@article{ref1,
title="Female genital mutilation and sexual risk behaviors of adolescent girls and young women aged 15-24 years: evidence from Sierra Leone",
journal="Journal of Adolescent Health",
year="2023",
author="Mchenga, Martina",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="PURPOSE: Considering the high levels of female genital mutilation (FGM) in Sierra Leone with over 83% of girls and young women aged 15-24 years having undergone the practice, the study explores the potential influence of FGM on sexual behaviors of adolescent girls and young women (AGYW) in Sierra Leone. <br><br>METHODS: Cross-sectional data from the 2019 Demographic Health Survey were utilized to examine the association between FGM and three sexual behaviors; sexual debut before 18 years, child marriage and adolescent motherhood. To model this association, a generalized estimation equation technique was employed, while controlling for socio-demographic characteristics. Additionally, the study corrected for multiple-hypothesis testing using the Benjamini-Hochberg procedure with a specified false discovery rate of 0.05. Finally, percentage predicted probabilities of occurrence of the sexual risk behaviors in the presence of FGM were also calculated. <br><br>RESULTS: Of the 5524 AGYW, 76% had undergone FGM. FGM was associated with all three sexual risk behaviors. Sexual debut before 18 years had the highest predicted probability increase (+18.00 ppt, 95% CI: 14.41 to -21.59), followed by adolescent motherhood (+13.38 ppt, 95% CI: 10.16-16.60) and child marriage (+12.61 ppt; 95% CI: 10.22-15.01). Education was found to be protective against all three sexual risk behaviors. <br><br>DISCUSSION: The findings of this study demonstrate that FGM remains a prevalent practice in Sierra Leone, even among the younger generation. This practice is strongly associated with sexual behaviors that pose a significant risk to the health outcomes of AGYW. Investments in education by removing barriers to access for AGYW could lead to multiple gains.<p /> <p>Language: en</p>",
language="en",
issn="1054-139X",
doi="10.1016/j.jadohealth.2023.08.025",
url="http://dx.doi.org/10.1016/j.jadohealth.2023.08.025"
}