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Try out PMC Labs and tell us what you think. Learn More. Coercive experiences at sexual debut have been shown to be associated with other sexual risks throughout the life course. Using nationally representative surveys from 12—19 year old girls in Burkina Faso, Ghana, Malawi, and Uganda collected inwe examine the prevalence of sexual coercion at sexual debut among unmarried girls and its correlates. In-depth interviews collected in with the same demographic shows that there are four primary types of sexual coercion: forced sex; pressure through money or gifts; flattery, pestering, and threatening to have sex with other girls; and passive acceptance.

The article concludes with the research and policy implications of these findings. Worldwide, 40 percent of new cases of HIV infection occurred among young people between the ages of 15 and 24 years in Among those infected in sub-Saharan Africa, 59 percent are female. What is experienced as coercion is gender- and culturally-specific.

For example, youths in Nigeria stated that if a boy has spent money on a girl, then pressure from the male to engage in sex was acceptable. A growing body of research has reported ificant associations between coerced sex and a range of negative reproductive and as well as psychological and emotional health outcomes.

Reproductive health risks correlated with sexual coercion include sexually transmitted infections which can cause cervical cancer and infertility including HIV, unintended pregnancy which can possibly lead to unsafe abortion and as a consequence morbidity and even mortality, as well as the onset of risk-taking behaviors including other nonconsensual sexual experiences, multiple partnerships and unprotected sex. This paper draws on from in-depth interviews and nationally representative surveys to examine coercive experiences at sexual debut of females aged 12—19 years in Burkina Faso, Ghana, Malawi and Uganda.

The larger study encompasses focus group discussions with 14—19 year olds; in-depth interviews with adolescents 12—19 years old, in-depth interviews with key adults teachers, parents, community leaders and health workers and a national survey of 12—19 year old adolescents, all of which were conducted in each of the four countries.

Gender scripts play a ificant role in establishing the way sexual interaction takes place. One result of this gender inequality is that it is not commonly acceptable for girls to be sexual agents or demonstrate sexual interest. Inadequate social and legal sanctions create an environment in which sexual coercion happens largely with impunity. Perpetrating sexual coercion is not a highly stigmatized behavior and prosecuting a perpetrator remains extremely difficult, as evidenced by the Kobe Bryant rape trial of in the United States.

Even in countries with laws, there are ificant barriers for females to report these negative and potentially stigmatizing experiences. In some focus groups, rape or forced sex were described as a response to young women refusing sex, even after attempts by young men to negotiate for sex, particularly if young women received money or gifts mentioned among focus groups in Malawi. Sexual coercion within marriage or in boyfriend-girlfriend relationships was rarely mentioned. Measuring the prevalence of coercion is difficult because there are many different ways that coercion can be conceptualized.

Furthermore, reports of coercion are subject to personal interpretation based on perceptions of entitlement and gender roles in addition to recall bias. Although there has been growing interest in research on sexual coercion in sub-Saharan African 2 ; 6 ; 8 ; 30 ; 33 — 40most studies in the region have focused on the prevalence of non-consensual sex among females in general.

Very few studies have looked at the sexual coercion experiences of adolescent females in sub-Saharan Africa at their sexual debut. Studies conducted in South Africa, Kenya, Ghana and Uganda have found that the proportion of adolescent females who reported that their first sexual encounter was coerced ranged from 14 percent among a rural population in Uganda to 32 percent among urban residents of Cape Town.

There have been a of qualitative studies in sub-Saharan Africa that have shown that young people have sex for economic reasons. Items such as food, gifts, clothing, books and toiletries have been identified as encouragements for young women to have sex. The prevalence of this form of coercion is not limited to taking place between a male and his sexual partner. Parents also pressure their daughters to have sex for economic reasons. It is clear to see that in spite of the recent attention to the issue of sexual coercion, what have been lacking are nationally representative studies on the subject.

The presented in this paper provide those s for the four countries included in the study. The qualitative evidence shed further insight into the trends that the quantitative data represent. Data for the study are derived from national surveys and in-depth interviews IDIs —all conducted with adolescents. Nationally-representative household surveys 1 on adolescent sexual and reproductive health were conducted in among 12—19 year old males and females: 5, in Burkina Faso, 4, in Ghana, 4, in Malawi, and 5, in Uganda. The sample, which covered all 12—19 year-old de facto residents in private households, was a two-stage stratified sample de: district and households.

When there was more than one eligible 12—19 year old in the household who was interviewed, one of the respondents was randomly selected to answer an additional section with questions on sensitive topics including physical and sexual abuse. The survey was pretested, modified accordingly, and then translated into the major languages spoken in each of the four countries. The translation was pretested again before the instrument was finalized. On average, each interview lasted approximately 55 minutes.

Training of the field personnel was based on standard Demographic and Health Survey DHS training protocols for conducting an interview. Further DHS protocols were followed regarding making callbacks and completing survey questionnaires. Same-sex interviews were conducted because of the sensitive nature of the topics covered. Consent was obtained from all young people before they participated and parental or guardian consent was also obtained for people younger than 18 years.

