Premarital sexual practices and its predictors among in-school youths of shendi town, west Gojjam zone, North Western Ethiopia

Reproductive Health Premarital sexual practices and its predictors among in-school youths of shendi town, west Gojjam zone, North Western Ethiopia Alemayehu Bogale 0 Assefa Seme 1 0 College of Health and Medical sciences, Haramaya University , Haramaya , Ethiopia 1 School of public health, College of Health Sciences, Addis Ababa University , Addis Ababa , Ethiopia Background: Youth who begin early pre-marital sexual activity are more likely to be engaged in unsafe sex. Early sexual debut puts them at increased risk for acquiring or transmitting sexually transmitted infections, including HIV; and makes them highly vulnerable to unwanted pregnancy and its consequences. This study was conducted to assess premarital sexual practices and its predictors among in-school youths in North West Ethiopia. Methods: A cross-sectional study was carried among 826 in school youths from December; 2011 to January; 2012 in Shendi town. A multistage sampling technique was used to select the study participants. Binary and multiple logistic regression analyses were performed to examine the relationship between premarital sexual practices and selected exposure variables. Results: Nearly one fifth 157 (19%) of the participants reported having had premarital sexual intercourse, of which 91 (22.7%) were males and 66 (15.5%) were females. The mean (SD) age at first sexual intercourse was 16 .48 (1.59) for males and 15.89 (1.68) for females. More than three - fourth of sexually active in-school youths engaged in premarital sexual relationship before celebrating their 18th birthday. Being greater than 20 years (AOR = 3.67; 95% CI = 1.98, 6.82), living with friends or relatives (AOR = 2.47; 95% CI = 1.46, 4.16), living alone (without parental control (AOR = 2.51; 95% CI = 1.38, 4.55) and watching pornographic movies (AOR = 1.73; 95% CI = 1.18, 2.53) were found to be significantly associated with premarital sexual practices. Conclusion: A significant number of in-school youths had started premarital sexual activity that might predispose them to different sexual and reproductive health risks. Therefore, various efforts need to be initiated through school-based information, education, and behavioral change communication, interventions, such as life skills education and negotiation. Youths; Premarital sex; Sexual initiation; Ethiopia - Background According to the 2007 Ethiopian census, youths aged 1524 years were more than 15.2 million which contributes to 20.6% of the whole population [1]. These very large and productive groups of the population are frequently exposed to various forms of sexual and reproductive health risks including, sexual coercion, early marriage or sexual debut, female genital cutting, unplanned pregnancies, closely spaced pregnancies, abortion, sexually transmitted infections (STIs), and HIV/AIDS [2,3]. Early sexual debut increases young peoples' risk for infection with HIV and other STIs. Youth who begin early sexual activity are more likely to be exposed to high-risk sex, often having multiple partners and revealed that premarital sexual practices range from 11.8% to 23.2% among in-school youths. Unprotected sexual activity results not only in exposing youths to STIs, including HIV/AIDS, but also unwanted pregnancy for females, which may cause serious health, social and economic problems. In addition, unwanted pregnancy may lead to school dropout and a failure to complete their education. The situation gets worse for those who are not physically and mentally maturated, such as the youth. Most frequently, unwanted pregnancies also end up with unsafe abortion, which can lead to death and loss of life [2]. According to the 2005 Ethiopian behavioral surveillance survey, the prevalence of premarital sexual practices among in-school youths in Amhara Region was 4.5% [4]. Moreover, different studies conducted afterwards in the region showed that premarital sexual practices among inschool youth are increasing. With the higher level of HIV infection and poorer sexual and reproductive health outcomes among youths [5,6], it is crucial to identify the determinants of sexual activity to inform policy makers and local program managers. However, in-school youth premarital sexual practice and its related health effects were not dealt in-depth within the study area. Besides, most youths in secondary education in Shendi town are living far apart from their families and in an environment away from home without the usual familial control. Therefore, studying premarital sexual practices and its predictors is an essential issue. Thus, this study tried to explore premarital sexual practices and associated factors among inschool youths in Shendi town of North West Ethiopia. Methods Study design and setting A cross-sectional study with quantitative and qualitative data collection methods was conducted from December 2011 to January 2012 to assess the prevalence of premarital sex and associated sexual and reproductive health risks among in-school youths of Shendi town, West Gojjam Zone, Amhara National Regional State, Ethiopia. The town is located 427 kilo meters to the North West of Addis Ababa. There are 2 high schools in the town - Dejazemach Bekele high school and Mekonnen Shendi preparatory school. Target population Source population The source population for the study included all inschool youths who were residing in Shendi town or its surrounding kebeles (districts) and who were schooling during the survey. Study population The study population was in-school youths aged 15 to 24 years who were enrolled as a regular day-time student in the 2011/2012 academic calendar. Sampling method and data collection Sample size determination Sample size was calculated using a single population proportion formula based on the assumptions of 20.2% prevalence (P) of premarital sex among in-school youths in Injibara town of Awi zone [5], a 95% confidence level (Za/2), a 4% margin of error (d), a design effect of 2 and a 10% non-response rate. Accordingly, the total sample size calculated was about 851. Sampling strategy A multistage cluster sampling with proportional to size allocation technique was used to select the required number of study subjects as briefly described below. First, thirty four sections were randomly selected out of the total seventy three sections and the samples assigned to each school were distributed proportional to the section size. All never married, day-time; regular students who were aged 15 to 24 years and schooling at the time of the study were identified from the register. Data collection A structured, pre-tested and self-administrated Amharic (a local language) questionnaire was used to collect the required information. Training was given for data collectors and supervisors for 2 days about, the contents of the questionnaire, its administration and issues related to confidentiality of the responses and the rights of the respondents. The data collection was coordinated by (...truncated)