{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:29:19Z","timestamp":1793143759685,"version":"4.5.0"},"reference-count":68,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T00:00:00Z","timestamp":1652313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T00:00:00Z","timestamp":1652313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Reprod Health"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite national and international commitments and efforts to prevent risky sexual behaviours, a high proportion of young people in South Africa are engaged in risky sexual behaviour. However, most efforts are currently directed toward addressing individual-level factors at the expense of not addressing neighbourhood-level determinants such as social disorganisation, contributing to risky sexual behaviour among young people in South Africa. This study investigated the multilevel factors of risky sexual behaviours among young people by gender in South Africa, using the lens of socio-ecological and social disorganisation frameworks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data from a nationally representative sample of 1268 males and 2621 females aged 15\u201324\u00a0years, giving a total of, 3889 never-married youths, were drawn from the 2016 South Africa Demographic and Health Survey. Analysis was conducted using multilevel mixed-effect logistic regressions with random community-level effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Findings show that youth who were from a heterogeneous ethnic group (AOR\u2009=\u20090.49, CI: 0.35\u20130.67), household size of 5\u2009+\u2009members (AOR\u2009=\u20090.78, CI: 0.54\u20131.15), community education (AOR\u2009=\u20090.97, CI: 0.72\u20131.32) were associated with low engagement in multiple sexual partnerships. Youths who were employed (AOR\u2009=\u20090.84, CI: 0.59\u20131.18), and from high-level community poverty (AOR\u2009=\u20090.76, CI: 0.58\u20131.00) were also associated with reduced odds of unprotected sex. In addition, older youth aged 20\u201324\u00a0years (AOR\u2009=\u200912.6, CI: 9.93\u201316.00); secondary education attainment (AOR\u2009=\u20091.01, CI 0.58\u20131.77); family structure (AOR\u2009=\u20091.37, CI: 0.75\u20131.15); Gauteng province (AOR\u2009=\u20091.45 CI: 0.92\u20132.28); residential mobility (AOR\u2009=\u20091.25, CI: 1.02\u20131.53), community media exposure to contraceptives (unprotected sex) (AOR\u2009=\u20091.38, CI: 1.09\u20131.76)\u00a0were more likely to engage in risky sexual behaviour.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The study revealed that neighbourhood and individual-level factors were important in explaining the factors associated with risky sexual behaviour among young people in South Africa. In addition, engagement in risky sexual behaviour was high, with minimal variation among young females and males in South Africa. It specifies that the practice of risky sexual behaviour is significantly associated with multilevel factors of social disorganisation that cut across gender. These results imply that there is a need to review policies of sexual risks reduction for each gender, which might help mitigate the adverse effects of social disorganisation for women and men youths in South Africa.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12978-022-01407-9","type":"journal-article","created":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T11:04:04Z","timestamp":1652353444000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["A multilevel mixed effect analysis of neighbourhood and individual level determinants of risky sexual behaviour among young people in South Africa"],"prefix":"10.1186","volume":"19","author":[{"given":"Clifford Obby","family":"Odimegwu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7457-4363","authenticated-orcid":false,"given":"Nebechukwu Henry","family":"Ugwu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,12]]},"reference":[{"key":"1407_CR1","unstructured":"Darroch JE, Woog V, Bankole A, Ashford LS. ADDING IT UP: costs and benefits of meeting the contraceptive needs of adolescents. 2018; https:\/\/www.guttmacher.org\/adding-it-up."},{"key":"1407_CR2","unstructured":"United Nations Children\u2019s Fund. For Every Child, End AIDS. In: Seventh stocktaking report. New York: The United Nations Children\u2019s Fund. p. 2016. https:\/\/data.unicef.org\/wpcontent\/uploads\/2016\/12\/HIV-and-AIDS-2016Seventh-Stocktaking-Report.pdf."},{"key":"1407_CR3","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1186\/s12978-021-01161-4","volume":"18","author":"AK Olika","year":"2019","unstructured":"Olika AK, Kitila SB, Terfa YB, et al. Contraceptive use among sexually active female adolescents in Ethiopia: trends and determinants from national demographic and health surveys. Reprod Health. 2019;18:104. https:\/\/doi.org\/10.1186\/s12978-021-01161-4.","journal-title":"Reprod Health"},{"issue":"6","key":"1407_CR4","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1016\/j.jadohealth.2019.09.015","volume":"65","author":"M Liang","year":"2019","unstructured":"Liang M, Simelane S, Fillo GF, Chalasani S, Weny K, Canelos PS, Jenkins L, Moller A, Chandra-Mouli V, Say L, Michielsen K, Engel DMC, Snow R. The state of adolescent sexual and reproductive health. J Adolesc Health. 2019;65(6):S3\u201315. https:\/\/doi.org\/10.1016\/j.jadohealth.2019.09.015.","journal-title":"J Adolesc Health"},{"issue":"8","key":"1407_CR5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0220855","volume":"14","author":"PL Pandey","year":"2019","unstructured":"Pandey PL, Seale H, Razee H. Exploring the factors impacting on access and acceptance of sexual and reproductive health services provided by adolescent-friendly health services in Nepal. PLoS ONE. 2019;14(8): e0220855. https:\/\/doi.org\/10.1371\/journal.pone.0220855.","journal-title":"PLoS ONE"},{"issue":"s1","key":"1407_CR6","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1016\/j.ijgo.2015.02.006","volume":"131","author":"JL Morris","year":"2015","unstructured":"Morris JL, Rushwan H. Adolescent sexual and reproductive health: the global challenges. Int J Gynecol Obstet. 2015;131(s1):540\u20132.","journal-title":"Int J Gynecol Obstet"},{"key":"1407_CR7","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s12978-018-0460-4","volume":"15","author":"I Yakubu","year":"2018","unstructured":"Yakubu I, Salisu WJ. Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review. Reprod Health. 2018;15:15. https:\/\/doi.org\/10.1186\/s12978-018-0460-4.","journal-title":"Reprod Health"},{"issue":"4","key":"1407_CR8","doi-asserted-by":"publisher","first-page":"41","DOI":"10.11648\/j.ijhpebs.20170304.12","volume":"3","author":"H Amare","year":"2017","unstructured":"Amare H, Azage M, Negash M, Getachew A, Desale A, Abebe N. Risky sexual behavior and associated factors among adolescent students in Tana Haik high school, Bahir Dar, Northern Ethiopia. Int J HIV\/AIDS Prev Educ Behav Sci. 2017;3(4):41\u20137.","journal-title":"Int J HIV\/AIDS Prev Educ Behav Sci"},{"issue":"4","key":"1407_CR9","doi-asserted-by":"publisher","first-page":"447","DOI":"10.15270\/56-4-886","volume":"56","author":"S Bala","year":"2020","unstructured":"Bala S, Kang\u2019ethe S. Interplay between substance use and health: behavioural dynamics among female adolescents in Butterworth, South Africa. Soc Work. 2020;56(4):447\u201359. https:\/\/doi.org\/10.15270\/56-4-886.","journal-title":"Soc Work"},{"key":"1407_CR10","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1007\/s13178-018-0351-z","volume":"16","author":"T Morison","year":"2019","unstructured":"Morison T, Herbert S. Rethinking \u2018Risk\u2019 in sexual and reproductive health policy: the value of the reproductive justice framework. Sex Res Soc Policy. 2019;16:434\u201345. https:\/\/doi.org\/10.1007\/s13178-018-0351-z.","journal-title":"Sex Res Soc Policy"},{"key":"1407_CR11","unstructured":"United Nations Population Fund (UNFPA) and ICPD25. Sexual and Reproductive Health and Rights: an essential element of Universal Health Coverage. Integrated definition of sexual and reproductive health and rights. https:\/\/www.unfpa.org\/sites\/default\/files\/pub-pdf\/UF_SupplementAndUniversalAccess_30-online.pdf."},{"key":"1407_CR12","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1186\/s12978-020-009985","volume":"17","author":"YD Wado","year":"2020","unstructured":"Wado YD, Bangha M, Kabiru CW, Feyissa GT. Nature of, and responses to key sexual and reproductive health challenges for adolescents in urban slums in sub-Saharan Africa: a scoping review. Reprod Health. 2020;17:149. https:\/\/doi.org\/10.1186\/s12978-020-009985.","journal-title":"Reprod Health"},{"key":"1407_CR13","doi-asserted-by":"publisher","first-page":"1884","DOI":"10.1186\/s12889-020-09996-5","volume":"20","author":"AA Seidu","year":"2020","unstructured":"Seidu AA, Ahinkorah BO, Dadzie LK, et al. A multi-country cross-sectional study of self-reported sexually transmitted infections among sexually active men in sub-Saharan Africa. BMC Public Health. 2020;20:1884. https:\/\/doi.org\/10.1186\/s12889-020-09996-5.","journal-title":"BMC Public Health"},{"key":"1407_CR14","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1186\/s12978-018-0614-4","volume":"15","author":"M Zgambo","year":"2018","unstructured":"Zgambo M, Kalembo FW, Mbakaya BC. Risky behaviours and their correlates among adolescents living with HIV in sub-Saharan Africa: a systematic review. Reprod Health. 2018;15:180. https:\/\/doi.org\/10.1186\/s12978-018-0614-4.","journal-title":"Reprod Health"},{"key":"1407_CR15","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1186\/s12978-019-0722-9","volume":"16","author":"IO Morhason-Bello","year":"2019","unstructured":"Morhason-Bello IO, Kabakama S, Baisley K, Francis SC, Watson-Jones D. Reported oral and anal sex among adolescents and adults reporting heterosexual sex in sub-Saharan Africa: a systematic review. Reprod Health. 2019;16:48. https:\/\/doi.org\/10.1186\/s12978-019-0722-9.","journal-title":"Reprod Health"},{"issue":"2","key":"1407_CR16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0246308","volume":"16","author":"BO Ahinkorah","year":"2021","unstructured":"Ahinkorah BO, Kang M, Perry L, Brooks F, Hayen A. Prevalence of first adolescent pregnancy and its associated factors in sub-Saharan Africa: a multi-country analysis. PLoS ONE. 2021;16(2): e0246308. https:\/\/doi.org\/10.1371\/journal.pone.0246308.","journal-title":"PLoS ONE"},{"issue":"4","key":"1407_CR17","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1080\/03630242.2017.1306607","volume":"58","author":"S Challa","year":"2018","unstructured":"Challa S, Manu A, Morhe E, Dalton VK, Loll D, Dozier J, Zochowski MK, Boakye A, Adanu R, Hall KS. Multiple levels of social influence on adolescent sexual and reproductive health decision-making and behaviors in Ghana. Women Health. 2018;58(4):434\u201350. https:\/\/doi.org\/10.1080\/03630242.2017.1306607.","journal-title":"Women Health"},{"key":"1407_CR18","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1186\/s12978-018-0505-8","volume":"15","author":"K Asrese","year":"2018","unstructured":"Asrese K, Mekonnen A. Social network correlates of risky sexual behavior among adolescents in Bahir Dar and Mecha Districts, North West Ethiopia: an institution-based study. Reprod Health. 2018;15:61. https:\/\/doi.org\/10.1186\/s12978-018-0505-8.","journal-title":"Reprod Health"},{"issue":"1","key":"1407_CR19","doi-asserted-by":"publisher","first-page":"e0209675","DOI":"10.1371\/journal.pone.0209675","volume":"14","author":"V Vongxay","year":"2019","unstructured":"Vongxay V, Albers F, Thongmixay S, Thongsombath M, Broerse JEW, et al. Sexual and reproductive health literacy of school adolescents in Lao PDR. PLoS ONE. 2019;14(1):e0209675. https:\/\/doi.org\/10.1371\/journal.pone.0209675.","journal-title":"PLoS ONE"},{"key":"1407_CR20","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1186\/s12889-018-5331-y","volume":"18","author":"M Mutumba","year":"2018","unstructured":"Mutumba M, Wekesa E, Stephenson R. Community influences on modern contraceptive use among young women in low and middle-income countries: a cross-sectional multi-country analysis. BMC Public Health. 