Sexual behaviors and associated factors among youths in Nekemte town, East Wollega, Oromia, Ethiopia: A cross-sectional study

RESEARCH ARTICLE Sexual behaviors and associated factors among youths in Nekemte town, East Wollega, Oromia, Ethiopia: A cross-sectional study Zelalem Desalegn Waktole ID* Department of Public Health, Institute of Health Science, Wollega University, Nekemte, Oromia, Ethiopia * a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: Waktole ZD (2019) Sexual behaviors and associated factors among youths in Nekemte town, East Wollega, Oromia, Ethiopia: A cross-sectional study. PLoS ONE 14(7): e0220235. https://doi.org/ 10.1371/journal.pone.0220235 Editor: Andrew R. Dalby, University of Westminster, UNITED KINGDOM Received: February 1, 2019 Abstract Background Recent trends in sexual behavior, demonstrated in most countries, continue to indicate that more people are adopting safer sexual behaviors. However, there are signs of an increase in risky sexual behaviors in several countries. This study aimed to assess sexual behaviors and associated factors among youths in Nekemte town, East Wollega, Ethiopia in 2017. Methods A community-based cross sectional study was conducted using a self-administered questionnaire. Then, the collected data were analysed using logistic regressions with 95% confidence interval (CI). Besides, the results of data analysis were ‘presented using appropriate descriptive measures and tables. Accepted: July 11, 2019 Published: July 29, 2019 Findings Copyright: © 2019 Zelalem Desalegn Waktole. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Almost half of the respondents, 144(48.6%) had practiced sexual intercourse. Factors associated with ever had sexual intercourse include: being in age group 20-24(AOR = 2.322, 95% CI (1.258, 4.284)), having pocket money (AOR = 1.938, 95% CI (1.057, 3.556)), not attending school (AOR = 2.539, 95% CI (1.182, 5.456)), watching pornography (AOR = 4.314, 95% CI (2.265, 8.216)) and drinking alcohol (AOR = 7.725, 95% CI (3.077, 19.393)). Data Availability Statement: All relevant data are within the manuscript and its Supporting Information files. Funding: The author received no specific funding for this work. Conclusion High proportions of youths were practicing sexual intercourse. Targeting those identified associated factors in future intervention plan would improve the sexual behaviors of youths. Competing interests: The author has declared that no competing interests exist. PLOS ONE | https://doi.org/10.1371/journal.pone.0220235 July 29, 2019 1 / 10 Sexual behaviors and associated factors Introduction Youths are defined as those belonging to the age group of 15 to 24 years. Many important life events and health-damaging behaviors start during the youth years. As a result, youth is a time of both risk and opportunity. The period between the initiation of sexual activity and marriage is often a time of sexual experimentation and may involve risky behaviors [1, 2, 3]. HIV/AIDS has become one of the world’s most serious health and development challenges for the last three decades. UNAIDS reported that globally 33.3 million people were living with HIV at the end of 2009. Sub-Saharan Africa has only 13% of the world’s population but home to more than two-thirds (68%) of people living with HIV which bears an inordinate share of the burden and young people form a significant number in the population [4, 5, 6]. Young people are at the center of the global AIDS epidemic and the 1.7 billion young people worldwide; 5.4 million are estimated to be HIV positive. Young people aged 15–24, account for 41% of new HIV infections (Among those 15 and over) [4, 7]. One of the most severe consequences of HIV/AIDS is the loss of young adults in their most productive years and Ethiopia is one of the most affected countries in East Africa. The expression of the pandemic in the country is primarily young, with the majority of the victims aged 15–24 years [8, 9, 10]. Risky sexual behavior is defined as unprotected vaginal, oral or anal intercourse. Young people who initiate sexual intercourse at an early age face a higher risk of becoming pregnant or contracting an STI than young people who delay the initiation of sexual activity [3, 11]. The burden of risky sexual behaviors is reflected in economic and psychological costs in addition to sexually transmitted infections (ISTs) [12, 13]. Recent trends in sexual behavior, demonstrated in most countries, continue to indicate that more people are adopting safer sexual behaviors. However, there are signs of an increase in risky sexual behaviors in several countries. Recent evidence indicates a significant increase in the number of sexual partners and a decline in condom use in some countries including Ethiopia [14]. Condom use during sexual intercourse is an effective method for avoiding pregnancy and infection from STIs [2]; however, a study showed that significant proportions of respondents do not always use a condom with non-regular partners, though they know that condom use protects from HIV infection. Some even thought that condom is less effective and /or potentially dangerous to disseminate HIV [15]. It is clear that youths living in an urban area are at higher risk because of their sexual behaviors [2]. Accordingly, this study tried to identify factors associated with the sexual behaviors of youths in Nekemte town and the results would contribute as an input for a future intervention plan. Methods and materials The study was conducted in Nekemte town, which is the capital city of East Wollega Zone, Oromiya National Regional State. Nekemte town is located 331 km away from the capital city of the country (Addis Ababa), in the Western direction. The town has 97,877 total populations and divided into six sub-cities. The estimated number of youths in the town with age group 15–24 is 22,480. The study was conducted from July 24 to 29, 2017. Community based quantitative cross-sectional study design was used to collect data using a self-administered questioner. The sample size was calculated using a single population proportion formula by taking 21.5% prevalence of premarital sexual intercourse [16], 5% margin of error and confidence interval of 95%. A design effect of 2 was considered and yielded a 298 final sample size by PLOS ONE | https://doi.org/10.1371/journal.pone.0220235 July 29, 2019 2 / 10 Sexual behaviors and associated factors adding 15% for non-response. Those who had been living in the town at least for the last six months before data collection dates were included. All households which are found in each sub-city were initially mapped and numbered. The study subjects were recruited using probability proportional to the number of households in all sub-cities. Every Kth (the proportion of total youths in each sub-city divided by their respective sample siz (...truncated)