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Unformatted text preview: R E S E A R C H A R T I C L E Psychosocial Distress and Alcohol Use as Factors in Adolescent Sexual Behavior Among Sub-Saharan African Adolescents R ANDY M. P AGE , PhD a C OUGAR P. H ALL , PhD b ABSTRACT BACKGROUND: This study examines the relationship between sexual behavior, alcohol use, and indicators of psychosocial distress (mental health) of adolescents in 6 sub-Saharan African countries using the Global School-based Student Health Survey (GSHS). METHODS: The sample consisted of 22,949 adolescents from Botswana, Kenya, Namibia, Uganda, Zambia, and Zimbabwe who participated in 2003 or 2004 GSHS surveys. Statistical analysis was conducted to determine whether sexual behaviors increased with levels of psychosocial distress and alcohol use. RESULTS: Sexual behaviors (having sex or having sex with 2 or more people) were associated with both psychosocial distress and alcohol use. Odds ratios showed that both boys and girls reporting psychosocial distress and alcohol use were at higher risk for having sex. Results also indicated that the likelihood of sexual behaviors increased when there was an increase in the number of psychosocial indicators and frequency of alcohol consumption. CONCLUSION: The results of this study are consistent with those conducted in the United States suggesting that sexual behavior, psychosocial distress, and substance use are interconnected. These findings highlight the need for school health education and health services in sub-Saharan Africa, specifically the efforts to reduce psychosocial distress and prevent substance use in efforts to prevent the spread of human immunodeficiency virus and other sexually transmitted infections. Keywords: human sexuality; mental health; substance abuse. Citation: Page RM, Hall CP, Psychosocial distress and alcohol use as factors in adolescent sexual behavior among sub-Saharan African adolescents. J Sch Health. 2009; 79: 369-379. Accepted March 30, 2009 a Professor, (email@example.com), Department of HealthScience, 221Richards Building, BrighamYoungUniversity, Provo, UT84604. b Assistant Professor, (firstname.lastname@example.org), Department of HealthScience, 221Richards Building, BrighamYoungUniversity, Provo, UT84604. Address correspondenceto: Randy M. Page, Professor, (email@example.com), Department of HealthScience, 221Richards Building, BrighamYoungUniversity, Provo, UT84604. Journal of School Health August 2009, Vol. 79, No. 8 2009, American School Health Association 369 S ub-Saharan Africa as a region has the highest prevalence of human immunodeficiency virus (HIV) infection in the world. 1 Although this region has only 11% of the worlds population, it accounts for the majority of people living with HIV/acquired immunodeficiency syndrome (AIDS) (68%), new HIV infections (68%), and AIDS-related deaths (76%)....
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