title: Multiple sexual partnership mediates the association between early sexual debut and sexually transmitted infection among adolescent and young adult males in Nigeria.
abstract: OBJECTIVE
  To assess the relationship between early sexual debut, risky sexual behaviours and sexually transmitted infections (STIs) among young males.
  
  
  METHODS
  The study was cross-sectional analytical in design and involved 1278 Nigerian males aged 15-24 years. Logistic regression was used in assessing the statistical relationship between early sexual debut (<16 years) and self-reported STIs (history of at least one of three symptoms - painful urination, genital discharge, and genital ulcer/sore - within the past 12 months), with demographic factors, sexual behaviours and psychosocial measures controlled for.
  
  
  RESULTS
  The prevalence of self-reported symptoms was 4.2% for genital discharge, 4.1% for painful urination, and 2.0% for genital sore/ulcer. Overall, 6.8% had STI symptom(s). At bivariate analysis, early sexual debut (p = 0.021), multiple partners (p < 0.001), concurrent partners (p = 0.002), and sex with casual/commercial partners (p = 0.013) were associated with STIs. At multivariate analysis, early sexual debut (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.17-3.84) remained significantly associated with STIs. Multiple sexual partnership (OR = 2.00, 95% CI = 1.13-3.52) was also significantly associated with STIs, and is a mediator of the association between early debut and STI.
  
  
  CONCLUSIONS
  Multiple sexual partners and early sexual debut are associated with STIs among adolescent and young adult males.
authors.affiliation: Department of Community Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria. adesegunfatusi@yahoo.co.uk
authors.forename: Adesegun
authors.initials: A
authors.lastname: Fatusi
authors.forename: Wenjuan
authors.initials: W
authors.lastname: Wang