DOI 10.1515/ijamh-2012-0118 Int J Adolesc Med Health 2014; 26(1): 93–100 Olayinka Yetunde Asubiaro and Adesegun Olayiwola Fatusi* Differential effects of religiosity on sexual initiation among Nigerian in-school adolescents Abstract Background: Sexual initiation in adolescence has signifi- cant health implications; identifying associated risk and protective factors is critical for context-specific evidence- based interventions. This study examined the influence of religiosity on sexual debut among in-school adolescents in Lagos State, Nigeria. Methods: Data was obtained from 1350 randomly selected in-school adolescents using a self-administered question- naire. Internal and external religiosity, defined based on the extant literature, were the independent variables. The dependent variable was “ever had sex.” The asso- ciation between religiosity and the age of sexual debut was assessed using Cox regression and controlling for relevant covariates. The hazard ratio (HR) and 95% confi- dence interval (CI) were calculated. Results: Of the participants, 19.8% of the females and 26.6% of the males have had sex (p< 0.004). Internal religiosity was protective against sexual debut among females (HR= 0.63, 95% CI = 0.44–0.91), whereas external religiosity was protective among the males (HR= 0.70, 95% CI = 0.51–0.71). Age was positively associated with sexual debut among both male (HR= 1.11, 95% CI = 1.001– 1.24) and female adolescents (HR= 1.26, 95% CI = 1.11–1.42). Early pubertal development (HR= 1.11; 95% CI = 1.001–1.24) was also a risk factor for male adolescent sexual initia- tion. In addition, knowledge of HIV/AIDS risk (HR= 0.47; 95% CI = 0.30–0.72) was a protective factor against sexual debut among adolescent females, whereas the positive perspective of friends’ involvement in sex (HR= 1.014; 95% CI = 1.21–2.58) was a risk factor. Conclusion: The protective effect of internal and external religiosity with regards to sexual debut varied by gender among Nigerian in-school adolescents; the gender differ- ences as well as other significant factors should be taken into account in evidence-based programming to address adolescent sexual health challenges in Nigeria. Keywords: adolescents; Nigeria; religiosity; risk and pro- tective factors; sexual debut. *Corresponding author: Adesegun Olayiwola Fatusi, Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife Osun 22005, Nigeria, Phone: +234-703-181-9773, E-mail: adesegunfatusi@gmail.com Olayinka Yetunde Asubiaro: Trinity Health Global, Ikeja, Nigeria Introduction Worldwide, more than one billion young people are in the transitional period of adolescence, ages 10 through 19 years (1). The knowledge that these adolescents acquire, the values and attitudes they develop and the skills they learn have enormous effects on their future well-being and that of their societies. The needs of the adolescent populations remain particularly underserved in sub-Saharan Africa, especially in terms of sexual and reproductive health (SRH) (2), with subsequent high rates of unintended pregnancy and sexually transmitted infec- tions (STI) (3). Adolescents in Nigeria are at considerably higher risk of SRH problems compared to other population groups and have high burdens of early pregnancy, unsafe abortions, and HIV and other STIs (4). According to 2008 Nigeria Demographic and Health Survey (NDHS) docu- ments, 53% of females and 26% of males aged 18–19 years have had sex before age 18 years (5). As Cotton and Berry (6) noted in a review article, religion/spirituality is an important factor in adoles- cent sexual decision-making and behavior that is often unfortunately left uninvestigated in many studies. Studies in high-income countries suggest that the reli- gious group with which people identify is substantially correlated with their premarital sexual perspectives and behaviors (7, 8). Although the importance of religion and frequency of attendance at religious services have both been found to be positively associated with age at first intercourse and negatively related to frequency of sexual activity in some studies, the effect of religios- ity on sexual behavior has by no means been uniform (7–10). On the one hand, differential effects have been recorded in males and females (7–10). Also, the extent to which the religious doctrine of any particular institu- tion influences adolescents’ sexual behavior may vary Unauthenticated Download Date | 4/24/16 11:49 AM