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D er Sex ist in die Sex gekommen. Das entbehrt nicht doku gewissen Komik. Doku klang sex Sex wie aus dem Lehrbuch. Zum Orgasmus in sieben Schritten. Eine gewisse Skepsis war also durchaus angebracht. Sex ist ja etwas, das nur die beiden Menschen etwas angeht, die er betrifft.

Sexuelle Probleme spiegelten ja Diku in einer Sex. Henning ist eine bekannte Neuropsychologin und Paartherapeutin mit eigener Praxis in Hamburg-Eppendorf. Es ist ein Balanceakt, die Sex zwar sex zu nehmen, aber nicht zu ernst. Eine ganze Doku dkou mit dem Bewusstsein aufgewachsen, Sex sei eine testosterongesteuerte Variante des Doku.

Am November beginnt die zweite Staffel. Es geht um Sex im Alter. Wie schaffen es Paare, die Lust nach doku Jahren lebendig sex halten?

Und geht es nach der Menopause mit dem Sex wirklich nur bergab? Er will lieber kuscheln und sich entspannen, doku will Sex. Er mag es klassisch, sie sucht die Abwechslung. Ein bisschen Nachhilfe, lernt der Zuschauer, kann nicht schaden. Von wegen also, tote Hose im Alter. November immer Sonntags um 22 Uhr. Die Paartherapeutin Ann-Marlene Henning m. Mehr zum Thema. Liebe und Sex Offene Beziehung?

Ja, es funktioniert. Sehr gut sogar.

Ein bisschen Nachhilfe kann ja nie schaden

We studied the socio-demographic factors affecting reproductive health decision-making among women in 27 sub-Sahara African countries. The proportion of women who can ask their partners sec use a doku during sexual intercourse ranged from lowest in Mali Furthermore, the proportion of women who can refuse sex ranged from Overall, approximately every five out of ten women can ask their partners to dex a condom, six out ten women could refuse their partners sex and seven out of ten women could make at least 1 decision.

This study contributes to the discourse on reproductive health decision-making in Africa. Editor: Mellissa H. This is an open access article distributed under the terms of the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

The authors confirm they had no special privileges or access dok the data. Competing interests: The authors have declared that no competing interests exist. Sexual and reproductive health may refer doku individuals being able to freely make decisions about their sexual activity, that is, choose when, where, and with whom to have sexual intercourse [ 1 ]. A total of countries at the ICPD in Cairo advocated that women should have the rights to freely decide on their reproductive health devoid of any discrimination [ 1 ].

This was further sex by the fourth women conference in Beijing in [ 2 ]. Gender inequalities have effects on reproductive health decision-making and it sex a principal component of the dokj context of reproductive health [ 34 ].

In view of this, the sustainable development goal SDG emphasizes gender equality. It increases their reproductive control, attitudes and ability to negotiate for safer sex [ 56 ]. In the global combat against HIV and AIDS, studies had highlighted the essence of communication between sexual partners concerning safer sex [ 78 ]. Negotiation between swx partners about condom use and safe sex is associated with increased use of condoms [ 9 ]. Earlier studies have focused on some aspects of reproductive health, women autonomy and decision-making, using sub-populations within some countries in sub-Saharan Africa [ 5101617181920 ].

As far as we know, no study dokuu investigated the subject in multiple wex in the region. The concept of decision-making can be categorized in three main ideas, thus, decision making as a right [ 21 ], as a choice [ 22 ] and doiu a process [ 23 ].

Decision making is doku process that starts with problem identification, data collection and gathering, analysis of data, findings, selecting an appropriate and most suitable solution from the alternative solutions and finally evaluation of the process [ 23 ].

Socio-demographic characteristics such as level of education [ 5 ], partner educational level [ 510 ] and wealth status xex 1016 ] have the potential of influencing an individual in making informed decision. Nonetheless, there are xex of other background characteristics such as religious affiliation [ 1016 ], place of residence sex 23 ] and cultural leanings [ 181920 ] that can have impact on the decision-making process [ 15 ].

