https://orcid.org/0000-0001-7951-0844
Abstract
Background
Early sexual initiation – sexual activity that begun earlier than 18 years of age – is among risky sexual behaviors which may be associated with increased risks of adverse outcomes such as sexually transmitted infections (STIs), unwanted pregnancy and unsafe abortions. However, there is no nationally representative evidence on early initiation of sexual intercourse and its determinant factors among adolescent females in Ethiopia.
Methods
Data were extracted from the 2016 Ethiopian Demographic and Health Survey (EDHS) to assess early initiation of sexual intercourse and factors contributing to it in adolescent females. The analysis included a weighted sample of 3881 adolescent females aged 15–19 years. A multivariable logistic regression analysis was conducted and the results were presented as adjusted odds ratio (AOR) at 95% confidence interval (CI), declaring statistical significance at a p-value <0.05 in all analyses.
Results
About 1 in 5 (21.9%, 95% CI: 20.5%, 23.33%) adolescent females experienced early sexual debut. Administrative regions (Amhara, AOR = 2.3, 95% CI: 1.30, 4.09 and Gambella, AOR = 4.89, CI 95%: 1.08, 22.07), religion (Muslim, AOR = 1.76, 95% CI: 1.24, 2.49), substance use (e.g., ever chewed khat, AOR = 2.02, 95% CI: 1.47, 2.77, ever drunk alcohol, AOR = 1.83, 95% CI: 1.35, 2.48) and having no knowledge on family planning (AOR = 4.47, 95% CI: 2.22, 8.99) were found to have statistically significant association with early sexual debut in adolescent females. Whereas any levels of formal education decreased the odds of early sexual debut (primary, AOR = 0.44, 95% CI: 0.35, 0.56; secondary, AOR = 0.19, 95% CI: 0.13, 0.28, and higher, AOR= 0.31, 95% CI: 0.15, 0.63). Similarly, all categories of wealth indices as compared to the poorest were protective of early sexual initiation in adolescent females (AOR = 0.40–0.57) as was for education as compared to no education (AOR = 0.19–0.44).
Conclusion
A significant proportion of adolescent females initiate early sexual intercourse in Ethiopia and multifaceted factors appear to determine their early sexual experiences. Contextualized interventions including strengthening information, education and communication on adverse consequences of early sexual initiation in regions and improving contraceptive knowledge of teenagers will play a paramount role.
Abbreviations
AOR, adjusted odds ratio; CI, confidence interval; COR, crude odds ratio; CSA, Central Statistical Agency; EDHS, Ethiopian Demographic and Health Survey; WHO, World Health Organization.
Data Sharing Statement
This research uses national survey data that is publicly available for research collected by the Central Statistical Agency [Ethiopia] and ICF. National Demographic and Health Survey of Ethiopia in 2016 [Dataset]. Accessed (http://idhsdata.org). The datasets used and/or analyzed in the current study are available from the corresponding author on reasonable request.
Ethics and Consent Statement
The 2016 EDHS data are available to the general public by request in different formats from the Measure DHS website [http://idhsdata.org]. We applied the measure DHS by briefly stating the objectives of the study and got the permission to download the dataset in SPSS format. Permission letter for access to database was received from Measure DHS, ICF International, Rockville, Maryland, USA.
Acknowledgment
We would like to express our deepest gratitude to Measure DHS, ICF International, Rockville, Maryland, USA, for providing the data for the analysis.
Author Contributions
Conceived and designed the study: ET and BTM; Methodology: BTM, ET and GF; Analysis: BT and ET; Drafting the manuscript and made revisions: BTM, ET, AAA and GF. All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.