The influence of gender-equitable attitudes on sexual behaviour among unmarried adolescents in rural Tanzania: a longitudinal study
Outcomes: Human Immunodeficiency Virus, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways This study explores how both individual and community-level gender-equitable attitudes influence adolescent sexual and reproductive health and rights (SRHR) in rural Tanzania. Gender-equitable attitudes were measured using the Gender-Equitable Men (GEM) scale, both at the individual level and aggregated to the village level to capture perceived community norms. The study found that adolescents living in communities with higher GEM scores had greater odds of HIV testing and lower odds of age-disparate relationships. For girls, higher individual GEM scores were associated with increased contraceptive and condom use. These findings highlight the importance of targeting both personal beliefs and perceived social expectations in efforts to shift norms and reduce adolescent sexual risk—especially for girls.
Objectives To assess whether gender-equitable attitudes—both at the individual and community levels—are associated with reduced sexual risk behaviors among unmarried adolescents, and whether these associations differ by sex.
Methods This was a longitudinal observational study using data from the Ujana Salama cluster randomized controlled trial in rural Tanzania. The sample included 2,017 unmarried adolescents aged 16–21. Researchers used data from Wave 2 (2018) and Wave 3 (2019) to assess how gender attitudes predicted later sexual behaviors, including transactional sex, HIV testing, and condom use. Community attitudes were measured by aggregating individual Gender-Equitable Men (GEM) scale scores at the village level.
Intervention Details Although not the focus of this analysis, the broader Ujana Salama program included life skills, livelihoods training, mentoring, cash grants, and adolescent-friendly SRHR services. The study used data from both intervention and control sites but aimed to examine associations rather than intervention impacts.
Results High community-level gender-equitable attitudes were associated with increased HIV testing and decreased odds of age-disparate relationships. Among girls, high individual gender-equitable attitudes were linked to more condom and contraceptive use. However, attitudes were not significantly associated with transactional sex, early sexual debut, or number of sexual partners. No significant associations were found for boys across outcomes.
Conclusions Gender-equitable attitudes, especially at the community level, can shape adolescent sexual behavior and health outcomes. Interventions aiming to shift norms must involve whole communities—including boys and men—to effectively support gender equity and adolescent SRHR.
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