Underage marriage, sexual debut, and factors associated with risky sexual behavior among high school students, Sidama Region, southern Ethiopia

Abstract

Background: Most reproductive health problems of youths happen as a result of underage marriage, early sexual debut, and engaging in other risky sexual practices. Little is known about the magnitudes of underage marriage, age at first sexual debut, and factors affecting risky sexual behaviour among students of Sidama Region in Ethiopia. The aim of this study was to determine student’s age at first sexual debut, magnitude of underage marriage and factors associated with risky sexual behaviour.

Methods: A cross-sectional study was conducted using a stratified sampling technique on 1,577 students from May to June 2016. The data were collected using self-administered questionnaires and analyzed using SPSS version 20 and Stata version 12. Descriptive statistics, binary & multivariable logistic regression models were used to determine the magnitude and predictors of risky sexual behavior.

Results: The mean age at first sexual intercourse was 15 years (SD=+3). Sexual debut or proportion of students who started sex at and below the age of 14 years was 20.9 % (95% confidence interval [CI]: 18, 9%-23%). The magnitude of underage marriage was 6.2 %( 95% CI: 5.1%-7.5%). Drinking alcohol was the most important factor associated with risky sex (AOR: 13.2, 95% CI [8.1-21.5]). Other factors include chewing khat (AOR: 2.2, 95% CI: 1.4-3.3), having family growing khat (AOR: 1.6, 95% CI: 1.1-2.2), and living alone or far away from own parents are among some of the factors

Conclusion: A significant proportion of students had early exposure to sex, were engaged in risky sex and in an illegal formal and informal under age marriage.  The study also identified nine modifiable factors associated with student’s risky sexual practice. The observed lower mean age at student’s first sex, student’s early and illegitimate marital engagement and the high magnitude of student’s risky sex demand an urgent, tailored, strategic and concerted effort.