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Differential effects of religiosity on sexual initiation among Nigerian in-school adolescents

Abstract Background: Sexual initiation in adolescence has significant health implications; identifying associated risk and protective factors is critical for context-specific evidence-based interventions. This study examined the influence of religiosity on sexual debut among in-school adolescents in Lagos State, Nigeria. Methods: Data was obtained from 1350 randomly selected in-school adolescents using a self-administered questionnaire. Internal and external religiosity, defined based on the extant literature, were the independent variables. The dependent variable was “ever had sex.” The association between religiosity and the age of sexual debut was assessed using Cox regression and controlling for relevant covariates. The hazard ratio (HR) and 95% confidence interval (CI) were calculated. Results: Of the participants, 19.8% of the females and 26.6% of the males have had sex (p<0.004). Internal religiosity was protective against sexual debut among females (HR=0.63, 95% CI=0.44–0.91), whereas external religiosity was protective among the males (HR=0.70, 95% CI=0.51–0.71). Age was positively associated with sexual debut among both male (HR=1.11, 95% CI=1.001–1.24) and female adolescents (HR=1.26, 95% CI=1.11–1.42). Early pubertal development (HR=1.11; 95% CI=1.001–1.24) was also a risk factor for male adolescent sexual initiation. In addition, knowledge of HIV/AIDS risk (HR=0.47; 95% CI=0.30–0.72) was a protective factor against sexual debut among adolescent females, whereas the positive perspective of friends’ involvement in sex (HR=1.014; 95% CI=1.21–2.58) was a risk factor. Conclusion: The protective effect of internal and external religiosity with regards to sexual debut varied by gender among Nigerian in-school adolescents; the gender differences as well as other significant factors should be taken into account in evidence-based programming to address adolescent sexual health challenges in Nigeria.