Determinants of Adolescent Vulnerability to Early Marriage and Early Sexual Debut in the Context of HIV and AIDS

Although orphanhood and co-residence with chronically ill or HIV-positive adult are frequently used as proxy markers of vulnerability for children under age 18 affected by HIV/AIDS, evidence shows these are not robust measures of child vulnerability across national and epidemic contexts (Akwara et al, 2010). Data from 11 nationally representative household surveys were analyzed using multivariate methods to establish if these markers consistently identified adolescents age 15-17 with worse outcomes, net of other socio-demographic factors. Data were pooled for 11 countries, and separate logistic regression models were fitted to assess the strength of associations between each of the outcomes and the analytical variables. The current analysis focuses on the following outcomes: early marriage (age 15-17); and early sexual debut (age 15-17). The results indicate that orphanhood, child’s living arrangement, household wealth, and adult education are associated with the selected outcomes in adolescents. The presence of chronically ill adult in the household almost made no difference in odds of poor outcomes, after controlling for other analytical variables. The results of the analysis contributed to the redefinition of vulnerable children including adolescents in the context of HIV/AIDS and change in policy and programming guidance.