2018;18:430. https:\/\/doi.org\/10.1186\/s12889-018-5331-y.","journal-title":"BMC Public Health"},{"key":"1407_CR21","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1186\/s12879-018-3138-1","volume":"18","author":"R Abdul","year":"2018","unstructured":"Abdul R, Gerritsen AAM, Mwangome M, Geubbels E. Prevalence of self-reported symptoms of sexually transmitted infections, knowledge and sexual behaviour among youth in semi-rural Tanzania in the period of adolescent friendly health services strategy implementation. BMC Infect Dis. 2018;18:229. https:\/\/doi.org\/10.1186\/s12879-018-3138-1.","journal-title":"BMC Infect Dis"},{"key":"1407_CR22","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1186\/s12889-020-08474-2","volume":"20","author":"D Govender","year":"2020","unstructured":"Govender D, Naidoo S, Taylor M. \u201cMy partner was not fond of using condoms and I was not on contraception\u201d: understanding adolescent mothers\u2019 perspectives of sexual risk behaviour in KwaZulu-Natal, South Africa. BMC Public Health. 2020;20:366. https:\/\/doi.org\/10.1186\/s12889-020-08474-2.","journal-title":"BMC Public Health"},{"issue":"2","key":"1407_CR23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0228584","volume":"15","author":"S Dias","year":"2020","unstructured":"Dias S, Gama A, Loos J, Roxo L, Sim\u00f5es D, et al. The role of mobility in sexual risk behaviour and HIV acquisition among sub-Saharan African migrants residing in two European cities. PLoS ONE. 2020;15(2): e0228584. https:\/\/doi.org\/10.1371\/journal.pone.0228584.","journal-title":"PLoS ONE"},{"key":"1407_CR24","doi-asserted-by":"publisher","first-page":"1396","DOI":"10.1007\/s10461-018-2367-z","volume":"23","author":"A Dzomba","year":"2019","unstructured":"Dzomba A, Tomita A, Govender K, Tanser F. Effects of migration on risky sexual behavior and HIV acquisition in South Africa: a systematic review and meta-analysis, 2000\u20132017. AIDS Behav. 2019;23:1396\u2013430. https:\/\/doi.org\/10.1007\/s10461-018-2367-z.","journal-title":"AIDS Behav"},{"issue":"2","key":"1407_CR25","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1017\/S002193201800010X","volume":"51","author":"C Odimegwu","year":"2019","unstructured":"Odimegwu C, Somefun O, Chisumpa V. Regional differences in positive sexual behaviour among youth in sub-Saharan Africa. J Biosoc Sci. 2019;51(2):254\u201372. https:\/\/doi.org\/10.1017\/S002193201800010X.","journal-title":"J Biosoc Sci"},{"key":"1407_CR26","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1186\/s12905-021-01286-5","volume":"21","author":"MS Nabaggala","year":"2021","unstructured":"Nabaggala MS, Reddy T, Manda S. Effects of rural\u2013urban residence and education on intimate partner violence among women in Sub-Saharan Africa: a meta-analysis of health survey data. BMC Womens Health. 2021;21:149. https:\/\/doi.org\/10.1186\/s12905-021-01286-5.","journal-title":"BMC Womens Health"},{"issue":"10","key":"1407_CR27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0206197","volume":"13","author":"OD Somefun","year":"2018","unstructured":"Somefun OD, Odimegwu C. The protective role of family structure for adolescent development in sub-Saharan Africa. PLoS ONE. 2018;13(10): e0206197. https:\/\/doi.org\/10.1371\/journal.pone.0206197.","journal-title":"PLoS ONE"},{"issue":"7","key":"1407_CR28","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1037\/amp0000204","volume":"73","author":"AD Benner","year":"2018","unstructured":"Benner AD, Wang Y, Shen Y, Boyle AE, Polk R, Cheng Y-P. Racial\/ethnic discrimination and well-being during adolescence: a meta-analytic review. Am Psychol. 2018;73(7):855\u201383. https:\/\/doi.org\/10.1037\/amp0000204.","journal-title":"Am Psychol"},{"key":"1407_CR29","unstructured":"Mmopelwa D, Morrissey O, Owens T. HIV\/AIDS and sexual behaviour in Botswana. 2021."},{"key":"1407_CR30","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1007\/s10389-01901140-x","volume":"29","author":"AA Seidu","year":"2021","unstructured":"Seidu AA, Ahinkorah BO, Ameyaw EK, et al. Risky sexual behaviours among school-aged adolescents in Namibia: secondary data analyses of the 2013 Global school-based health survey. J Public Health (Berl). 