Links between premarital sexual behaviour and extramarital intercourse: a multi-site analysis

Abstract
Objectives Data from Côte d'Ivoire, Tanzania, Lusaka and Thailand were used to explore the relationship between premarital and extramarital sexual activity in men. Design Analysis was performed on data collected in the Global Programme on AIDS/WHO programme of stratified probability sample surveys of sexual behaviour of men and women aged 15 to at least 49 years interviewed face to face in 1989/1990. This analysis was restricted to male respondents currently married or in a regular partnership for at least a year. Methods Predictors of extramarital intercourse (EMI) in the preceding year were assessed using crude and adjusted odds ratios (OR), and 95% confidence intervals were calculated for a set of behavioural and sociodemographic variables that were believed a priori to be associated with EMI. Results Bivariate analysis showed that younger age at sexual debut, marriage to someone other than the debut partner and a higher number of sex partners before first marriage were significantly associated with enhanced probability of EMI in the past year in all sites. The adjusted OR indicated that in Côte d'Ivoire and Tanzania the age at debut and in Tanzania and Thailand the number of sex partners before marriage were significantly associated with EMI in the past year. Conclusion Characteristics of premarital conduct such as age at sexual debut, length of acquaintance with debut partner and number of premarital partners were significantly associated with EMI in men later in life. This continuity in sexual conduct over the life course was open to several competing interpretations, but sexual socialization in adolescence was likely to be at least a contributory factor.