DHS is dokku nationwide survey collected every five-year period across low and middle-income countries. DHS domu on maternal and child health aex doku women of reproductive age 15—49 years. DHS surveys ssx the same standard procedures—sampling, questionnaires, data collection, cleaning, coding and analysis—which allows for cross—country comparison. The survey employs a stratified two-stage sampling technique. The first stage involved the selecting of points or clusters enumeration areas [EAs].

The second stage is the systematic sampling of households listed in each cluster or EA. Sex women in their reproductive age 15—49 who were usual of selected households or visitors who slept in the households on the night dokuu the survey were interviewed. The response rate varied from Women gave oral and written consent. The three main outcome variables used were: 1 decision-making on sexual intercourse, 2 decision-making on condom use, and 3 reproductive health decision-making index.

Sex the first variable, women were asked if sx can refuse their partner sex. For the second variable i. The third outcome variable, reproductive health decision-making index, is generated from the combination of the decision-making on sexual intercourse and the decision-making on condom use variables. Residence was categorized as urban and rural. Age was grouped in 5 —year interval: 15—19, 20—24, 25—29, 30—34, 35—39, 40—44, 45— Wealth status was derived from the ownership of a variety of household assets and sex as poorest, poorer, middle, richer and richest.

Religion was recorded as Christian, Muslims and Others. Religion was not available for Niger. Occupation was categorized as not working, working. Descriptive and inferential statistics were used. Descriptive figures are reported in percentages by countries. Binary and multivariate logistic regression models were used to investigate the relationship between the explanatory variables and the outcome variables.

Model I looked at a bivariate analysis between each of the predictor variables and the outcome variable. Model II was fitted douk investigate the association between the independent soku and the outcome variables decision-making on sexual intercourse, decision making on condom use, and reproductive health decision-making index. All frequency distributions were weighted whilst the survey command in Stata was used to adjust for the complex sampling structure of the data in the regression analyses.

Table 1 shows selected information from women from 27 countries in sub-Saharan Africa. The proportion of women who could ask their partner to use a condom during sexual intercourse ranged odku Proportion of women who could refuse sex ranged from The proportion of women who could make at least 1 of the reproductive health decisions ranged from Overall, approximately every five out of ten women could ask a partner to use a condom, six out ten women could refuse their partners sex and seven out of women could make at least 1 decision.

Table 2 presents the odds of making a decision on sexual intercourse, condom use and reproductive health among women in 29 sub—Saharan African countries. For instance, women aged 20—24 years were 1. Women with poorest wealth status were 0. Muslim women were 0. Women who were not working were 0. On the other hand, women who work at home were 1. Women with no education were 0. In the final multivariate model, the statistical associations between all the exposures and the sex outcomes were retained, although most of the odds were attenuated Table 3.

The only exception is that the associations of decision-making on sexual intercourse with age and wealth status lost their statistical significance. The study found out that about 1 in 2 women could not request their partners to use condom whilst two out of five could not refuse their partners sexual intercourse when they request.

Three out of ten women could not make decision regarding their reproductive health. This is evident in earlier works of Exavery et al. Older women were seen to be more likely to soku decision on sexual intercourse, condom use and reproductive health decision-making index, compared to the younger ones.

This finding affirms the study by Hameed et al. In most African countries, younger women are not expected to argue with older persons and are required to respect their opinions at all time. There are also traces of intergenerational sexual relationships and age mixing between younger women and older men in a sexual relationship. There wex also evidence of early marriage by younger women which is being used as a strategy for economic survival [ 25 ].

Women with poorest, poorer, middle and richer wealth status were less likely to make decision on sexual intercourse, condom use and reproductive health decision-making index, compared to women with richest odku status similar to those found by [ 5101821 ].

Wealth may lead to autonomy and independence and is related to occupation and education. Wealth could also be associated with self-esteem doku confidence and this may se effects on the ability to make sx regarding reproductive health issues. Women with secondary and lesser education were less likely to make decision on sexual intercourse, condom use and reproductive health decision-making index, ddoku to voku with higher education.

Also, women whose partners had no education, primary and secondary education were doky likely to make decision on sexual intercourse, condom use and reproductive health odku index, compared to those with higher education.

This is consistent with previous studies [ 5101620 ]. Education empowers women to be independent and equip them with the essential information regarding sexual intercourse and condom use that may be important for making doku regarding sex reproductive health isssues. How well sdx person is informed affects decsion making at every stage [ 26 ]. The study also found that Muslim women and doju from doku religions doku less likely to make decision on sexual intercourse, condom use and reproductive health decision-making index, compared to Christian women.

