Does Youth-Friendly Service Intervention Reduce Risky Sexual Behavior in Unmarried Adolescents? A Comparative Study in West Gojjam Zone, Northwest Ethiopia

Figures & data

Table 1 Distribution of Sociodemographic Characteristics of Respondents by Program and Nonprogram Areas in West Gojjam Zone, Northwest Ethiopia, June 2018

	YFS-Program Status, n (%)		Total (n=1,125)
	Program (n=545)	Nonprogram (n=580)
Sex
Male	318 (58.3)	307 (52.9)	625 (55.6)
Female	227 (41.7)	273 (47.1)	500 (44.4)
Age
15–17 years	221 (40.6)	252 (43.4)	473 (42.0)
18–19 years	324 (59.4)	328 (56.6)	652 (58.0)
Mean (SD)	17.6 (1.3)	17.5 (1.3)	17.6 (1.4)
Religion
Orthodox	532 (97.6)	578 (99.7)	1,111 (98.7)
Muslim	13 (2.4)	2 (0.3)	14 (1.3)
Ethnicity
Amhara	538 (98.7)	565 (97.4)	1,103 (98.0)
Others*	7 (1.3)	15 (2.6)	22 (2.0)
Education
Illiterate	43 (7.9)	37 (6.4)	80 (7.1)
Write and read only	80 (14.7)	102 (17.6)	182 (16.2)
1–8 grade	330 (60.6)	271 (46.7)	601 (53.4)
9–12 grade	92 (16.9)	170 (29.3)	262 (23.3)
Current schooling status
In school	387 (71.0)	353 (60.9)	740 (65.8)
out of school	158 (29.0)	227 (39.1)	385 (34.2)
Living arrangements
With both parents	425 (78.0)	356 (61.4)	781 (69.4)
With single parent	103 (18.9)	143 (24.7)	246 (21.9)
With relative	17 (3.1)	81 (14.0)	98 (8.7)
Receive pocket money
Yes	242 (44.4)	398 (68.6)	640 (56.9)
No	303 (55.6)	182 (31.4)	485 (43.1)
Wealth index
Poorest	20 (3.7)	118 (20.3)	138 (12.3)
Poor	72 (13.2)	203 (35.0)	275 (24.4)
Medium	98 (18.0)	104 (17.9)	202 (18.0)
Rich	206 (37.8)	94 (16.2)	300 (26.7)
Richest	149 (27.3)	61 (10.5)	210 (18.7)
Maternal education
Illiterate	369 (67.7)	462 (79.7)	831 (73.9)
Write and read only	176 (32.3)	118 (20.3)	294 (26.1)
Paternal education
Illiterate	290 (53.2)	244 (42.1)	534 (47.5)
Write and read only	255 (46.8)	336 (57.9)	591 (52.5)

Note: *Oromo, Tigre, and Agew.

Table 2 Distribution of Behavior-Related Characteristics of Unmarried Adolescents by Program/Nonprogram Areas in West Gojjam Zone, Northwest Ethiopia, June 2018

	YFS-Program Status, n (%)		Total (n=1,125)
	Program (n=545)	Nonprogram (n=580)
Ever used alcohol
Yes	392 (71.9)	541 (93.3)	933 (82.9)
No	153 (28.1)	39 (6.7)	192 (17.1)
Ever used khat*
Yes	23 (4.2)	31 (5.3)	54 (4.8)
No	522 (95.8)	549 (94.7)	107 (95.2)
Ever smoked cigarettes
Yes	11 (2.0)	21 (3.6)	32 (2.8)
No	534 (98.0)	559 (96.4)	1093 (97.2)
Watching pornography
Yes	154 (28.3)	184 (31.7)	338 (30.0)
No	391 (71.7)	396 (68.3)	787 (70.0)
Frequency of attending religious institution
Sometimes	373 (68.4)	374 (64.5)	747 (66.4)
Many times	172 (31.6)	206 (35.5)	378 (33.6)
Peer influence
Positive	469 (86.1)	401 (69.1)	870 (77.3)
Negative	76 (13.9)	178 (30.9)	255 (22.7)

Note: Plant with stimulant properties that is chewed.

