Community influences on young people's sexual behavior in 3 African countries.
OBJECTIVE
I examined the role of community-level factors in the reporting of risky sexual behaviors among young people aged 15 to 24 years in 3 African countries with varying HIV prevalence rates.


METHODS
I analyzed demographic and health survey data from Burkina Faso, Ghana, and Zambia during the period 2001 through 2003 to identify individual, household, and community factors associated with reports of risky sexual behaviors.


RESULTS
The mechanisms through which the community environment shaped sexual behaviors varied among young men and young women. Community demographic profiles were not associated with reports of risky sexual behavior among young women but were influential in shaping the behavior of young men. Prevailing economic conditions and the behaviors and attitudes of adults in the community were strong influences on young people's sexual behaviors.


CONCLUSIONS
These results provide strong support for a focus on community-level influences as an intervention point for behavioral change. Such interventions, however, should recognize specific cultural settings and the different pathways through which the community can shape the sexual behaviors of young men and women.
Stephenson
Rob
R
Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, USA. rbsteph@sph.emory.edu
D000293:Adolescent; D000349:Africa / Q000453:epidemiology; D000367:Age Factors; D002050:Burkina Faso / Q000453:epidemiology; D003466:Cultural Characteristics; D005260:Female; D005869:Ghana / Q000453:epidemiology; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D015233:Models, Statistical; D010379:Peer Group; D012111:Residence Characteristics; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology