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Assessment of Time of Sexual Initiation and Its Associated Factors among Students in Northwest Ethiopia

Received: 5 December 2014    Accepted: 17 December 2014    Published: 27 December 2014
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Abstract

Introduction: As many evidences showed, commencing sex at younger age was risk for acquiring HIV (Human Immunodeficiency Virus) and other sexually transmitted infections (STIs) and of experiencing unplanned Pregnancy due to practicing of it without plan/ not using protective materials. In North East Ethiopia, of half (51.3%) of youths initiated sex at median age of 17 years, 39.1% of them were practicing without plan, three quarter (73.1%) were not discussing about contraception and half of them were having more than one sexual partner. In northwest Ethiopian students, the prevalence of HIV infection, and other STIs was 1.1%, and 10.7% respectively and a quarter (24.3%) of students was experiencing pregnancy that was ended with abortion (89%). In parallel, about half of students in similar area was commencing sex at mean age of about 17 years and about half (47.2%) students were having more than one sexual partner though less than half (45.2%) of them were using condom during sexual practice. In the presence of earlier sexual onset and its consequences, there is no prior local evidence. Therefore the current study is aimed to calculate time of sexual debut and to determine its associated factors. Methodology: The study was conducted among 326 systematically selected day time regular Debre Markos preparatory (grade 11-12th) students. Data was collected by pretested Amharic (local language) version self-administered questionnaire. A coded questionnaire was entered by EpiData version 3.1 and analyzed by SPSS version 20. Time of sexual onset was estimated using the actuarial life table and Kaplan Meier survival. Log rank test was used to compare age of sexual debut across categories of categorical variable. Cox proportional-hazard model was used to calculate hazard rate and to determine independent predictors of outcome. Result: Above one third (37.7%) participants were commencing sex. The median time of sexual initiation was 16 years. Of those beginning sex, about 40.7% were not using condom during sex. In multivariate Cox proportional hazard model, predictors that are risk for younger age sexual onset were being female, rural resident, smoker, alcohol drinker, and watching pornography movies. Thus organizations working on school youths should further work to enhance age of sexual onset by giving especial attention for risk groups.

Published in Science Journal of Public Health (Volume 3, Issue 1)
DOI 10.11648/j.sjph.20150301.13
Page(s) 10-18
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Age of Sexual Initiation, Sexual Practice, HIV, STI, youth, Student, Ethiopia