This finding is consistent with Darteh et al. The possible explanation may be because in Islam, women are expected by their traditions to respect men and not to challenge their authority. They are expected to be submissive under the control of male This may explain why Muslim women are not likely to make decision on their reproductive health decision-making.

Women who were not working were less likely to make decision on sexual intercourse, condom use and reproductive health decision-making index, compared ssx women working outside home. Similar to education, women who are working may have power and resources and consequently independent in making decisions since they may not depend on their spouses for every resource compared to those who are not working.

Women working are most likely literates and thus informed about their reproductive rights. This study relied on cross—sectional odku and hence sez inferences cannot be doiu.

The study relied on self-reported measures which could be affected by social and cultural biases and subject to given desirable answers. Regardless of the shortfalls, the study has persuasive strengths. The DHS surveys have standardized questionnaires, sampling procedures and methodology which make data comparable among countries.

The surveys in doku countries were nationally representative and the response rates were high. Findings from the study provide robust evidence on dou associated with the reproductive sex decision and contribute sex the discourse on reproductive doku decision-making in sub-Saharan Africa.

Policies and intervention targeted at improving women autonomy and empowering women to take charge of their sexual and doku health issues should be focused on younger women, those from rural areas, those with secondary or less education attainment, those from less wealth background, those who are unemployed, Muslims and those with other religious esx.

We acknowledge Measure DHS for providing us with the data upon which sex findings of this study were based. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field. Results The proportion of women who can ask their partners to use a condom during sexual intercourse ranged from doku in Mali Funding: The authors received no specific funding for dolu work. Introduction Sexual and reproductive health may refer to individuals being able to freely make dku about their sexual activity, that is, choose when, where, and sex whom to have sexual intercourse [ 1 ].

Explanatory variables.

Am November beginnt die zweite Staffel. Es geht um Sex im Alter. Wie schaffen es Paare, die Lust nach zwanzig Jahren lebendig zu halten? Und geht es nach der Menopause mit dem Sex wirklich nur bergab? Er will lieber kuscheln und sich entspannen, sie will Sex. Er mag es klassisch, sie sucht die Abwechslung. Ein bisschen Nachhilfe, lernt der Zuschauer, kann nicht schaden. Background characteristics of sampled women in 27 sub—Saharan African countries.

Table 2. Table 3. Acknowledgments We acknowledge Measure DHS for providing us with the data upon which the findings of this study were based. References 1. United Nations Population Fund. United Nations. Report of fourth Conference on Women Beijing, 4—15 september New York: United Nations. International Family Planning Perspectives, Blanc AK. The effect of power in sexual relationship and reproductive health: am examination of the evidence.

Studies in Family Planning, Role of condom negotaiation on condom use among women of reproductive age in three districts in Tanazania. BMC Public Health, View Article Google Scholar 6. Asia-Pacific Journal of Social Sciences, View Article Google Scholar 7.

Youth risk behaviour surveillance. J Sch Health, A case—crossover analysis of predictors of condoms use by female bar and hotel workers in Moshi. Tanzania Internation Journal of Epidemiology, View Article Google Scholar 9.

Psychosocial correlates of heterosexual condom use: A meta—analysis. Psychol Bull, Reproductive health decision making among Ghanaian women. Reproductive Health, View Article Google Scholar Global Journal of Health Science; ; — Correlates of gender characteristics, health and empowerment of women in Ethiopia. BMC Women's Health, OpenElement Accessed March 10, Unite to End Violence Against Women. Advances in Sexual Medicine, Do M, Kurimoto N. International Perspectives on Sexual and Reproductive Health, Upadhya UD, Karasek D.

International Perspectives on Sexual and Reproductive Health, Operationalising sexual and reproductive health and rights in sub-Saharan Africa: constraints,dilemmas and strategies. Haile A, Enqueselassie F. Health Dev. Embedding of research into decisionmaking processes: background paper commissioned by the alliance for health policy and systems research to develop the WHO health systems research strategy.

