Determinants of sexual activity and its relation to cervical cancer risk among South African women.
BACKGROUND
Invasive cervical cancer is the commonest cause of cancer morbidity and mortality in South African women. This study provides information on adult women's sexual activity and cervical cancer risk in South Africa.


METHODS
The data were derived from a case-control study of hormonal contraceptives and cervical cancer risk. Information on age of sexual debut and number of lifetime sexual partners was collected from 524 incident cases and 1541 hospital controls. Prevalence ratios and adjusted prevalence ratios were utilised to estimate risk in exposures considered common. Crude and adjusted relative risks were estimated where the outcome was uncommon, using multiple logistic regression analysis.


RESULTS
The median age of sexual debut and number of sexual partners was 17 years and 2 respectively. Early sexual debut was associated with lower education, increased number of life time partners and alcohol use. Having a greater number of sexual partners was associated with younger sexual debut, being black, single, higher educational levels and alcohol use. The adjusted odds ratio for sexual debut < 16 years and >/= 4 life-time sexual partners and cervical cancer risk were 1.6 (95% CI 1.2 - 2.2) and 1.7 (95% CI 1.2 - 2.2), respectively.


CONCLUSIONS
Lower socio-economic status, alcohol intake, and being single or black, appear to be determinants of increased sexual activity in South African women. Education had an ambiguous effect. As expected, cervical cancer risk is associated with increased sexual activity. Initiatives to encourage later commencement of sex, and limiting the number of sexual partners would have a favourable impact on risk of cancer of the cervix and other sexually transmitted infections.
Cooper
Diane
D
Women's Health Research Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925, Cape Town, South Africa. Diane.Cooper@uct.ac.za
Hoffman
Margaret
M
Carrara
Henri
H
Rosenberg
Lynn
L
Kelly
Judy
J
Stander
Ilse
I
Denny
Lynnette
L
Williamson
Anna-Lise
AL
Shapiro
Samuel
S
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000453:epidemiology / Q000208:ethnology; D044383:Black People; D016022:Case-Control Studies; D003268:Contraception Behavior; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage; D004522:Educational Status; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D012847:Single Person; D013019:South Africa / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000208:ethnology
D003278:Contraceptives, Oral, Hormonal