Journal of Community Health

, Volume 41, Issue 1, pp 70–77

Early Sexual Debut: A Risk Factor for STIs/HIV Acquisition Among a Nationally Representative Sample of Adults in Nepal

  • Roman Shrestha
  • Pramila Karki
  • Michael Copenhaver
Original Paper

DOI: 10.1007/s10900-015-0065-6

Cite this article as:
Shrestha, R., Karki, P. & Copenhaver, M. J Community Health (2016) 41: 70. doi:10.1007/s10900-015-0065-6


While early sexual debut is highly prevalent in Nepal, its link to sexually transmitted infections (STIs/HIV) risk factors has not been explored at a national level. The objective of this study was to assess potential association between early sexual debut and risk factors for STIs/HIV acquisition, including sexual risk behaviors, sexual violence, and teenage pregnancy among adults in Nepal. Data were taken from the nationally representative Nepal Demographic Health Survey (2011), which employed a two-stage complex design to collect data. A sample of 12,756 adults (ages 15–49 years) were included. Multivariate logistic models were conducted, adjusted for demographic characteristics, to assess the association between early sexual debut and STIs/HIV-related risk factors. The prevalence of early sexual debut in this sample was 39.2 %, with a mean age of coital debut at 17.9 years. After adjusting for potential confounders, individuals with early sexual debut were significantly more likely to report a history of STIs (aOR 1.19; 95 % CI 1.06–1.35) and had a significantly higher risk profile, including having multiple sex partner (aOR 2.14; 95 % CI 1.86–2.47), inconsistent condom use (aOR 0.72; 95 % CI 0.61–0.86), paid for sex (aOR 1.61; 95 % CI 1.14–2.27), a history of sexual violence (aOR 1.99; 95 % CI 1.63–2.43), and teenage pregnancy (aOR 12.87; 95 % CI 11.62–14.26). Individuals who have early sexual debut are more likely to engage in risk behaviors that place them at increased risk of STIs/HIV acquisition. STIs/HIV prevention strategies should aim at delaying sexual debut to decrease the disproportionate burden of adverse health outcomes, including STIs/HIV, among individuals in Nepal.


Early sexual debut Sexual risk behavior Sexually transmitted infection HIV/AIDS Nepal 

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Community Medicine and Health CareUniversity of Connecticut Health CenterFarmingtonUSA
  2. 2.Center for Health, Intervention, and Prevention (CHIP)University of ConnecticutStorrsUSA
  3. 3.Department of Allied Health SciencesUniversity of ConnecticutStorrsUSA

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