Ensuring privacy of the interview was absolutely critical to fielding the survey, and interviewers were trained to conduct interviews in places or ways that would assure privacy for adolescent respondents. The section on physical and sexual abuse was not to be administered if anyone older than 3 years was within hearing distance. Approximately 55 in-depth interviews were conducted with females ages 12—19 in each of the four study countries and consisted of in- and out-of-school adolescents recruited from urban and rural locations Table 1.

In addition, interviews were conducted among young people in specific groups that were considered to be at higher than average risk: young married women, women with children, refugees Ghana and Uganda and petty traders.

The interviewers were the same sex as the respondent, they took place in a neutral location, and they lasted between 30 minutes and 2.

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The discussions were tape-recorded, transcribed and translated from local languages into English and, in the case of Burkina Faso, into French. Each individual who participated in an in-depth interview was treated as a unit of analysis. Text was written based on common themes arising from the summary text. A word must be said about interpreting unwanted sexual debuts from the in-depth interview narratives. In a few of the situations where the girl identified her sexual debut as forced, the emotions expressed surrounding sexual debut do not match the description of the sex as coercive.

In Malawi, the case of an urban, out of school 18 year old demonstrates how this occurred:. While there he asked if I could spend a night there. At first I refused but I gave in after his sister supported the idea, and this was my first time to have sexual intercourse with him. As the narrative in toto does not describe a negative or unwanted experience, for the purposes of this analysis, narratives that included elements such as this one were not considered coerced.

Their interpretation is taken up again in the discussion. Since it is less clear what this response means, for the purposes of this analysis, these respondents are not categorized as having experienced a coercive sexual debut.

Burkina Faso is the exception, but does not depart radically from the trend. In the IDIs, experiences forced sexual debuts emerged as a frequent theme. Some females in all the four countries reported being forced to have sexual intercourse at sexual debut. In virtually all cases, the victim knew the perpetrator who was either a boyfriend or a casual acquaintance.

Respondent: He started fondling my breast and I asked him why he was doing that. He told me he was just playing with me. Then all of a sudden he pulled me to the bed and had sexual intercourse with me. R: I did not tell anybody because my father had already warned me about them [the teachers in training, one of whom raped her] and had told me not to fetch water for them again. So I was afraid to tell my parents.

One of the themes that emerged in the narratives of adolescents who experienced forced sex at sexual debut was the fact that they were trapped by the male with whom they were either in a romantic relationship or he was otherwise known to female. So during the time we were there I had sex with him. One day I was waiting for a friend of mine and was seated along the path. He grabbed my shoes and took them. I feared to go home without the shoes.

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So I followed him…When I reached in his house, he closed the door and forced me into sex. I could not scream because I was in his house and dreaded the embarrassment it would cause…I felt bad and regretted why I had gone there but I did not tell anyone. I kept it a secret. It was very painful. I cried a lot but dried the tears. I went back home and pretended as if nothing happened. He deceived me to have sex with him and that is how our relationship started… [She laughs]…You know, that boy forced me into having sex, he played about with my head.

He told me to go to his home for exam papers, by then we had started our exams. So I went. He forced me into sex. I tried to fight but he over-powered me. He kissed [me] then he had sex with me. Anyway, it was like this. My friend is the one who took me to his house. When we were there we saw that boy also coming. But she had gone and the boy forced me into sex. Some girls reported resorting to evading the males to avoid unwanted sexual intercourse.

In two of the cases from Malawi where forced sex was reported, the girls exhibited a notable amount of agency after the sex. An urban, 18 year old said she wished that he had asked her before bringing her to the lodge where he forced her to have sex and an urban, 18 year old let the man who forced her to have sex know he had done something wrong and because of that experience, she ended the relationship with him.

Decisive, clear communication from the girl such as these examples cited above was anomalous. The role money or gifts play in leading to sexual intercourse warrants analysis in its own right and this has been done elsewhere. In Malawi, gifts were generally not described as having a coercive influence. In comparison, the vast majority of the sex associated with money or gifts in Uganda was described as coercive. The boy in the narrative below had invited the respondent to go to a video club, an informal movie viewing location, to watch a movie:.

R: He charmed me and then we had sex. It was my first time. Sugar daddy relationships were not the norm among the respondents. The following Ugandan who was in a relationship with a man 15 years older than her was the only one to narrate a clear sugar daddy relationship. He would pick me from home secretly and take me for film shows in town. At the end of it all he asked me to show him that I loved him by having sex with him and I complied.

I could not refuse because I was ashamed of all the things he had done for me. This relationship resulted in a pregnancy and only after she was pregnant did she find out he was married and had children with another woman. R: He came to find me here, we went to a small drinking place in the scrubland and afterwards we continued.

R: No, he flattered me. Out of a desire to please her partner, possibly to maintain the relationship, girls acquiesced to sexual intercourse under varying degrees of duress.

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R: We talked about it and I told him we had to protect ourselves. Girls in romantic relationships related being pestered by their partners to have sex, experiencing emotional isolation after turning them down. The first time he asked to have sex and I refused, we spent about a week when we were not talking.

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It was like our relationship had ended.

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