Trends in age at first sex in Uganda: evidence from Demographic and Health Survey data, and longitudinal cohorts in Masaka and Rakai.
Résumé
Objectives To derive the best possible estimates of trends in age at first sex among successive cohorts of Ugandan men and women based on all the data available from the Demographic and Health Surveys (DHS) and the cohort studies in Masaka and Rakai districts. Methods The datasets from the DHS, Masaka cohort and Rakai cohort were analysed separately. Survival analysis methods were used to estimate median ages at first sex for men and women born in the 1950s through 1980s and to compute hazard ratios for first sex comparing later to earlier cohorts. Results The DHS and Masaka data show an increase in women's age at first sex in the more recent birth cohorts compared to those born before 1970 but this is less apparent in the Rakai data. Succesive male cohorts in Masaka appear to have first increased and subsequently decreased their age at first sex, a trend that is also apparent, but not significant, in the DHS data. Younger men in Rakai have an earlier age at first sex than those born before 1980. Conclusions Women in Uganda who were born after 1970 have, on average, had sex at a later age than those born earlier. Men's age at first sex has not changed consistently over the period in question. Differences between Masaka and Rakai may reflect socio-economic differences. Most of the change in age at first sex occurred too late to have contributed to the initial decline in HIV incidence.
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