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Despite the declining HIV/AIDS prevalence globally, nearly half of all new HIV infections still occur among youth, especially in sub-Saharan Africa. While determinants of risky sexual behaviour have received copious attention in the literature, we still lack multi-country studies that track regional changes in sexual risk among youth in sub-Saharan Africa. This study seeks to fill part of this gap by identifying the determinants of risky sexual behaviours among adolescents in Ghana, Central African Republic (CAR) and Eswatini (formerly Swaziland). We used nationally representative sample data from the Multi Indicator Cluster survey, round four (MICS4). Results of the descriptive analysis show that overall consistent condom use is still extremely low in sub-Saharan Africa. In Ghana, only 8.5% of male youth and 7% of female youth consistently use condoms. In CAR this figure is 8% and 4% in male youth and female youth respectively. In Eswatini, with one of highest HIV prevalence in the world, the prevalence of consistent condom use is at 29% in males and 20% in females, higher than both in Ghana and CAR. Results of hierarchical models show that age at first sex does not predict risky sexual behaviour in Ghana, but it does predict risky sexual behaviour in CAR although only among young males. In Swaziland, age at first sex predicts risky sexual behaviour in both male and female youth but the relationship is not in the expected direction. Low socio-economic status predicts inconsistent condom use in all the three countries, but only among young females. This paper provides relevant policy lessons and recommendations. [ABSTRACT FROM AUTHOR]

The following is a population-based survey of the Central African Republic (CAR) female refugee population displaced to rural Djohong District of Eastern Cameroon and associated female Cameroonian host population to characterise the prevalence and circumstances of sexual violence. A population-based, multistage, random cluster survey of 600 female heads of household was conducted during March 2010. Women heads of household were asked about demographics, household economy and assets, level of education and sexual violence experienced by the respondent only. The respondents were asked to describe the circumstances of their recent assault. The lifetime prevalence of sexual violence among Djohong district female heads of household is 35.2% (95% CI 28.7–42.2). Among heads of household who reported a lifetime incident of sexual violence, 64.0% (95% CI 54.3–72.5) suffered sexual violence perpetrated by their husband or partner. Among the host population, 3.9% (95% CI 1.4–10.5) reported sexual violence by armed groups compared to 39.0% (95% CI 25.6–54.2) of female refugee heads of household. Women who knew how to add and subtract were less likely to report sexual violence during their lifetime (OR 0.16, 95% CI 0.08–0.34). Sexual violence is common among refugees and host population in Eastern Cameroon. Most often, perpetrators are partners/husbands or armed groups. [ABSTRACT FROM PUBLISHER]