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Share sensitive information only on official, secure websites. Ashleigh L. Early sexual debut first intercourse at or before age 15 years and forced sexual initiation are associated with increased risk behaviors for HIV acquisition, including transactional sex and multiple sexual partners, but studies are limited. During —, in nine countries funded by the U. Comprehensive violence and HIV prevention programs for adolescent girls and young women are needed to prevent early sexual debut and reduce the risk for HIV infection.

Girls in sub-Saharan Africa also experience sexual violence at higher rates than do boys 2 , and women who experience intimate partner violence have 1. In multiple logistic regression models, forced sexual initiation was associated with being unmarried, violence victimization, risky sexual behaviors, sexually transmitted infections STIs , and poor mental health.

Early sexual debut was associated with lower education, marriage, ever witnessing parental intimate partner violence during childhood, risky sexual behaviors, poor mental health, and less HIV testing. Comprehensive violence and HIV prevention programming is needed to delay sexual debut and protect adolescent girls and young women from forced sex. VACS are nationally representative, multistage cluster household surveys of persons aged 13—24 years.

All study protocols included oral informed consent, parental consent for minors, safeguards to protect privacy and confidentiality of participants, and referrals to postviolence care as needed. Early sexual debut was defined as first sexual intercourse at or before age 15 years among adolescent girls and young women aged 16—24 years who had ever had sex with or without violence.