Sexual initiation and associated factors among young women in West Shoa, Ambo Town, Ethiopia: a community-based cross-sectional study

Nigatu et al. BMC Women's Health (2018) 18:76 https://doi.org/10.1186/s12905-018-0563-7 RESEARCH ARTICLE Open Access Sexual initiation and associated factors among young women in West Shoa, Ambo Town, Ethiopia: a community-based cross-sectional study Digafe Tsegaye Nigatu1* , Asefa Seme2, Shewaye Fituma1 and Mesfin Tafa Segni3 Abstract Background: For physiological as well as behavioral reasons, sexual debut increases young individuals’ risk for infection with sexually transmitted infection including HIV. It is fundamental to recognize the factors related to sexual debut in a broader context for designing and implementing effective interventions targeting youth. Methods: Community-based cross-sectional study was employed from January to May, 2013 among females of Ambo town. A multistage sampling technique was applied. The participants were selected using simple random sampling technique. Face to face interview using structured and pretested questionnaires were used to collect thedata from the study participants. Bivariate and multivariate logistic regression analysis was used to determine the predictors of sexual initiation. Results: Three hundred seventeen (49.9%) of the respondents have ever had sex. The mean age at first sexual initiation was 16.6 (SD ±2.3) years. Being in age group 20-24 [Adjusted Odds Ratio (AOR) & (95% CI) = 2.75 (1.74, 4.34)], Educational level [AOR& (95% CI) = 0.20 (0.08, 0.48)], being in school [AOR& (95% CI) = 0.19 (0.11, 0.33)], having paid job [AOR& (95% CI) = 2.20 (1.19, 4.07)], peer pressure [AOR& (95% CI) = 3.20 (2.08, 4.94)], alcohol consumption [AOR& (95% CI) = 2.17 (1.43, 3.28)], and pornographic materials [AOR& (95% CI) = 2.27 (1.43, 3.61)] had significant association with sexual initiation. Conclusion: Substantial numbers of females had started sexual activity that might expose them to different reproductive health problems. In general age group, peer pressure, alcohol consumption and watching pornographic materials were found to be predictors for the sexual debut. Therefore, building life skills, establishing youth friendly clubs should be intensified. Background According to World Health Organization (WHO), youth is defined as an individual aged 15 to 24 years while adolescents are those aged 10 to 19 years and young people as those between the ages of 10 to 24 years old. Adolescence is a period of opportunity and risk when numerous young people practice critical and life-defining experiments such as their first sexual experience, marriage, pregnancy, and parenthood [1]. * Correspondence: 1 Department of Public Health, College of Medicine & Health Sciences, Ambo University, Ambo, Ethiopia Full list of author information is available at the end of the article Worldwide, the youths aged 15 to 24 estimated for more than 1 billion people and the majority live in developing countries [2]. Youth represent slightly more than 20 % of Africa’s population. In sub-Saharan Africa, coitalactivity is not a new phenomenon. In recent, maturity occurs at earlier age, and the time for marriage is increased; due to this fact the practice of sexual activity occur before marriage. Sexual debut increases youths’ risk for infection with numerous reproductive health issues including sexually transmitted infection and HIV [3, 4]. Ethiopia is one of the most fascinating countries in sub-Saharan Africa where there are diverse cultures, traditions, social values and practices that has impact on © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Nigatu et al. BMC Women's Health (2018) 18:76 the sexual debut. Consequently, they become victims of reproductive health problems [5, 6]. Different literatures have demonstrated that the time of sexual initiation among female youths affected by socio-demographic factors and other factors such as pornographic materials, Khat and alcohol [7, 8]. Due to these effects, a substantial proportion of young people are engaged into sexual practice prematurely. So far conducted studies demonstrated that the proportion of premarital sexual activity among 15–24 years young people in Oromia region was 31%, which is significantly higher than the national average (19%). However, factors that influence sexual initiation in Oromia youths have not yet been studied in detail [9]. Due to biological and cultural factors, girls are at a much greater risk at early ages than boys. In Ethiopia, young girls are more vulnerable to HIV than boys because of early age at sexual debut, early marriage, sexual abuse and violence such as rape and abduction [10]. Therefore, this study has been intended to determine the proportion of age at first sex and factors associated with sexual initiation among girls in the Ambo town. Methods Study design and study setting Community-based cross-sectional study design was conducted among females in Ambo town from Jan. to May, 2013. Ambo town is the capital of West Shewa Zone, in Oromia regional state. The town located 114 km west of Addis Ababa and it has three kebeles. According to the town municipality, more than 67,514 populations live in the town in 2009 (2001 E.C) including the population of expansion areas; of which males accounts for 34,276 (50.8%) and females 33,238 (49.2%). Study participants & sample size calculation The respondents were all female youths in the age group of 15 to 24, who lawfully reside in the town at the time of the survey. The sample size was considered by assuming a 95% level of confidence interval, 0.05 margins of error, and with expected prevalence of sexual initiation among female youths 51% [2]. Finally, by considering a design effect of 1.5 and 10% of non-response rate, the final sample size was 675. Sampling procedure Finally, 675 respondents took part in the study. A multistage sampling procedure was employed. The town has three kebeles and two kebeles were selected by a lottery method. We then further subdivided these kebeles by Got (i.e village). From each Got/village, households were selected by simple random sampling, based on proportional allocation of the size of households in each Got or Page 2 of 6 village and using the number of household as a sampling frame. The first households were selected from the town using the town’s house number registration by lottery method. In cases of selected household with more than one eligible study subject, only a single respondent was chosen by random method. In cases (...truncated)