Table 3 Distribution of Unmarried Adolescents by SRH-Related Knowledge and Attitudes Between Program/Nonprogram Areas in West Gojjam Zone, Northwest Ethiopia, June 2018

	YFS-Program Status, n (%)		Total (n=1,125)	χ^2 P-value
	Program (n=545)	Nonprogram (n=580)
Knowledge on FP
Good	410 (75.2)	385 (66.4)	795 (70.7)	0.001
Poor	135 (24.8)	195 (33.6)	330 (29.3)
Knowledge on HIV
Good	365 (67.0)	125 (21.6)	490 (43.6)	<0.001
Poor	180 (33.0)	455 (78.4)	635 (56.4)
Attitudes toward condom use
Favorable	218 (40.0)	114 (19.7)	332 (29.5)	<0.001
Unfavorable	327 (60)	466 (80.3)	793 (70.5)
SRH-service utilization
Yes	219 (40.2)	138 (23.8)	357 (31.7)	<0.001
No	326 (59.8)	442 (76.2)	768 (68.3)
Attitudes toward premarital sex
Approve	156 (28.7)	109 (18.8)	265 (25.6)	<0.001
Disapprove	389 (61.3)	471 (81.2)	860 (76.4)
t-tests
Attitudes toward SRH-service use, mean (SD)	21.5 (4.1)	21.3 (3.5)	21.4 (3.8)	0.06
Parental knowledge on SRH, mean (SD)	5.24 (1.41)	4.96 (1.48)	5.10 (1.46)	<0.001
Parental attitudes toward SRH-service use by unmarried adolescents, mean (SD)	15.9 (2.7)	14.5 (6.5)	15.2 (5.1)	<0.001
Parent–adolescent communication on SRH, mean (SD)	14.9 (3.4)	13.7 (3.3)	14.3 (3.4)	<0.001

Table 4 Distribution of Unmarried Adolescents’ Sexual Behavior Between Program/Nonprogram Areas in West Gojjam Zone, Northwest Ethiopia, June 2018

	YFS-Program Status, n (%)		Total (n=1,125)	χ^2 P-value
	Program (n=545)	Nonprogram (n=580)
Ever had sex (n=1,125)
Yes	189 (34.7)	220 (37.9)	409 (36.4)	0.26
No	356 (65.3)	360 (62.1)	716 (63.6)
Age at first sex
<18 years	119 (64.3)	135 (60.0)	254 (62.0)	0.41
≥18 years	66 (35.7)	90 (40.0)	156 (38.0)
Age at first sex, mean (SD)	16.9 (1.25)	16.9 (1.21)	16.9 (1.22)	t-test (0.68)
Number of sexual partner ever (n=409)
One	150 (79.4)	187 (85.0)	337 (82.4)	0.152
Two	39 (20.6)	33 (15.0)	72 (17.6)
Ever used condoms (n=409)
Yes	47 (24.9)	51 (23.2)	98 (24.0)	0.725
No	142 (75.1)	169 (76.8)	311 (76.0)
Sex in past 12 months (n=409)
Yes	165 (83.7)	162 (73.6)	327 (80.0)	<0.001
No	24 (12.7)	58 (26.4)	82 (20.0)
Condom use in past 12 months (n=98)
Yes	31 (66.0)	35 (68.6)	66 (67.3)	0.401
No	16 (34.0)	16 (31.4)	32 (32.7)

Table 5 Distribution of Unmarried Adolescents by Sexual Behavior Risk Between Program/Nonprogram Areas in West Gojjam Zone, Northwest Ethiopia, June 2018 (n=1,125)

	YFS-Program Status, n (%)		Total	χ^2 P-value
	Program (n=545)	Nonprogram (n=580)
Risky sexual behavior
First sex before age 15 years (n=409)	6 (3.2)	1 (0.5)	7 (1.7)	0.05
Multiple partners in last 12 months (n=327)	25 (15.2)	17 (10.5)	42 (12.8)	0.24
Inconsistent condom use in last 6 months (n=327)	148 (91.9)	157 (94.6)	305 (93.3)	0.38
Safe sexual behavior
Ever abstained	356 (65.3)	360 (62.1)	716 (63.6)	0.26
Secondary abstinence (n=409)	24 (5.9)	58 (14.2)	82 (20.0)
Consistent condom use in last 6 months (n=327)	13 (8.1)	9 (5.4)	22 (6.7)	0.38
Overall sexual behavior
Safe	409 (75.0)	411 (70.9)	820 (72.9)	0.12
Risky	136 (25.0)	169 (29.1)	305 (27.1)

