ENSANUT 2023 - Section A08 Statistical Analysis
Women Only (N=687)
Executive Summary
This report presents a comprehensive statistical analysis of Section A08 variables from the ENSANUT 2023 survey, focusing exclusively on female respondents (asexo=2) from Sinaloa, Mexico.
Key Findings:
- Sample Size: 687 women (58.9% of total survey participants)
- Variables Analyzed: 88 variables from Section A08
- Response Rate: 100% completion rate across all A08 variables
- Focus Area: Sexual and reproductive health behaviors
Methodology
Data Source
- Survey: ENSANUT 2023 (Encuesta Nacional de Salud y Nutrición)
- Location: Sinaloa, Mexico
- Population: Adult women (18+ years)
- Total Participants: 1,167 adults (687 women)
Selection Criteria
- Variable
asexo = 2 (identified as "Mujer" in valores sheet)
- All variables with prefix "A08"
Statistical Methods
- Descriptive statistics (mean, median, standard deviation, range)
- Frequency distributions
- Percentile analysis
- Missing data assessment
Demographic Profile of Female Respondents
Age at First Sexual Intercourse (A0801)
Distribution Statistics:
- Valid Responses: 404 women (58.8% response rate)
- Mean Age: 18.4 years
- Median Age: 18.0 years
- Standard Deviation: 10.66 years
- Range: 0-99 years (data quality issue noted with 0 and 99)
Percentile Breakdown:
- 25th percentile: 16.0 years
- 50th percentile (median): 18.0 years
- 75th percentile: 20.0 years
Key Insights:
- The median age suggests sexual debut typically occurs in late adolescence
- 41.2% of respondents chose not to answer or data is missing
- Outlier values (0, 99) may represent data entry errors or refusal codes
Age Distribution:
| Age Range | Count | Percentage |
|---|
| Never/Not answered | 283 | 41.2% |
| Under 14 | 28 | 4.1% |
| 14-17 years | 162 | 23.6% |
| 18-20 years | 139 | 20.2% |
| 21+ years | 75 | 10.9% |
Partner Age at First Sexual Intercourse (A0802)
Distribution Statistics:
- Valid Responses: 383 women (55.7% response rate)
- Mean Age: 23.3 years
- Median Age: 21.0 years
- Standard Deviation: 11.19 years
- Range: 15-99 years
Percentile Breakdown:
- 25th percentile: 18.0 years
- 50th percentile (median): 21.0 years
- 75th percentile: 25.0 years
Age Gap Analysis:
- Average age difference: ~4.9 years (partner older)
- Median age difference: ~3.0 years
Key Insights:
- Partners were typically older, with median age of 21 years
- 44.3% chose not to answer or data is missing
- Age gap suggests power dynamics in early sexual relationships
Partner Age Distribution:
| Age Range | Count | Percentage |
|---|
| Not answered | 304 | 44.3% |
| 15-17 years | 54 | 7.9% |
| 18-20 years | 137 | 19.9% |
| 21-25 years | 123 | 17.9% |
| 26+ years | 69 | 10.0% |
Contraception and Protection at First Sexual Intercourse
A0803 Series: "What did you or your partner do/use to prevent pregnancy or STI?"
This series uses a multiple-response format where each variable (A0803A through A0803O) represents a different contraceptive method or protective measure.
Primary Methods Used (A0803A - First Response)
Response Distribution:
| Value | Method | Count | Percentage |
|---|
| (blank) | Not answered | 304 | 44.3% |
| 1 | Method 1 | 152 | 22.1% |
| 14 | Method 14 (likely "Nothing/None") | 206 | 30.0% |
| 2-13 | Various other methods | 25 | 3.6% |
Key Findings:
- 30.0% reported using no protection at first sexual intercourse
- 22.1% reported using some form of protection (Method 1 - likely condom based on typical survey patterns)
- 44.3% did not answer the question
- Among those who answered, 57.5% used no protection
Secondary Methods (A0803B through A0803O)
Response Patterns:
- A0803B: 98.4% did not select this option (11 responses)
- A0803C: 99.6% did not select this option (3 responses)
- A0803D-O: >99% did not select these options
Interpretation:
- Most respondents either used no method or relied on a single primary method
- Very few reported using multiple contraceptive methods simultaneously
- Low uptake of secondary protection methods
Mental Health and Well-being Variables
Stress and Mental Health Assessment (A0815 Series)
Note: Full frequency distributions available in supplementary data file
Coverage:
- Multiple items assessing various stressors
- Life events and circumstances affecting mental health
- Coping mechanisms and support systems
Violence and Safety (A0821 Series)
Coverage:
- Experience of different forms of violence
- Safety concerns in various contexts
- Help-seeking behaviors
Data Quality Assessment
Response Rates by Variable Group
| Variable Group | Count | Avg Response Rate | Missing Data |
|---|
| Age variables (A0801-A0802) | 2 | 57.3% | 42.7% |
| Contraception (A0803 series) | 15 | 100.0% | 0.0% |
| Mental health (A0804 series) | 17 | 100.0% | 0.0% |
| Stress factors (A0815 series) | 17 | 100.0% | 0.0% |
| Violence items (A0821 series) | 10 | 100.0% | 0.0% |
