Background: Traditional and new media use links to young people's sexual risk behaviour. The social contexts of young people's daily lives that influence media use and sexual risk behaviour are often investigated as independent causal mechanisms. We examined the link between media use and young people's sexual risk behaviour, considering the intersecting socio-contextual factors in Sub-Saharan Africa.
Methods: Age-adjusted bivariate logistic regression models tested the association between traditional media (TV, radio, and newspapers), and new media (mobile phone and online) use and sexual risk behaviour using the Demographic and Health Surveys from six Sub-Saharan African countries among unmarried sexually active youths, aged 15-24 years. Multivariate logistic regression models ascertained the media sources that had an additional influence on young people's sexual risk behaviour, after accounting for socio-contextual factors, and knowledge about HIV and other sexually transmitted infections.
Results: Socio-contextual factors attenuated the association between media use and young people's sexual risk behaviour in many countries. However, those who did not have access to new and traditional media were more likely to use unreliable contraceptive methods or not use contraception. Adolescents in Nigeria who did not own phones were 89% more likely to use unreliable contraceptive methods or not use any methods [(AOR = 1.89 (1.40-2.56), p < .001)], those in Angola who did not read newspapers had higher odds of not using contraception or used unreliable methods [(aOR = 1.65 (1.26-2.15), p < .001)]. Young people in Angola (aOR = 0.68 (0.56-0.83), p < .001), Cameroon [(aOR = 0.66 (0.51-0.84), p < .001)], Nigeria [(aOR = 0.72 (0.56-0.93), p = .01)], and South Africa [(aOR = 0.69 (0.49-0.98), p = .03)] who did not own phones were less likely to have 2 or more sexual partners compared to those who owned phones. Lack of internet access in Mali was associated with lower odds of having 2 or more sexual partners (aOR = 0.45 (0.29-0.70), p < .001). Traditional media use was significantly associated with transactional sex in many countries.
Conclusions: Media use is linked to sexual risk behaviour among young people in Sub-Saharan Africa. Socioeconomic inequalities, levels of globalization, as well as rural-urban disparities in access to media, underscore the need to deliver tailored and targeted sexual risk reduction interventions to young people using both traditional and new media.
In addition to television, radio, magazines, and newspapers, young people in Sub-Saharan Africa are increasingly using their phones and the Internet to connect with their peers. However, these media sources can lead to sexual risk behaviour because of access to inappropriate and inaccurate information. Social environmental factors in Sub-Saharan Africa, such as gender, place of residence, and socio-economic status influence young people’s access to and use of these media sources. However, many studies that consider the influence of these social factors on the use of media among young people evaluate each of them and fail to consider that these social forces jointly influence young people’s access to the internet, and ability to own phones, watch television, or read newspapers. Our study considered these combined social factors and their influence on the link between the use of media and sexual risk behaviour among young people. We found that considering these social environmental factors reduced the association between media use and young people’s sexual risk behaviour but those who did not have access to these media sources were more likely to use unreliable methods to prevent pregnancy or sexually transmitted diseases. Those who listened to the radio, or read newspapers and magazines were more likely to give or receive cash or other gifts in exchange for sex. In contrast, young people who never owned phones or lacked access to the internet were less likely to have had multiple sexual partners. Our findings stress the need to consider social contexts and media use in promoting young people’s sexual health.
© 2024. The Author(s).