2021;29:451\u201361. https:\/\/doi.org\/10.1007\/s10389-01901140-x.","journal-title":"J Public Health (Berl)"},{"issue":"1","key":"1407_CR31","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1080\/17290376.2020.1858947","volume":"18","author":"S Pengoid","year":"2021","unstructured":"Pengoid S, Peltzer K. Sexual risk behaviour and its correlates among adolescents in Mozambique: results from a national school survey in 2015. SAHARA-J J Soc Aspects HIV\/AIDS. 2021;18(1):26\u201332. https:\/\/doi.org\/10.1080\/17290376.2020.1858947.","journal-title":"SAHARA-J J Soc Aspects HIV\/AIDS"},{"issue":"1","key":"1407_CR32","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-018-3623-7","volume":"18","author":"S James","year":"2018","unstructured":"James S, Pisa PT, Imrie J, Beery MP, Martin C, Skosana C, Delany-Moretlwe S. Assessment of adolescent and youth friendly services in primary healthcare facilities in two provinces in South Africa. BMC Health Serv Res. 2018;18(1):1.","journal-title":"BMC Health Serv Res"},{"key":"1407_CR33","doi-asserted-by":"publisher","first-page":"1249","DOI":"10.1186\/s12889-020-09356-3","volume":"20","author":"S Shamu","year":"2020","unstructured":"Shamu S, Khupakonke S, Farirai T, et al. Knowledge, attitudes and practices of young adults towards HIV prevention: an analysis of baseline data from a community-based HIV prevention intervention study in two high HIV burden districts, South Africa. BMC Public Health. 2020;20:1249. https:\/\/doi.org\/10.1186\/s12889-020-09356-3.","journal-title":"BMC Public Health"},{"key":"1407_CR34","doi-asserted-by":"publisher","first-page":"1370","DOI":"10.1186\/s12889-020-09488-6","volume":"20","author":"AI Ajayi","year":"2020","unstructured":"Ajayi AI, Ezegbe HC. Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa. BMC Public Health. 2020;20:1370. https:\/\/doi.org\/10.1186\/s12889-020-09488-6.","journal-title":"BMC Public Health"},{"key":"1407_CR35","doi-asserted-by":"publisher","DOI":"10.1080\/03623319.2020.1727225","author":"E Biney","year":"2020","unstructured":"Biney E, Ewemooje OS, Amoateng AY. Predictors of sexual risk behaviour among unmarried persons aged 15\u201334 years in South Africa. Soc Sci J. 2020. https:\/\/doi.org\/10.1080\/03623319.2020.1727225.","journal-title":"Soc Sci J"},{"issue":"1","key":"1407_CR36","first-page":"346","volume":"10","author":"Z Ntloko","year":"2018","unstructured":"Ntloko Z, Kheswa J. Parental emotional attachment and sexual behaviour of female adolescents in Eastern Cape, South Africa. Int J Soc Sci Humanity Stud. 2018;10(1):346\u201368.","journal-title":"Int J Soc Sci Humanity Stud"},{"key":"1407_CR37","unstructured":"National Department of Health (NDoH), Statistics South Africa (Stats SA), South African Medical Research Council (SAMRC), and ICF. 2018. South Africa Demographic and Health Survey 2016 Key Findings. Pretoria, South Africa, and Rockville, Maryland, USA: NDoH, Stats SA, SAMRC, and ICF."},{"issue":"4","key":"1407_CR38","doi-asserted-by":"publisher","first-page":"307","DOI":"10.7196\/SAMJ.2017.v107i4.12141","volume":"107","author":"MF Chersich","year":"2017","unstructured":"Chersich MF, Wabiri N, Risher K, Shisana O, Celentano D, Rehle T, Evans M, Rees H. Contraception coverage and methods used among women in South Africa: a national household survey. SAMJ South Afr Med J. 2017;107(4):307\u201314.","journal-title":"SAMJ South Afr Med J"},{"issue":"1","key":"1407_CR39","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/S0277-9536(02)00017-5","volume":"56","author":"L Eaton","year":"2003","unstructured":"Eaton L, Flisher AJ, Aar\u00f8 LE. Unsafe sexual behaviour in South African youth. Soc Sci Med. 2003;56(1):149\u201365. https:\/\/doi.org\/10.1016\/S0277-9536(02)00017-5.","journal-title":"Soc Sci Med"},{"key":"1407_CR40","unstructured":"National Department of Health (NDoH), Statistics South Africa (Stats SA), South African Medical Research Council (SAMRC), and ICF. 2019. South Africa Demographic and Health Survey 2016. Pretoria, South Africa, and Rockville, Maryland, USA: NDoH, Stats SA, SAMRC, and ICF."