Social and psychological determinants of sexual activity and contraceptive use: a hierarchical analysis among youth in Southern Ghana

Abstract

The objective of this study was to determine the predictors of risky sexual behavior by an integrated approach using proximate determinants , intermediate variables and wider background factors . The indices evolved from behavioral theories addressing social, psychological and cultural factors that influenced Ghanaian youth. Two hundred and ninety respondents were recruited from high schools, youth clubs, youth workshops and marketplaces from six regions in Ghana using randomization techniques. The responses were examined employing hierarchical logistic regression modeling. All of the ten indices had significant association with the sexual behavior index, the outcome variable, thus making the case that risky sexual behavior was influenced by a wide spectrum of variables including both personal and environmental factors. The bivariate analysis showed eight of the thirteen hypotheses were supported when individual indices,were examined. To accomplish the ultimate objective of changing behavior in order to decrease risky sexual behavior, the integrated model as a whole was highly significant. Therefore, if there were resources to make global changes in relation to all of the factors, one would expect high success, but if resources were limited and one had to prioritize, then one would have to focus on the three determinants which emerged as significant. The intervention should target access to information and contraceptive supplies, relationship status and greater female function in the relationship. The relationship status should encourage steady relationships and discourage casual relationships

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