Association of age at first sex with HIV-1, HSV-2, and other sexual transmitted infections among women in northern Tanzania.
BACKGROUND
To examine the association between age at first sex and the prevalence of sexually transmitted infections (STIs), including HIV-1 and HSV-2, in women in Moshi urban district, northern Tanzania.


METHODS
A total of 2019 women aged 20 to 44 were randomly selected in a 2-stage sampling from Moshi urban district, northern Tanzania. Information on demographics and sexual behaviors were obtained. Blood and urine samples were drawn for testing of HIV-1, HSV-2, and other STIs.


RESULTS
Women who had their first sexual intercourse at age between 18 and 19 (OR = 0.66; 95% CI = 0.50-0.86) or 20+ (OR = 0.46; 95% CI = 0.36-0.60) were less likely to have STIs, including HIV-1 and HSV-2, than women who had their first intercourse before their 18th birthday. The hazards of having had first sex at an earlier age were significantly higher for women who tested positive for STIs (HR = 1.52; 95% CI: 1.37-1.69) or had STI symptoms (HR = 1.17; 95% CI: 1.05-1.30). Early age at first sex was associated with having a regular noncohabiting partner (HR = 1.40; 95% CI: 1.23-1.58), female circumcision (HR = 1.20; 95% CI: 1.02-1.40), and coercion at first intercourse (HR = 1.47; 95% CI: 1.15-1.89).


CONCLUSIONS
In sub-Saharan Africa, where the prevalence of HIV and other STIs is high, a better understanding of the determinants of the age at first sex is crucial for HIV/STI prevention programs. Prevention programs should not only aim at delaying the age at first sex but also address factors leading to early age at first sex.
Ghebremichael
Musie
M
Department of Biostatistics, Harvard University School of Public Health and Dana Farber Cancer Institute, 3 Blackfan Circle, Boston, MA 02115, USA. musie@jimmy.harvard.edu
Larsen
Ulla
U
Paintsil
Elijah
E
D000328:Adult; D000367:Age Factors; D003075:Coitus; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D015497:HIV-1; D006558:Herpes Genitalis / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D018258:Herpesvirus 2, Human; D006801:Humans; D007407:Interviews as Topic; D015995:Prevalence; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
J Am Acad Child Adolesc Psychiatry. 1996 Oct;35(10):1375-83
8885592
Int Fam Plan Perspect. 2004 Dec;30(4):182-9
15590384
AIDS. 2001 Aug;15 Suppl 4:S41-50
11686464
J Infect Dis. 2001 Mar 15;183(6):865-70
11237802
J Infect Dis. 2002 Jan 1;185(1):45-52
11756980
AIDS. 1994 Nov;8(11):1585-91
7848595
Int Fam Plan Perspect. 2003 Mar;29(1):32-40
12709310
Trop Med Int Health. 2005 Jan;10(1):105-15
15655020
Sex Transm Dis. 2005 Jun;32(6):358-63
15912082
Sex Transm Infect. 1999 Apr;75(2):98-102
10448361
J Biosoc Sci. 2007 Mar;39(2):231-44
16566848
AIDS Care. 2006 May;18(4):379-87
16809117
Sex Transm Dis. 1992 Nov-Dec;19(6):331-4
1492259
J Infect Dis. 2005 May 1;191(9):1403-9
15809897
BMJ. 1998 Jan 3;316(7124):29-33
9451263
J Infect Dis. 2008 Jul 15;198(2):241-9
18593294
AIDS. 1997 Nov 15;11(14):1757-63
9386811
Lancet. 1990 Feb 10;335(8685):338-40
1967779
AIDS. 2008 Jan 11;22(2):193-201
18097221
Fam Plann Perspect. 2000 May-Jun;32(3):104-10
10894255
Sex Transm Infect. 1998 Jun;74 Suppl 1:S23-8
10023349
J Infect Dis. 2007 May 1;195(9):1260-9
17396994
Int J STD AIDS. 1994 Nov-Dec;5(6):424-31
7849121
Stud Fam Plann. 2007 Mar;38(1):1-10
17385378
AIDS. 2001 May 4;15(7):931-4
11399966
Afr J Reprod Health. 2007 Apr;11(1):33-42
17982946
Sex Transm Dis. 2009 Feb;36(2):102-7
19060779
Int J Gynaecol Obstet. 1997 Nov;59(2):153-5
9431883
Sex Transm Infect. 2000 Apr;76(2):98-102
10858710
Int J STD AIDS. 2003 Mar;14(3):202-7
12665445
Child Abuse Negl. 1999 Jan;23(1):45-60
10075192
N Engl J Med. 1994 Sep 15;331(11):712-6
8058079
Sex Transm Infect. 2004 Dec;80 Suppl 2:ii28-35
15572637
Soc Sci Med. 2003 Jan;56(1):149-65
12435558
Int Fam Plan Perspect. 2004 Dec;30(4):156-63
15590381
AIDS Care. 1998 Oct;10(5):571-82
9828954
Sex Transm Infect. 2007 Aug;83(5):365-8
17493979
Am J Epidemiol. 2005 Apr 15;161(8):774-80
15800270
J Acquir Immune Defic Syndr. 2002 Apr 1;29(4):409-17
11917247
Reprod Health Matters. 2001 May;9(17):44-52
11468845
Am J Orthopsychiatry. 1996 Jul;66(3):390-400
8827262
AIDS. 1993 Apr;7(4):579-83
8507423
AIDS. 2008 Dec;22 Suppl 4:S41-56
19033754
Sex Transm Dis. 2006 Dec;33(12):712-8
16755271
Sex Transm Dis. 2007 Jan;34(1):20-4
16691158
Trop Med Int Health. 2001 Aug;6(8):643-53
11555430
AIDS. 2004 Jul 2;18(10):1435-42
15199320