Context: The social and economic context in which Malian adolescents begin sexual activity is different from that experienced by previous generations. Little is known about the forces that currently shape adolescents' sexuality and affect their reproductive health.
Methods: A representative sample of 1,696 Malian adolescents (775 males and 921 females) aged 15-19 were interviewed in 1998 about sexual behavior and knowledge. Thirty focus-group discussions provided complementary insights into the context of and reasons for adolescents' first sexual encounters.
Results: Nearly half of sexually experienced urban males said they would have preferred to delay their first intercourse, compared with about one-fifth of females and of rural males. Males most often said curiosity and peer pressure (including pressure from their girlfriends) had led them to begin having sex earlier than they would have liked, while females in urban areas cited love and those in rural areas cited a promise of marriage. Focus groups, however, suggested that young urban women often had sex to obtain cash to meet their material needs and desires. Unmarried urban females who exhibited high self-esteem and an internal locus of control were significantly more likely to be satisfied with the timing of their first sexual encounter; these factors had no effect among males. Among adolescents who were satisfied with the timing of their first sexual experience, both males and females were more likely to have used a modern contraceptive at first intercourse, and females were more likely to have ever used a modern method. Multivariate analyses, however, indicated that a large part of the effect among females was mediated by psychological factors: High self-esteem and an internal locus of control were associated with an increased likelihood of having ever used contraceptives. Among young men, ever-use was strongly associated with self-esteem and was only weakly associated with the timing of first intercourse.
Conclusions: In Mali, young women's psychological characteristics are strongly associated with their sexual experience (including the timing of their first sexual encounter) and ultimately with their ability to protect themselves from sexual health risks.
International Family Planning Perspectives (2001) 27 (2): 56-62