},{"key":"1407_CR41","unstructured":"National Department of Health (NDoH), Statistics South Africa (Stats SA), South African Medical Research Council (SAMRC), and ICF. 2018. South Africa Demographic and Health Survey 2021 Key Findings. Pretoria, South Africa, and Rockville, Maryland, USA: NDoH, Stats SA, SAMRC, and ICF."},{"key":"1407_CR42","unstructured":"Department of Health, Medical Research Council & Measure DHS+. South Africa demographic and health survey 1998. Full Report Pretoria: Department of Health. 2002."},{"issue":"1","key":"1407_CR43","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1037\/0003-066X.47.1.6","volume":"47","author":"D Stokols","year":"1992","unstructured":"Stokols D. Establishing and maintaining healthy environments: toward a social ecology of health promotion. Am Psychol. 1992;47(1):6\u201322.","journal-title":"Am Psychol"},{"key":"1407_CR44","first-page":"465","volume-title":"Health behaviour and health education theory, research, and practice","author":"JF Sallis","year":"2008","unstructured":"Sallis JF, Owen N, Fisher EB. Ecological models of health behaviour. In: Glanz K, Rimer BK, Viswanath K, editors. Health behaviour and health education theory, research, and practice. 4th ed. San Francisco: Jossey-Bass; 2008. p. 465\u201386.","edition":"4"},{"issue":"4","key":"1407_CR45","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1177\/109019818801500401","volume":"15","author":"KR McLeroy","year":"1988","unstructured":"McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q. 1988;15(4):351\u201377.","journal-title":"Health Educ Q"},{"issue":"4","key":"1407_CR46","doi-asserted-by":"publisher","first-page":"253","DOI":"10.4278\/0890-1171-10.4.253","volume":"10","author":"L Breslow","year":"1996","unstructured":"Breslow L. Socio-ecological strategies for promoting healthy lifestyles. Am J Health Promotion. 1996;10(4):253\u20137.","journal-title":"Am J Health Promotion"},{"issue":"4","key":"1407_CR47","doi-asserted-by":"publisher","first-page":"282","DOI":"10.4278\/0890-1171-10.4.282","volume":"10","author":"D Stokols","year":"1996","unstructured":"Stokols D. Translating social ecological theory into guidelines for community health promotion. Am J Health Promotion. 1996;10(4):282\u201398.","journal-title":"Am J Health Promotion"},{"key":"1407_CR48","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1177\/002214650804900303","volume":"49","author":"CR Browning","year":"2008","unstructured":"Browning CR, Burrington LA, Leventhal T, Brooks-Gunn J. Neighborhood structural inequality, collective efficacy, and sexual risk behavior among urban youth. J Health Soc Behav. 2008;49:269\u201385.","journal-title":"J Health Soc Behav"},{"key":"1407_CR49","doi-asserted-by":"publisher","DOI":"10.1177\/00111287211041527","author":"CE Kubrin","year":"2021","unstructured":"Kubrin CE, Branic N, Hipp JR. (Re) conceptualizing neighborhood ecology in social disorganization theory: from a variable-centered approach to a neighborhood-centered approach. Crime Delinq. 2021. https:\/\/doi.org\/10.1177\/00111287211041527.","journal-title":"Crime Delinq"},{"issue":"4","key":"1407_CR50","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1111\/j.1745-9125.1988.tb00854.x","volume":"26","author":"RJ Bursik","year":"1988","unstructured":"Bursik RJ. Social disorganization and theory of crime and delinquency: problems and prospects. Criminology. 1988;26(4):519\u201351.","journal-title":"Criminology"},{"issue":"3","key":"1407_CR51","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1017\/S0021932011000654","volume":"44","author":"J Uchudi","year":"2012","unstructured":"Uchudi J, Magadi M, Mostazir M. A multilevel analysis of the determinants of high-risk sexual behaviour in sub-Saharan Africa. J Biosoc Sci. 2012;44(3):289\u2013311.","journal-title":"J Biosoc Sci"},{"issue":"1","key":"1407_CR52","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1080\/17290376.2016.1218792","volume":"13","author":"ND Ngidi","year":"2016","unstructured":"Ngidi ND, Moyo S, Zulu T, Adam JK, Krishna SBN. Qualitative evaluation of selected social