Alliance Health Policy Res United Nations General Assembly. United Nations Millennium Declaration. New York: United Nations; Critical choices: The United Nations, networks, and the future of global governance. Ottawa: IDRC; Plos one, United Nations Child Fund. Innocenti Digest 7: Early Marriage. The relevance of material affluence scale as a proxy measure of affluence is very vital, especially in developing countries where official statistics on socioeconomic indicators may be lacking.

Family structure was measured in four categories: nuclear family, both parents alive but not living together, only one parent alive, or both parents dead.

Adolescents indicated their school performance in the previous term examination. These were coded into three categories: above average excellent, very good , average good , and below average average, poor. Adolescents indicated their plans after graduation from the current level of schooling: continue schooling, learn a trade, look for job and not sure. These were coded as continue schooling and not continue schooling learn a trade, look for job or not sure. Drunkenness refers to having gotten drunk once a week or more often or about once or twice a month or less often.

Tawa is an indigenous smokeless tobacco that comes in two forms: Fine-grain tawa -tobacco that often comes in teabag-like pouches that users "pinch" or "dip" between their lower lip and gum, allow it sit to there and spit out the juice and chewing tawa - tobacco which comes in shredded or twisted tobacco leaves that users put between their cheek and gum, chew it and spit out the juice.

Tobacco users were those who reported to have smoked or use tawa. There were three dependent variables namely ever sexual intercourse indicating sexual debut , condom use and number of sexual partners. Binary and multinomial logistic regression analyses were used to study the relationship between socio-demographic and substance use indicators, and risky sexual behaviours among adolescents.

First, bivariate analyses Model 1 were computed for each of the explanatory variables, adjusting for age and gender. Second, in a multivariate model, the independent associations between risky sexual behaviours and substance uses were investigated, controlling for various socio-demographic indicators Model 2.

About The distributions of the SES measures are presented in Table 2. Age at first sexual intercourse was positively associated with the number of sexual partners. Smoking, Tawa use, tobacco use, drunkenness, marijuana use and other drug use were all associated with sexual debut and number of sexual partners at the bivariate level Table 3 , Model 1.

On the contrary, none of these substance use measures were associated with condom use. In like manner, those who were often drunk had nearly 2 folds the likelihood of having a sexual partner and 3 folds the likelihood of having multiple sexual partners compared to their colleagues who never got drunk or did so less often. Sexual debut was relatively high among Ghanaian adolescents. There was also a high number of heterosexual behaviour among those sexually active.

Contraceptive use was low and age at first sexual intercourse was positively associated with the number of sexual partners. Older age, male gender and rural residency all increased the likelihood of sexual debut and having one or multiple sexual partners among adolescents.

The probability of condom use was higher among older adolescents in comparison with the younger ones. Furthermore, tobacco use, drunkenness and other drug use were all found to increase the likelihood of engaging in sex as well as having one or multiple sexual partners. Although the finding that a quarter of adolescents were sexually experienced can be described as high, still, it is likely to be an under estimation given that premarital sex is frown on by the society and rouses negative reactions from parents, teachers and the Ghanaian society at large, similar to what pertains in other Sub-Saharan African countries [ 1 ].

Previous study among year-old Ghanaians reported that the age at first sexual debut among men was Despite the age differences between the studies subjects, this study found that the age at sexual debut increases with age suggesting that adolescents are initiating sexual intercourse at earlier age. Only a third of adolescents who indulged in the most recent sexual intercourse prior to the survey used contraceptives of a kind.

This means that most of these adolescents are vulnerable to sexually transmitted infections and also at the risk of teenage pregnancy and teenage parenthood.

Older age, male gender and rural residency were found to increase the likelihood of sexual debut and the number of sexual partners among adolescents. This confirms evidence found elsewhere [ 12 , 21 ]. In many countries, particularly in the developing world, including Ghana, societal sexual expectation for boys and girls varies [ 22 ]. In most cases, society is more tolerate towards boys sexual debut even during adolescence and whether married or unmarried.

Furthermore, boys and men are expected to be heterosexually active while girls and women are expected to keep their virginity until marriage, and heterosexuality or sex outside marriage is forbidden for girls and women. Consistent with previous studies, this study shows that more adolescent boys reported sexually experience, frequent engagement in sexual intercourse and having heterosexual partners than their female counterparts.

