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ORIGINAL RESEARCH article

Front. Reprod. Health
Sec. Adolescent Reproductive Health and Well-being
Volume 7 - 2025 | doi: 10.3389/frph.2025.1475421

Assessing Factors Influencing Adolescent Sexual Debut in Nigeria: A Multi-Cluster Survival Analysis Approach

Provisionally accepted
Fabio Correa Fabio Correa 1*Peter Enesi Omaku Peter Enesi Omaku 2Braimah Joseph Odunayo Braimah Joseph Odunayo 3
  • 1 University of the Free State, Bloemfontein, South Africa
  • 2 Federal Polytechnic Nasarawa, Nasarawa, Nigeria
  • 3 Ambrose Alli University, Ekpoma, Nigeria

The final, formatted version of the article will be published soon.

    Early sexual debut is an area of concern in Nigeria with implications for reproductive health. This study addresses this by proposing a more effective survival model -one that incorporates both independent and identically distributed (IID) and Besag intrinsically conditional auto-regressive (ICAR) random effect priors, using a generalised additive model that accounts for both individual and spatial influences on age at first sex. We analyse data from the 2018 Nigerian NDHS survey and compare our model with existing models: a model without the cluster frailty effect, a model that ignores the Besag ICAR and includes the IID, and a model that ignores the IID and includes only the Besag ICAR. Our approach, which combines independent and spatial random effects, outperforms others based on statistical criteria (Deviation Information Criterion and the Widely Applicable Information Criterion). As shown in this study, the proposed model effectively captures the complexity of age at first sex. In addition, visualisations reveal significant geographic and social clusters with high rates of early sexual debut in Nigeria. These findings highlight the importance of considering multi-level clustering to better understand and promote healthy sexual behaviour among young Nigerians through targeted interventions.

    Keywords: Generalised additive model, Besag, Conditional auto-regressive, InlA, spatial analysis

    Received: 07 Aug 2024; Accepted: 09 Jan 2025.

    Copyright: © 2025 Correa, Omaku and Odunayo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Fabio Correa, University of the Free State, Bloemfontein, South Africa

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.