factors that impact sexual risk-taking behaviour among African students in Kwazulu-Natal, South Africa. SAHARA-J J Soc Aspects HIV\/AIDS. 2016;13(1):96\u2013105.","journal-title":"SAHARA-J J Soc Aspects HIV\/AIDS"},{"issue":"10","key":"1407_CR53","doi-asserted-by":"publisher","first-page":"676","DOI":"10.7196\/SAMJ.8809","volume":"104","author":"ME Beksinska","year":"2014","unstructured":"Beksinska ME, Pillay L, Milford C, Smit JA. The sexual and reproductive health needs of youth in South Africa-history in context. S Afr Med J. 2014;104(10):676\u20138.","journal-title":"S Afr Med J"},{"key":"1407_CR54","unstructured":"World Health Organization. Measuring sexual health: conceptual and practical considerations and related indicators. WHO Document Production services, Geneva, Switzerland. 2010."},{"issue":"6","key":"1407_CR55","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1093\/heapol\/czl029","volume":"21","author":"S Vyas","year":"2006","unstructured":"Vyas S, Kumaranayake L. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan. 2006;21(6):459\u201368. https:\/\/doi.org\/10.1093\/heapol\/czl029.","journal-title":"Health Policy Plan"},{"key":"1407_CR56","unstructured":"Sampson JR. Family management and child development: insights from disorganization theory, eds in Facts, Framework, and Forecast. Taylour and Francis Groups. 1985."},{"issue":"4","key":"1407_CR57","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1111\/j.1745-9125.1993.tb01139.x","volume":"31","author":"BD Warner","year":"1993","unstructured":"Warner BD, Pierce GL. Re-examining social disorganization theory using calls to the police as a measure of crime. Criminology. 1993;31(4):493\u2013517.","journal-title":"Criminology"},{"key":"1407_CR58","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1007\/s12119-018-9508-4","volume":"22","author":"A Marume","year":"2018","unstructured":"Marume A, Maradzika J, January J. Adolescent sexting and risky sexual behaviours in Zimbabwe: a cross-sectional study. Sex Cult. 2018;22:931\u201341. https:\/\/doi.org\/10.1007\/s12119-018-9508-4.","journal-title":"Sex Cult"},{"issue":"4","key":"1407_CR59","doi-asserted-by":"publisher","first-page":"e460","DOI":"10.1016\/S2214-109X(18)30060-3","volume":"6","author":"CL Ward","year":"2018","unstructured":"Ward CL, Artz L, Leoschut L, Kassanjee R, Burton P. Sexual violence against children in South Africa: a nationally representative cross-sectional study of prevalence and correlates. Lancet Global Health. 2018;6(4):e460\u20138. https:\/\/doi.org\/10.1016\/S2214-109X(18)30060-3.","journal-title":"Lancet Global Health"},{"issue":"7","key":"1407_CR60","doi-asserted-by":"publisher","first-page":"2117","DOI":"10.1007\/s10508-019-1442-5","volume":"48","author":"XH Yang","year":"2019","unstructured":"Yang XH, Yuan S, Zhang R, Yu JF, Nzala SH, Wang PG, He QQ. Risky sexual behaviors and associated factors among college students in Lusaka, Zambia. Arch Sex Behav. 2019;48(7):2117\u201323.","journal-title":"Arch Sex Behav"},{"issue":"3","key":"1407_CR61","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1080\/17441692.2015.1014393","volume":"11","author":"M Kamndaya","year":"2016","unstructured":"Kamndaya M, Vearey Jo, Thomas L, Kabiru CW, Kazembe LN. The role of material deprivation and consumerism in the decisions to engage in transactional sex among young people in the urban slums of Blantyre, Malawi. Glob Public Health. 2016;11(3):295\u2013308. https:\/\/doi.org\/10.1080\/17441692.2015.1014393.","journal-title":"Glob Public Health"},{"issue":"10","key":"1407_CR62","doi-asserted-by":"publisher","first-page":"e027047","DOI":"10.1136\/bmjopen-2018-027047","volume":"9","author":"BJ Hall","year":"2019","unstructured":"Hall BJ, Garabiles MR, de Hoop J, Pereira A, Prencipe L, Palermo TM. Perspectives of adolescent and young adults on poverty-related stressors: a qualitative study in Ghana, Malawi and Tanzania. Br Med J. 2019;9(10):e027047. https:\/\/doi.org\/10.1136\/bmjopen-2018-027047.","journal-title":"Br Med J"},{"key":"1407_CR63","first-page":"1","volume":"20","author":"G D\u2019Anna","year":"2021","unstructured":"D\u2019Anna G, Lazzeretti M, Castellini G, Ricca V, Cassioli E, Rossi E, Silvestri C, Voller F. Risk of eating disorders in a representative sample of Italian adolescents: prevalence and association with self-reported interpersonal factors. Eating Weight Disorders-Studies Anorexia, Bulimia Obesity. 