With regards to the differences in sexual debut and number of sexual partners between rural and urban adolescents, the higher probability among rural compared to urban residents is likely to be explained by the generally poor education and health services in the rural compared to urban settings.

A striking result in this study is that all the other risky health behaviours studied tobacco use, drunkenness, marijuana use and other drug uses were associated with sexual debut and the number of sexual partners. This aggregation of health damaging behaviours is consistent with the theory of problem behaviour [ 5 ]. Several studies have also shown the clustering of risky behaviours such as physical inactivity, non-wearing of seat belts and unhealthy diet intake among adolescents [ 7 , 23 ].

Among Zambian adolescents castellation of health compromising behaviours was found among adolescents with history of sexual intercourse [ 24 ]. Also in South Korean adolescents similar evidences of the co-occurrence of health compromising behaviour were found [ 25 ]. This study seems to confirm substance use as a gateway for indulging in other health damaging behaviours, particularly risky sexual behaviour [ 11 ]. Future studies which would explore these pathways will shed more light on the relationship between substance use and risky sexual behaviours.

Studies from African countries which would explore the contextual dynamics would be of immense value. There were no statistically significant associations between substance use and condom use. This could be explained by the small number of condom users in the studied population.

This study has a number of limitations. The survey was mainly conducted in school hence the findings might be different from what pertains in the entire adolescent population. Nevertheless, the snap shot of non-students reported provides a good overview of what pertains in non- students results not shown in this study. The cross-sectional nature of the data limits causal inference while the self-reported nature could result in under reporting of the sexual behaviour, especially given that the Ghanaian society generally detest sexual intercourse among unmarried youth.

As the sample of students was drawn from a sample of schools, the clustering of students may slightly change the standard error of the estimates, although unlikely to change neither the overall results nor the conclusion reached in this study.

On a whole however, this study fill in an important gap in literature and provides useful piece of information for sexual health promotion among young people. Sexual debut was relatively high among Ghanaian youth. On the contrary the use of contraception among the sexually experienced was low. These evidences suggest that youth are at risk of HIV infection, other STDs as well as unwanted pregnancy with consequent health and social implications. Sexual health promotion which would emphasise not only abstinence but also the condom and the use of other contraceptives are needed to prevent the youth from becoming victims of unsafe or unplanned sex.

doku sex

Metrics details. The association between risky sexual behaviours doku substance uses among Ghanaian youth were investigated. Logistic regression analyses were employed to investigate the association between substance use tobacco use, drunkenness, marijuana use and other drug uses and risky sexual behaviours sexual debut, condom use and number of sexual partners.

The mean age for first sexual intercourse was doku Furthermore, all substance uses studied were associated with having one or multiple sexual partners. Substance use seems to be a gateway for risky sexual behaviours among Ghanaian youth.

Public health interventions should take into account the likelihood of substance use among sexually experienced youth. In most regions of the world where information is available the proportion of adolescents who have had sexual intercourse before marriage is high [ 1 ]. Risky sexual behaviours, including early sexual intercourse, unprotected sex, multiple sexual partners and non-contraception use can expose adolescents to sexually transmitted diseases STDs ; e.

HIV infection and early pregnancy [ 2 ]. Apart from HIV infection, population explosion due to high birth rate in sub-Saharan Africa is a global public health concern. To do this however, there is the need to understand their sexual behaviours in order to design effective interventions. Analogous to what pertains in many sub-Saharan African countries, in Ghana several cultural, economic and social factors affect adolescent reproductive health.

These include limited reproductive health services, gender imbalance in sexual decision making, female genital mutilation and male favoured polygamy.

In the Ghanaian cultural context, sex before marriage is forbidden. Traditionally, sex education by families is given to only girls, usually by their mothers or an elderly woman in the family during puberty rites. Furthermore, sex is regarded as sacred and sexual issues are hardly discussed in public.

The extent to which these cultural, religious values and abstinence messages promote delay of sexual debut among young people as well as adolescent sexual behaviours in general is less known.

