Education and multiple sexual partnerships: the case of adolescents in informal settlements of Nairobi

HIV/AIDS prevalence in urban centres has been consistently reported as higher than its prevalence in rural areas and Kenya as a whole. HIV/AIDS prevalence is higher among adolescents than in the general population. Female adolescents are more affected than their male counterparts suggesting correspondingly higher levels of risky sexual behaviours such as multiple partners. Past studies on adolescence sexual behaviours focused on poverty and substance use without accounting for the integrative dynamics of education and sex that influence sexual behaviours and determine both reproductive and sexual health outcomes. Education and having multiple partners among females remain largely unexplored especially in informal settlements of Nairobi. Evidence points to low school enrolment rates, early school dropouts, wide sex gaps in school enrolment, early coital debut and sexual concurrency as the causes of poor sexual health outcomes. This study uses data collected from a representative sample of female adolescents in Nairobi's informal settlements to explore the relationship between education and having multiple sexual partners. African Population and Health Research Centre (APHRC) carried out the NCSS survey. The APHRC survey included an adolescence schedule to generate information on adolescence sexual health and knowledge on HIV/AIDS. This study focuses on 1,148 female adolescents in 12 24 years age bracket who responded to a question on number of sexual partners in a twelve-month period. The study incorporates individual level characteristics, knowledge of HIV/AIDS and access to multimedia HIV/AIDS information in investigating influence of education on the risk of having multiple sexual partners among female adolescents. Frequency distributions and cross tabulations were employed to describe background characteristics and associations. Multiple logistic regressions, however, was the main tool of analysis and for assessing predictor variables and risk of having multiple sexual partners. Findings indicate that approximately 35 percent of adolescent respondents had multiple sexual partners. The logistic regressions results show that the risk of having multiple sexual partners among adolescents with secondary education is 3.24 times greater than adolescents with no education considering gross effects of education. However, after controlling foi^demographic variables, secondary category is 1.33 times more likely to have multiple sexual partners than no education category. Adolescents with higher education are 0.07 times less likely to have multiple sexual partners than those with no education; and higher category is also statistically significant while after controlling for economic factors adolescents with higher education are 0.04 times less likely to have multiple sexual partners than adolescents with no education. The risk of having multiple sexual partners among adolescents with higher education remained low in all the models. However, inclusion of psychosocial and multimedia access of HIV/AIDS information marginally shifts risk of having multiple sexual partners upwards for all categories except higher education. Adolescents with secondary education are 1.2 times more likely to have multiple sexual partners than adolescents with no education after controlling for psychosocial factors. Overall, the study results suggest that the odds of having multiple sexual partners varies among age groups and marital status, which contribute to the effects of education on the risk of having multiple sexual partners. The observed higher odds of having multiple sexual partners in secondary category are attributed to unstable sexual unions while lower odds of higher education are attributed to stable sexual partners among older adolescents.