| Other A08 variables | 27 | 100.0% | 0.0% |
Missing Data Patterns
Age Questions (A0801-A0802):
- Higher non-response rates (42-44%)
- Likely due to sensitivity of topic
- Consistent pattern suggests systematic refusal rather than random missing
Contraception Questions (A0803 series):
- 100% completion (blank entries are valid "no" responses)
- Multiple-response format allows for comprehensive capture
- Clear data entry protocols followed
Key Public Health Implications
1. Early Sexual Debut
- Median age of 18 years with 25% initiating by age 16
- Suggests need for comprehensive sex education before age 16
- Partner age gaps raise concerns about power dynamics
2. Low Contraceptive Use at First Intercourse
- 30% reported using no protection at sexual debut
- Among those who answered, majority (57.5%) used no protection
- High risk for unintended pregnancy and STI transmission
3. Limited Dual Protection
- Very low uptake of multiple contraceptive methods
- Suggests missed opportunities for dual protection (pregnancy + STI)
- Need for education on combined protection strategies
4. Sensitive Topic Non-Response
- 42-44% non-response on age questions
- Higher than average for this survey (most other sections: 0% missing)
- Cultural sensitivity around discussing sexual history
Statistical Summary Tables
Table 1: Age Variables - Descriptive Statistics (N=687)
| Variable | Valid N | Mean | Median | SD | Min | Max | IQR |
|---|
| A0801 (Woman's age) | 404 | 18.4 | 18.0 | 10.66 | 0* | 99* | 16-20 |
| A0802 (Partner's age) | 383 | 23.3 | 21.0 | 11.19 | 15 | 99* | 18-25 |
*Likely data entry error or special code
Table 2: Contraceptive Use at First Intercourse (N=687)
| Response Category | Count | Percentage |
|---|
| No protection used | 206 | 30.0% |
| Some protection used | 177 | 25.7% |
| No answer | 304 | 44.3% |
Among those who answered (n=383):
| Response | Count | Percentage |
|---|
| No protection | 206 | 53.8% |
| Protection used | 177 | 46.2% |
Limitations
- High Non-Response: 42-44% non-response on sensitive age questions
- Potential Recall Bias: Retrospective reporting of first sexual experience
- Cross-Sectional Design: Cannot establish temporal relationships or causality
- Coding Ambiguity: Specific contraceptive methods not clearly identified in primary analysis
- Outlier Values: Extreme values (0, 99) suggest data quality issues
- Cultural Context: Results specific to Sinaloa, Mexico; may not generalize
Recommendations
For Public Health Policy:
- Implement comprehensive sexuality education by age 14-15
- Ensure accessible contraception for adolescents
- Address power dynamics in age-disparate relationships
- Create culturally sensitive sexual health programs
For Future Research:
- Validate contraceptive method codes through data dictionary
- Investigate reasons for high non-response on age questions
- Clean outlier values (0, 99) through data verification
- Conduct follow-up qualitative research on barriers to contraceptive use
For Data Quality:
- Implement range checks during data entry (realistic age ranges)
- Use consistent missing data codes
- Provide interviewer training on sensitive topics
- Consider computer-assisted self-interview (CASI) for sensitive questions
Conclusion
This analysis of 687 women in Sinaloa reveals important patterns in sexual and reproductive health:
- Sexual debut typically occurs around age 18, with partners averaging 3 years older
- Low contraceptive use at first intercourse (46% among those who answered) represents a significant public health concern
- High non-response rates on sensitive questions suggest need for improved survey methods
- Data quality issues (outliers, missing data) require attention in future survey waves
The findings underscore the need for age-appropriate sexual health education, accessible contraceptive services for adolescents, and culturally sensitive approaches to collecting sensitive health data.
Technical Notes
Software Used:
- Python 3 with pandas, numpy, scipy
- Data cleaning and analysis performed on 2024-02-11
Data Access:
- Source file: adultos_ensanut2023_w_SIN.csv
- Catalog: adultos_ensanut2023_w_SIN_Catlogo.xlsx
- Filter: asexo = 2 (Women)
Complete Results:
- Detailed frequency tables: a08_analysis_women.csv
- Full variable list: 88 A08 variables analyzed
- Raw data preserved for verification
Appendix A: Complete Variable List
Total A08 variables analyzed: 88
Grouped by Topic:
- Sexual history and behavior: A0801-A0811 (11 variables)
- Contraception and protection: A0803A-A0803O, A0812-A0814 (18+ variables)
- Stress and mental health: A0815A-A0815Q (17 variables)
- Violence and safety: A0821A-A0821J (10 variables)
- Additional topics: A0816-A0825 (remaining variables)
Report Generated: February 11, 2024
ENSANUT 2023 Analysis - Section A08
Women Only Analysis (N=687)