Table 6 Hierarchical Logistic Regression Model of Unmarried Adolescents’ Individual Attributes, Program, and Interpersonal-Related Variables, West Gojjam Zone, Northwest Ethiopia, June 2018 (n=1,125)

	Sexual Behavior, n (%)		Crude OR (95% CI)	Adjusted OR (95% CI)
	Safe (n=840)	Risky (n=305)		Model I	Model II	Model III
Sex
Male	498 (60.7)	127 (41.6)	1	1	1	1
Female	322 (39.3)	178 (58.4)	2.17 (1.66–2.83)***	4.72 (3.35–6.64)***	5.09 (3.89–8.02)***	5.26 (3.59–7.68)***
Age, mean (SD)	17.4 (1.4)	18.1 (1.1)	1.65 (1.46,1.85)***	1.83 (1.59–2.12)***	1.84 (1.58–2.13)***	1.88 (1.62–2,21)***
Schooling status
In school	579 (70.6)	161 (52.8)	1	1	1	1
out of school	241 (29.4)	144 (47.2)	2.15 (1.65–2.82)***	2.51 (1.59–2.98)***	2.33 (1.66–3.25)***	1.64 (1.12–2.39)**
Receive pocket money
Yes	427 (52.1)	213 (69.8)	1	1	1	1
No	393 (47.9)	92 (30.2)	0.47 (0.36–0.62)***	0.69 (0.49–0.99)***	0.58 (0.39–0.84)*	0.69 (0.45–1.03)
Religious attendance
Sometimes	593 (72.3)	154 (50.5)	1	1	1	1
Many times	227 (27.7)	151 (49.5)	2.56 (1.95–3.36)***	1.45 (1.02–2.05)*	1.30 (0.91–1.86)	1.22 (0.84–1.78)
Watch pornography
No	628 (76.6)	159 (52.1)	1	1	1	1
Yes	192 (23.4)	146 (47.9)	3.00 (2.27–3.96)***	2.52 (1.77–3.59)***	2.58 (1.78–3.73)***	2.35 (1.59–3.47)***
YFS availability
Yes	405 (49.4)	136 (44.6)	1		1	1
No	411(50.6)	169 (55.4)	1.24 (0.95–1.63)^		1.14 (0.81–1.59)	1.08 (0.75–1.56)
Knowledge on FP
Good	552 (67.3)	243 (79.7)	1		1	1
Poor	268 (32.7)	62 (20.3)	0.53 (0.38–0.72)***		0.39 (0.27–0.57)***	0.36 (0.24–0.53)***
Knowledge on HIV
Poor	453 (55.2)	182 (59.7)	1		1	1
Good	367 (44.8)	123 (40.3)	0.83 (0.64–1.08)^		1.28 (0.89–1.84)	2.62 (1.68–4.09)***
Attitudes toward SRH service use, mean (SD)	21.6 (3.8)	21.7 (3.9)	0.96 (0.92–1.01)^		1.03 (0.98–1.07)	1.09 (1.04–1.14)**
Parent’s SRH knowledge, mean (SD)	5.2 (1.5)	4.8 (1.6)	0.92 (0.84–1.01)^			1.03 (0.91–1.16)
Parent’s attitude towards SRH service use, mean (SD)	15.4 (5.7)	14.6 (2.4)	0.91 (0.86–0.96)***			0.90 (0.82–0.99)*
Parent–adolescent communication, mean (SD)	14.8 (3.4)	12.9 (3.1)	0.82 (0.78–0.89)***			0.80 (0.75–0.85)***
Living arrangements
With both parents	586 (71.5)	195 (63.9)	1			1
With single parent	234 (28.5)	110 (36.1)	1.41 (1.07–1.87)**			1.40 (0.95–2.07)
Peer influence
Positive	625 (76.2)	245 (80.3)	1			1
Negative	195 (23.8)	60 (19.7)	0.78 (0.56–1.08)^			0.78 (0.48–1.24)

Note: ***P<0.001; **P<0.01; *P<0.05; ^P<0.2.