Social Cognition Variables and Victimization as Predictors of Sexual Debut Among Adolescents in South Africa and Tanzania: A Multi-group SEM Analysis

Early sexual debut is common in South Africa and Tanzania, with potentially negative reproductive health outcomes. The role of violence as a predictor of sexual debut was studied, in a context of predictors borrowed from social cognition models. Data were taken from cluster-randomized trials of school-based HIV prevention interventions in three sites in South Africa and Tanzania. Analyses consisted of descriptive statistics and multi-group structural equation modelling. The basic model functioned fairly well for Cape Town, but less well for Mankweng and Dar es Salaam (low R 2 values). Attitudes were the strongest predictor of intention. Adding socio-demographic variables to the model did not reduce the associations much and neither did subsequent inclusion of violence. Sexual debut was strongly associated with victimization; adding violence also substantially increased R 2 for sexual debut. Besides social cognition factors, intimate partner violence should be addressed in future research on reproductive health interventions for adolescents.