Factors influencing the timing of first sexual intercourse among young people in Nyanza, Kenya.

Context: Despite the relevance of the timing of first intercourse for the risk of HIV infection, few studies have examined postponement of first sex as a strategy to prevent infection.

Methods: Survey data collected in October 2003 from 8,183 standard six and standard seven students aged 11-17 in 160 schools in Nyanza Province, Kenya, were used in logit and log-normal hazard models to understand the factors that influence the timing of first sexual intercourse.

Results: Both males and females who rejected myths about HIV transmission, those who experienced less sexual pressure and those who did not know anyone who had died of AIDS, as well as males who had a stronger belief in their ability to abstain, were more likely to postpone sexual intercourse than were young people who lacked those characteristics. Although lower levels of perceived HIV risk were associated with early sexual initiation, adolescents who felt they were at no risk of HIV infection were most likely to postpone initiation. The pattern of associations across gender suggests that males are pressured into very early sexual activity to prove their maturity, although males who had confidence that they could abstain were more likely to do so. Females, however, were not able to translate belief in their ability to abstain into abstinence and were influenced to engage in intercourse by social and environmental pressures.

Conclusions: To support delays in sexual initiation, HIV prevention programming and policy need to be focused on dispelling myths about HIV transmission and countering the gendered pressures that young people feel to initiate sexual activity during their early adolescence.