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Title: Gender and social differences in adolescent sexuality and reproduction in Nicaragua.
Author: Zelaya E, Marín FM, García J, Berglund S, Liljestrand J, Persson LA.
Journal: J Adolesc Health; 1997 Jul; 21(1):39-46. PubMed ID: 9215509.
Abstract:
PURPOSE: The aim of this research was to study gender and social differences in adolescent sexuality and reproduction, as reflected in age at first intercourse and age at first pregnancy, as a basis for future interventions in the municipality of León, Nicaragua. METHODS: In a community-based cross-sectional study including 7789 households, all women aged 15-49 years (n = 10,867) were interviewed about socioeconomic, sexual, and reproductive issues. A random subsample of men (n = 388) and women (n = 413) aged 15-49 years was interviewed in more detail about sexual patterns and reproduction. RESULTS: The median age at first intercourse for women and men was 17.8 and 16.2 years, respectively. Women's average latency period to end of first pregnancy was 22 months. There was a significant tendency to start active sexual life later among today's girls aged 15-20 years, compared to the groups 21-27, 28-35, and 36-49 years old. A similar trend was found in age at first pregnancy. These secular trends were not found among men. Age at first pregnancy for current adolescents was lower among those having less formal education. CONCLUSIONS: The short latency period between first sexual intercourse and end of first pregnancy, probably reflecting lack of access to counseling and contraception, is worrying in light of the growing sexually transmitted disease/human immunodeficiency virus threat. The secular trend of later start of reproduction, however, is a positive sign which partly may be an effect of increasing education in the Nicaraguan society. This study sought to uncover gender and social differences in adolescent sexuality and reproduction in Nicaragua through an investigation of age at first coitus and first pregnancy. Data were gathered through a 1993 cross-sectional, community-based survey of a representative sample of 7789 households in the municipality of Leon. Interviews were held with 10,867 women aged 15-49, and more detailed information was elicited from a random subsample of 388 men and 413 women. It was found that median age at first coitus was 17.8 for women and 16.2 for men, with 25% of the population engaging in coitus before age 15. Women delivered their first child at a median age of 19.6 years, whereas men became fathers at 21.2 years. Lack of formal education increased risk of earlier pregnancy for women by 2.5 times, but no increased risk occurred for rural versus urban residence. Earlier pregnancy occurred in women who did not live with their biological fathers during childhood and adolescence (living with a stepfather increased risk of early coitus and delivery even more). Men without a formal education became fathers at an earlier age in both urban and rural areas. The period between first coitus and delivery for women was 21.5 months (20 months for women with primary education or less and 27 months for those who completed ninth-grader or higher). Age groups comparisons (15-20, 21-27, 28-35, and 36-49) showed that the current adolescents were experiencing first coitus and first pregnancy significantly later than the older groups but that the 28-35 age group showed significantly earlier onset of each event. These results point to the need to improve gender equity and women's status and to develop a health care policy that responds to the special needs of adolescents (counseling, access to contraceptives, and availability of safe abortion). Sex education programs must begin at the primary levels in schools because of high drop-out rates.

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