Between April 2002 and June 2004, a total of 304 youth from the youth friendly STI clinic were recruited into the study out of whom 157(51.6%) were females. The reasons for visiting the clinic were; sickness in 193/304 (63.5%), HIV/STI voluntary testing and counselling in 55/304 (18.1%), being worried of their health in 46/304 (15.1%) while 2.0% were advised to come to the clinic by their contacts.
The social demographic characteristics of the study population are shown in Table . The majority of males were single and significantly older compared to females. Among the 44 married youth who attended the clinic all seven males and 25 of the 37 (67.6%) females visited the clinic due to ill health. Three males (2.0%) and ten females (6.4%) who came to the clinic reported that they had never engaged in sexual intercourse.
Social demographic characteristics of youth attending a sexually transmitted infections clinic
The mean age at first sexual intercourse was 16.4 years in males compared to 16.2 years in females. The mean age of the first opposite sexual partner was significantly higher for female compared to male youth (23.0 vs16.8 years) (p < 0.01). The mean age difference between the age at sex initiation and the age of the first sexual partner was 0.4 years for male youth compared to 5.8 years for females (p < 0.01).
Seventy four (50.3%) males compared to 67 (42.7%) females had ever used condoms. For contraception, only 8.3%, 6.4%, 5.7%, and 1.3% of the sexually active female youth used depot provera, contraceptive pills, monthly calendar or intra-uterine devices respectively. Sixteen female youth had had 59 pregnancies of which 16 (27.1%) were unplanned. A total of 25 abortions were reported of which 10 were spontaneous while 15 (60%) were induced all of these were from unplanned pregnancies. In addition, 70 (44.6%) female youth reported to have had undergone procedures for menstrual regulation indicating that they had engaged in unprotected sexual intercourse which could have exposed them to unplanned pregnancies.
The first sexual intercourse was involuntary in 9/136 (6.6%) of male and 17/140 (12.1%) of female youth. Among the males, 7/9 (77.8%) of the involuntary sexual experiences were with an older perpetrator compared to 16/17 (94.1%) in the females. Among the 25 youth with involuntary first sexual intercourse; 21(80.8%) reported that the person was known to them.
There were no significant differences in the number of lifetime sexual partners, HIV prevalence, ever used condom or involved in involuntary first sexual intercourse among those who had younger sexual partners as compared to those with older sexual partners in both males and females. However, male youth with older partners were significantly more likely to have taken illicit drugs and alcohol compared to females (data not shown).
Sixty six (42.0%) female youth had received gifts/money for sexual favours compared to 14 (9.5%) males. In both males and females, those who received gifts/money had significantly higher mean number of lifetime sexual partners compared to those who did not. The prevalence of HIV infection was similar (12.1 vs 12.6%) among the two groups of female youth.
Other sexual practices
Among the youth studied, 20/296 (6.7%) had ever practiced penile anal sex while 50/296 (16.9%) had ever practiced penile oral sex, and 17/291 (5.8%) had ever practiced oral-vaginal sex.
HIV results were available from 120/147 (81.6%) of male youth and 124/157 (79.0%) of the female youth. There was no significant difference in the mean age and sex distribution among those youth with HIV results compared to those in which the test results were not available. The prevalence of HIV infection was 7.5% (9/120) in males compared to 15.3% (19/124) in the females (p = 0.04).
The prevalence of other STIs was; gonorrhoea 1/147 (0.68%), genital warts 7/214(3.3%), syphilis 2/147(1.4%), candidiasis 3/147(2.0%), pelvic inflammatory disease (PID) 8/140 (5.7%), genital ulcer disease (GUD) 19/139 (13.7%) and vaginal discharge syndrome (VDS) 32/139 (23.0%). Because of low numbers of the various STIs in the study group no attempts were made to relate them with HIV infection or sociodemographic characteristics.