Date of Award


Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Richard B. Rothenberg

Second Advisor

Ike S. Okosun



Background: A variety of studies identified early sexual debut as a significant risk factor for HIV infection, particularly among young African women. However, little is known about this relationship in Central Africa.

Methods: This study was based on a cross-sectional analysis of Demographic and Health Surveys data drawn from four central African countries, Cameroon and Gabon with high HIV prevalence levels, Democratic Republic of Congo and Congo with low HIV prevalence levels. Relationship between sexual activity initiated before age 15 and HIV sero-status was examined in men and women aged 15-24 years, to determine potential differences in this relationship across countries. Logistic regression was used to build a standard multivariate analysis model allowing for comparison between countries while controlling for sociodemographic, economic, behavioral, most recent partner characteristics, and HIV prevention knowledge.

Results: HIV prevalences were significantly higher among women from high HIV prevalence countries compared to women living in lower HIV prevalence countries (p

Conclusion: Decline in heterosexual transmission of HIV in Central Africa will necessitate that behavioral interventions targeting young African women encourage delaying sexual debut and not engaging in other risky sexual behaviors.