaviors among in-school and out-of-school adolescents in sub-Saharan Africa, using Bronfenbrenner's ecological system theory as a framework.

Methods: A systematic review with narrative synthesis was performed of empirical studies about the determinants of sexual behavior among in-school and out-of-school adolescents aged 10 to 19 in sub-Saharan Africa, using quantitative data from Embase, PubMed, PsycInfo, SCOPUS, AJOL, and Google Scholar.

Results: A total of 132 studies were retrieved, identifying determinants of sexual behaviors such as sexual intercourse, sexual initiation at early age, multipartnership, condom use, contraceptive use, sexual abstinence, or sexual violence. Only four of these 132 studies involved out-of-school adolescents. Determinants of adolescent sexual behavior include demographic characteristics, socio-cognitive factors, problem behaviors, experiences, family relations, peers' influence, relationships, school dynamics, education system, health system, information system, sociodemographic characteristics, socio-economic characteristics, religion, and societal values and norms.

Conclusion: To design interventions that address adolescents' sexual and reproductive health needs, public health policymakers must consider the multifaceted and interconnected determinants of sexual behaviors among in-school and out-of-school adolescents.