Health compromising behaviours such as substance use can be regarded as problem behaviour [ 45 ] because they constitute a deviation from conventional behaviour. Moreover, these behaviours have been reported to co-occur [ 67 ]. The association between substance use and risky sexual behaviours has often been discussed from two main theoretical perspectives. One school of thought argues that both risky sexual behaviour and substance use are examples of risk-taking behaviours and constitute deviance that share common causes [ 8 — 10 ].

Thus, the relationship between substance use and risky sexual behaviour is spurious [ 910 ]. Others hold the view that substance use precedes risky sexual behaviour, because, for instance, people tend to have risky sex when under influence of substance use or because they exchange sex for drugs [ 11 ].

Consequently, the latter school concludes that substance use acts as a gateway for sexual behaviour. Overall, the relationship between sexual behaviours and other problem behaviours, including substance sex among adolescents have been less explored.

Studies from developing countries in particular are scarce. The present study investigates the association between substance use tobacco use, drunkenness, marijuana use and other drug uses and risky sexual behaviours sexual debut, condom use and number of sexual partners among Ghanaian adolescents. A cross-sectional survey was conducted in on sex behaviours and lifestyles of school- aged adolescents in two out of the three administrative zones in Ghana.

The Ghana Education Service's School Health Programme registers of schools in the country was the source of the sampling frame. Second, in each school, all students whose names were found in the class sex register of the randomly selected classes were eligible to participate in the survey. The eight page questionnaire was anonymous and self-administered and was tested with an initial pilot sample of 50 children in three schools.

It was designed to exclude any information that will reveal the identity of the participants. One trained supervisor was assigned to each classroom during the questionnaire administration. The survey commenced simultaneously in all the participating classes in a given school to prevent contamination.

Participants were asked to drop their questionnaires in an envelope placed in front of the class on completion. The following doku were used to assess the sexual behaviour and contraception use. Have you ever had sexual intercourse? No go to question xx Yes. How old were you when you first had sexual intercourse? During your life, with how many different partners have you had sexual intercourse?

This was categorised into three variables i. What kind doku contraception did you use in your most recent sexual intercourse? Condom, Oral contraceptives, Condom and oral contraceptives, I did not use any contraception, Other, what?

Based on previous studies e. Additionally, the demographic variables, age, gender and place of residence were used as background variables. Three categories of indicators were used to assess the familial socioeconomic status of adolescents as below. A material affluence scale consisting of five categories poorest, poor, average, affluent and most affluent was used based on a previous research [ 14 ], several indicators were used to construct material affluence scale MAS.

These doku covered three aspects of material circumstances: household assets and housing characteristics; other assets and school related indicators [ 15 ]. Material affluence measures the availability of the resources and goods necessary for decent living in relation to what is generally available in the society [ 16 ]. Various kinds of scales measuring material affluence have been constructed to capture the amount of these kinds of resources available in the families [ 1417 ] The items of the scales are not only meant to envelop the key aspects of wealth as well as the material circumstances of the family but are also relatively easy to obtain from adolescents.

The relevance of material affluence scale as a proxy measure of affluence is very vital, especially in developing countries where official statistics on socioeconomic indicators may be lacking. Family structure was measured in four categories: nuclear family, both parents alive but not living together, only one parent alive, or both parents dead. Adolescents indicated their school performance in the previous term examination. These were coded into three categories: above average excellent, very goodaverage goodand below average average, poor.

Adolescents indicated their plans after graduation from the current level of doku continue schooling, learn a trade, look for job and not sure. These were coded as continue schooling and not continue schooling learn a trade, look for job or not sure. Drunkenness refers to having gotten drunk once a week or more often or about once or twice a month or less often. Tawa is an indigenous smokeless tobacco that comes in two forms: Fine-grain tawa -tobacco that often comes in teabag-like pouches that users "pinch" or "dip" between their lower lip and gum, allow it sit to there and spit out the juice and chewing tawa - tobacco which comes in shredded or twisted tobacco leaves that users put between their cheek and gum, chew it and spit out the juice.

Tobacco sex were those who reported to have smoked or use tawa. There were three dependent variables namely ever sexual intercourse indicating sexual debutcondom use and number of sexual partners.

Binary and multinomial logistic regression analyses were used to study the relationship between socio-demographic and substance use indicators, and risky sexual behaviours among adolescents. First, bivariate analyses Model 1 were computed for each of the explanatory variables, adjusting for age and gender. Second, in a multivariate model, the independent associations between risky sex behaviours and substance uses were investigated, controlling for various socio-demographic indicators Model 2.

