Abstract:
Background: Sexual abstinence is a key component of the strategy to address unwanted pregnancies, sexually
transmitted infections and HIV among youth in sub-Sahara Africa. But contextual pressures make abstaining from
sex a formidable task for urban poor youth in the sub-region. Nevertheless, some youth in these settings still
manage to resist the pressure to initiate sex early, while others choose abstinence after an initial sexual debut. Few
studies in the sub-region have examined sexual abstinence among urban poor youth. We therefore examined the
factors that predict primary and secondary sexual abstinence among youth in urban poor Accra. The findings
highlight the protective factors associated with sexual intercourse and should help to address the needs of youth
at risk of unprotected sex.
Methods: The study analysed pooled data from two rounds of the Urban Health and Poverty Survey. The surveys
analysed were conducted in 2011 and 2013. The analysis was restricted to unmarried youth between age 20 and
24 years. The total sample comprised 235 female and male youth. We conducted multinomial logistic regression
analysis to examine the predictors of primary and secondary abstinence relative to current sexual intercourse.
Results: The results showed that being female, sexual communication with only fathers, sexual communication
with only friends and slum residence were negatively associated with primary sexual abstinence. Contrarily, being in
school, attaching importance to religion, residing in a household that received social support and sexual
communication with both parents were positively associated with primary abstinence. Regarding secondary
abstinence, only the sexual communication variables had significant effects. Sexual communication with both
parents positively predicted secondary abstinence while communication with fathers-only and friends-only had a
negative effect.
Conclusion: Sexual abstinence is predicted by factors which range from individual through household factors to
the locality of residence. Despite the importance of all the predictors, the study found that sexual communication
with both parents was the only factor that predicted a higher likelihood of both primary and secondary sexual
abstinence. We therefore recommend sexual communication between parents and youth as a key strategy for
promoting sexual abstinence among urban poor youth in Accra, Ghana