2021;20:1\u20138.","journal-title":"Eating Weight Disorders-Studies Anorexia, Bulimia Obesity"},{"key":"1407_CR64","doi-asserted-by":"publisher","DOI":"10.1037\/ort0000583","author":"K Czechowski","year":"2021","unstructured":"Czechowski K, Turner KA, Labelle PR, Sylvestre J. Sexual and romantic relationships among people experiencing homelessness: a scoping review. Am J Orthopsychiatry. 2021. https:\/\/doi.org\/10.1037\/ort0000583.","journal-title":"Am J Orthopsychiatry"},{"key":"1407_CR65","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/j.childyouth.2017.08.011","volume":"81","author":"CE Foster","year":"2017","unstructured":"Foster CE, Horwitz A, Thomas A, Opperman K, Gipson P, Burnside A, Stone DM, King CA. Connectedness to family, school, peers, and community in socially vulnerable adolescents. Child Youth Serv Rev. 2017;81:321\u201331. https:\/\/doi.org\/10.1016\/j.childyouth.2017.08.011.","journal-title":"Child Youth Serv Rev"},{"key":"1407_CR66","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/j.ssresearch.2015.05.004","volume":"53","author":"MW Metzger","year":"2015","unstructured":"Metzger MW, Fowler PJ, Anderson CL, Lindsay CA. Residential mobility during adolescence: do even \u201cupward\u201d moves predict dropout risk? Soc Sci Res. 2015;53:218\u201330. https:\/\/doi.org\/10.1016\/j.ssresearch.2015.05.004.","journal-title":"Soc Sci Res"},{"key":"1407_CR67","doi-asserted-by":"crossref","unstructured":"Gibbs JT. Developing intervention models for black families: Linking theory and research. In Black families 2017 (pp. 325\u2013351). Routledge.","DOI":"10.4324\/9781351316323-22"},{"key":"1407_CR68","doi-asserted-by":"publisher","DOI":"10.1515\/ijamh-2019-0135","author":"T Olaoye","year":"2019","unstructured":"Olaoye T, Agbede C. Prevalence and personal predictors of risky sexual behaviour among in-school adolescents in the Ikenne Local Government Area, Ogun State, Nigeria. Int J Adolesc Med Health. 2019. https:\/\/doi.org\/10.1515\/ijamh-2019-0135.","journal-title":"Int J Adolesc Med Health"}],"container-title":["Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12978-022-01407-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12978-022-01407-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12978-022-01407-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T12:32:58Z","timestamp":1700569978000},"score":1,"resource":{"primary":{"URL":"https:\/\/reproductive-health-journal.biomedcentral.com\/articles\/10.1186\/s12978-022-01407-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,12]]},"references-count":68,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["1407"],"URL":"https:\/\/doi.org\/10.1186\/s12978-022-01407-9","relation":{},"ISSN":["1742-4755"],"issn-type":[{"value":"1742-4755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,12]]},"assertion":[{"value":"10 January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 April 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The data used for the analysis was obtained from a secondary datasets from South Africa, with all identifier information removed. The survey was approved by the Ethics Committee of the Micro at Calverton in the USA and by the National Ethics Committee of each of the countries surveyed. All study participants gave informed consent before participation and all information was collected confidentially. The datasets were downloaded from the DHS website and the data is publicly available and unrestricted re-use for further analysis by researchers is permitted via open-license. Requisite permission in accessing and usage of dataset was obtained from the MEASURE-DHS archive. All methods used in this study are in compliance with the Statistics South Africa (Stats SA) guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"119"}}