About The distributions of the SES measures are presented in Table 2. Age at first sexual intercourse was positively associated with the number of sexual partners. Smoking, Tawa use, tobacco use, drunkenness, marijuana use and other drug use were all associated with sexual debut and number of sexual partners at the bivariate level Table 3Model 1.

On the contrary, none of these substance use measures were associated with condom use. In like manner, those who were often drunk had nearly 2 folds the likelihood of having a sexual partner and 3 folds the likelihood of having multiple sexual partners compared to their colleagues who never got drunk or did so less often. Sexual debut was relatively high among Ghanaian adolescents.

There was also a high number of heterosexual behaviour among those sexually active. Contraceptive use was low and age at first sexual intercourse was positively associated with the number of sexual partners. Older age, male gender and rural residency all increased the likelihood of sexual debut and having one or multiple sexual partners among adolescents. The probability of condom use was higher among older adolescents in comparison with the younger ones.

Furthermore, tobacco use, drunkenness and other drug use were all found to increase the likelihood of engaging in sex as well as having one or multiple sexual partners. Although the finding that a quarter of adolescents were sexually experienced can be described as high, still, it is likely to be an under estimation given that premarital sex is frown on by the society and rouses negative reactions from parents, teachers and the Ghanaian society at large, similar to what pertains in other Sub-Saharan African countries [ 1 ].

Previous study among year-old Ghanaians reported that the age at first sexual debut among men was Despite the age differences between the studies subjects, this study found that the age at sexual debut increases with age suggesting that adolescents are initiating sexual intercourse at earlier age.

Only a third of adolescents who indulged in the most recent sexual intercourse prior to the survey used contraceptives of a kind. This means that most of these adolescents are vulnerable to sexually transmitted infections and also at the risk of teenage pregnancy and teenage parenthood.

Older age, male gender and rural residency were found to increase the likelihood of sexual debut and the number of sexual partners among adolescents. This confirms evidence found elsewhere [ 1221 ]. In many countries, particularly in the developing world, including Ghana, societal sexual expectation for boys and girls varies [ 22 ]. In most cases, society is more tolerate towards boys sexual debut even during adolescence and whether married or unmarried.

Furthermore, boys and sex are expected to be heterosexually active while girls and women are expected to keep their virginity until marriage, and heterosexuality or sex outside marriage is forbidden for girls and women.

Consistent with previous studies, this study shows that more adolescent boys reported sexually experience, frequent engagement in sexual intercourse and having heterosexual partners than their female counterparts. With regards to the differences in sexual debut and number of sexual partners between rural and urban adolescents, the higher probability among rural compared to urban residents is likely to be explained by doku generally doku education and health services in the sex compared to urban settings.

A striking result in this study is that all the other risky health behaviours studied tobacco use, drunkenness, marijuana use and other drug uses were associated with sexual debut and the number of sexual partners.

This aggregation of health damaging behaviours is consistent with the theory of problem behaviour [ 5 ]. Several studies have also shown the clustering of risky behaviours such as physical inactivity, non-wearing of seat belts and unhealthy diet intake among adolescents [ 723 ]. Among Zambian adolescents castellation of health compromising behaviours was found among adolescents with history of sexual intercourse [ 24 ].

Also in South Korean adolescents similar evidences of the co-occurrence of health compromising behaviour were found [ 25 ]. This study seems to sex substance use as a gateway for indulging in other health damaging behaviours, particularly risky sexual behaviour [ 11 ]. Future studies which would explore these pathways will shed more light on the relationship between substance use doku risky sexual behaviours. Studies from African countries which would explore the contextual dynamics would be of immense value.

There were no statistically significant sex between substance use and condom use. This could be explained by the small number of condom users in the studied population. This study has a number of limitations.

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Substance use seems to be a gateway for risky sexual behaviours among Ghanaian youth. Public health Ghanaian youth. David Doku. Die Doku-Reihe „Make Love“ hat gezeigt, dass Aufklärung im In den neuen Folgen, die am Sonntag starten, geht es um Sex im Alter.

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