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age at menarche, schooling, and sexual debut in northern malawi初潮的年龄、教育和性在马拉维北部首次亮相
Age at Menarche, Schooling, and Sexual Debut in
Northern Malawi
1 2 1 2 1,2
Judith R. Glynn *, Ndoliwe Kayuni , Sian Floyd , Emmanuel Banda , Monica Francis-Chizororo , Clare
3 1 1 1,2 1
Tanton , Anna Molesworth , Joanne Hemmings , Amelia C. Crampin , Neil French
1 Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom, 2 Karonga Prevention Study, Chilumba,
Malawi, 3 Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London, London, United Kingdom
Abstract
Background: Age at sexual debut is a key behavioural indicator used in HIV behavioural surveillance. Early age at menarche
may precipitate early sex through perceived readiness for sex, or through school drop-out, but this is rarely studied. We
investigated trends and circumstances of sexual debut in relation to schooling and age at menarche.
Methods and Findings: A cross-sectional sexual behaviour survey was conducted on all individuals age 15–59 within a
demographic surveillance site in Karonga District, Malawi. Time trends were assessed using birth cohorts. Survival analysis
was used to estimate the median age at menarche, sexual debut and first marriage. The 25th centile was used to define
‘‘early’’ sex, and analyses of risk factors for early sex were restricted to those who had reached that age, and were done using
logistic regression. Of the 8232 women and 7338 men resident in the area, 88% and 78%, respectively, we
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