Peer-reviewed article
Female Genital Mutilation and Sexual Risk Behaviors of Adolescent Girls and Young Women Aged 15-24 Years: Evidence From Sierra Leone.
Mchenga M ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined the link between female genital mutilation (FGM) and sexual risk behaviors in adolescent girls and young women aged 15-24 years in Sierra Leone. Using data from 5,524 girls in the 2019 Demographic Health Survey, researchers found that 76% had undergone FGM. The study found FGM was associated with three harmful outcomes: earlier sexual debut (before age 18), child marriage, and becoming a mother as an adolescent. Education was identified as protective against all three outcomes.
Key points
- 76% of the 5,524 adolescent girls and young women surveyed had undergone FGM
- FGM was associated with an 18 percentage point increase in sexual debut before age 18
- FGM was associated with a 12.61 percentage point increase in child marriage
- FGM was associated with a 13.38 percentage point increase in adolescent motherhood
- Education was protective against all three sexual risk behaviors
Limitations
This is a cross-sectional study using survey data, which can only show associations, not prove that FGM causes these sexual risk behaviors. The study cannot determine the mechanisms through which FGM influences these outcomes or account for unmeasured confounding factors.
Abstract
Purpose Considering the high levels of female genital mutilation (FGM) in Sierra Leone with over 83% of girls and young women aged 15-24 years having undergone the practice, the study explores the potential influence of FGM on sexual behaviors of adolescent girls and young women (AGYW) in Sierra Leone. Methods Cross-sectional data from the 2019 Demographic Health Survey were utilized to examine the association between FGM and three sexual behaviors; sexual debut before 18 years, child marriage and adolescent motherhood. To model this association, a generalized estimation equation technique was employed, while controlling for socio-demographic characteristics. Additionally, the study corrected for multiple-hypothesis testing using the Benjamini-Hochberg procedure with a specified false discovery rate of 0.05. Finally, percentage predicted probabilities of occurrence of the sexual risk behaviors in the presence of FGM were also calculated. Results Of the 5524 AGYW, 76% had undergone FGM. FGM was associated with all three sexual risk behaviors. Sexual debut before 18 years had the highest predicted probability increase (+18.00 ppt, 95% CI: 14.41 to -21.59), followed by adolescent motherhood (+13.38 ppt, 95% CI: 10.16-16.60) and child marriage (+12.61 ppt; 95% CI: 10.22-15.01). Education was found to be protective against all three sexual risk behaviors. Discussion The findings of this study demonstrate that FGM remains a prevalent practice in Sierra Leone, even among the younger generation. This practice is strongly associated with sexual behaviors that pose a significant risk to the health outcomes of AGYW. Investments in education by removing barriers to access for AGYW could lead to multiple gains.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- This is an observational study examining the relationship between FGM status and sexual risk behaviors; no intervention was tested
- Population
- 5,524 adolescent girls and young women aged 15-24 years in Sierra Leone
Key finding
FGM associated with 18.00 percentage point increase in sexual debut before age 18 (95% CI: 14.41-21.59)