Neighbourhood Determinants of Early Sexual Debut and Multiple Sexual Partnerships: A cross-sectional Analysis of Adolescents in Rwanda, Ghana and South Africa.

Abstract Background: The relationship between neighbourhood characteristics and youth involvement in risky sexual behaviour such as early sexual debut and multiple sexual partnerships is well established in the literature. However, there are very few empirical studies using Demographic and Health Surveys to unpack the nature of this relationship in Africa. This study aims to identify the neighbourhood characteristics influencing young people's engagement in risky sexual behaviour in sub-Saharan Africa. Methods: Univariate, bivariate, and multivariate analyses on young people aged 15 to 24 years were conducted using the most recent Demographic and Health Survey Data (DHS 2014-2016) from Ghana, Rwanda, and South Africa to investigate the relationship between neighbourhood characteristics and youth risky sexual behaviour. Results: Individual and, in particular, neighbourhood characteristics (community poverty, community occupation, community media access, and community education) were found to be substantially linked with youth risky sexual behaviour. Conclusion: To lower the incidence of risky sexual behaviour in the community, programs aimed at appropriate policy options must be intensified. Adopting the implications of these findings is critical for a developmental approach aimed at reaching Africa’s long-term development goal of eliminating STIs among young people.