References
[1] Lloyd CB Growing Up Global: The Changing Transitions to Adulthood in Developing Countries: Executive Summary:In (eds Countries., P. O. T. T. A. I. D., Committee on Population and Board on Children, Y., and Families &Education.,D. O. B. A. S. S. A.) The National Academies Press, Washington DC, 2005: 1–14.
[2] Dixon-Mueller R. Starting young: sexual initiation and HIV prevention in early adolescence. AIDS and Behavior 2009; 13:100–109.
[3] Edgardh K. Sexual behaviour and early coitarche in a national sample of 17 year old Swedish girls. Sex Transm Infect 2000; 76:98–102. [PubMed: 10858710]
[4] Humblet O, Paul C, Dickson N. Core group evolution over time: high-risk sexual behavior in a birth cohort between sexual debut and age 26. Sex Transm Dis 2003; 30:818–24. [PubMed: 14603088]
[5] Buston K, Williamson L, Hart G. Young women under 16 years with experience of sexual intercourse: who becomes pregnant? J Epidemiol Community Health 2007; 61:221–5. [PubMed:17325399]
[6] Division of STD Prevention. Sexually Transmitted Disease Surveillance. Atlanta: Centers for Disease Control and Prevention. 2000.
[7] Niccolai LM, Ethier KA, Kershaw TS, Lewis JB, Meade CS, Ickovics JR. New sex partner acquisition and sexually transmitted disease risk among adolescent females. J Adolesc Health2004; 34:216–23. [PubMed: 14967345]
[8] Finer LB, Darroch JE, Singh S. Sexual partnership patterns as a behavioral risk factor for sexually transmitted diseases. FamPlannPerspect 1999; 31:228–36. [PubMed: 10723647]
[9] Kahn JA, Rosenthal SL, Succop PA, Ho GY, Burk RD. Mediators of the association between age of first sexual intercourse and subsequent human papillomavirus infection. Pediatrics 2002; 109:E5. [PubMed: 11773573]
[10] Abma J.C. and F.L. Sorenstein. Sexual Activity and Contraceptive Practices among Teenagers in the United States. 1988 and 1995 Series 23: Data from the National Survey of Family Growth No. 21. U.S. Department of Health and Human Services. 2002.
[11] Burk, R.D., G.Y. Ho, L. Beardsley, M. Lempa, M. Peters, and R. Bierman. Sexual Behavior and Partner Characteristics are the Predominant Risk Factors for Genital Human Papilloma Virus Infection in Young Women. Journal of Infectious Diseases 1996; 174:679–89.
[12] Burkett B.J, C.M. Peterson, L.M. Birch, C. Brennan, M.L. Nuchols, and B.E. Ward. The Relationship Between Contraceptives, Sexual Practices, and Cervical Human Papilloma Virus Infection Among a College Population. The Journal of Clinical Epidemiology 1992; 45: 1295–302.
[13] Kahn J.A., S.L. Rosenthal, P.A. Succop G.Y.F. Ho, and R.D. Burk. The Interval Between Menarche and Age of First Sexual Intercourse as a Risk Factor for Subsequent HPV Infection in Adolescent and Young Adult Women. Journal of Pediatrics 2002; 141:718–23.
[14] Latka M., J. Ahern, R.S. Garfein, L.Ouellet, P. Kerndt, P. Morse,et al. Prevalence, Incidence, and Correlates of Chlamydia and Gonorrhea Among Young Adult Injection Drug Users.Journal of Substance Abuse 2001;13:73–88.
[15] L.C. H. Bauer, A. Reingold, M.H. Schiffman, J.C. Chambers, C.J. Tashiro, and M.M. Manos. Determinants of Genital Human Papilloma Virus Infection in Young Women.Journal of the National Cancer Institute 1991; 83:997–1003.
[16] Simon G., Constance A. N., Geoffrey P G, Peter R.M., Tom Z., Michel C., et al. Sexual mixing patterns and sex-differentials in teenage exposure to HIV infection in rural Zimbabwe. Lancet 2002; 359: 1896–903
[17] Audrey P., KatieO.B.,CatherineM.P.,William C.M. and Helen R. Early Coital Debut and associated HIV Risk Factors among Young Women and Men in South Africa.International Perspectives on Sexual and Reproductive Health 2009;35(2):74–82.
[18] T B.H., S.Gregson, J.J.C. Lewis, B.A.Lopman, G. P. Garnett. Behavior change in generalized HIV epidemics: impact of reducing cross-generational sex and delaying age at sexual debut. Sex Transm Infect 2007; 83: i50-i54
[19] World Health Organization (WHO) Report on the Global AIDS epidemic. Switzerland, Geneva. 2012.
[20] R.Jewkes, K.Dunkle, M.Nduna, J. Levin, N.Jama, N.Khuzwayo, et al. Factors associated with HIV sero-positivity in young, rural South African men. International Journal of Epidemiology 2006;35:1455–1460
[21] R.Jewkes, K.Dunkle, M. Nduna, J. Levin, N.Jama, N.Khuzwayo, et al. Factors associated with HIV sero-status in young rural South African women: connections between intimate partner violence and HIV. International Journal of Epidemiology 2006;35:1461–1468
[22] Federal Democratic Republic of Ethiopia (FDRE), Country progress report on HIV/AIDS response. Addis Ababa, Ethiopia. 2012.
[23] Federal Democratic Republic of Ethiopia, ministry of health/national HIV/AIDS prevention and control office, AIDS in Ethiopia six report. Addis Ababa, Ethiopia. 2010.
[24] Central Statistical Agency (CSA) (2011) Ethiopia Demographic and Health Survey; final draft report. ICF International Calverton, Maryland, USA.
[25] Gashaw A., Afework K., Feleke M., Yigzaw K., Molla G.et al.Low prevalence of HIV infection and knowledge, attitude and practice on HIV/AIDS among high school students in Gondar, Northwest Ethiopia. Ethiop.J.HealthDev2007; 21(2):179-182.
[26] Abma, J., A. Chandra, W. Mosher, L. Peterson, and L. Piccinino. Fertility, Family Planning, and Women’s Health: New Data From the 1995 National Survey of Family Growth.Vital Health Statistics, Series 23, No. 19. Hyattsville, MD: National Center for Health Statistics. 1997.
[27] Mosher W.D. and J.W. McNally.Contraceptive Use at First Premarital Intercourse: United States, 1965–1988.Family Planning Perspectives 1991; 23(3):108–16.
[28] Sonenstein F.L., J.H. Pleck, and L.C. Ku.Sexual Activity, Condom Use, and AIDS Awareness Among Adolescent Males. Family Planning Perspectives 1989; 21(4):152–58.
[29] A.M. Doyle1, Sue Napierala M., M.L. Plummer and D.A. Ross. The sexual behavior of adolescents in sub-Saharan Africa: patterns and trends from national surveys Tropical Medicine and International Health July 2012 ; 17: 796–807
[30] Martinez G., Copen C.E., Abma J.C. Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, 2006–2010 National Survey of Family Growth. National Center for Health Statistics. Vital Health Stat 2011; 23(31).
[31] A Harrison, J Cleland, E Gouws, J Frohlich. Early sexual debut among young men in rural South Africa: heightened vulnerability to sexual risk? Sex Transm Infect 2005; 81:259–261.
[32] Trends in the Prevalence of Sexual Behaviors and HIV Testing National Youth Risk Behavior Survey: 1991–2011. Visit www.cdc.gov/yrbss or call 800−CDC−INFO (800−232−4636).
[33] Alemayehu S., Mesganaw F., Alemayehu W. Reproductive health needs of out-of-school adolescents: Across-sectional comparative study of rural and urban areas in northwest Ethiopia. Ethiop J Health Dev 2006; 20(1):10–17.
[34] Antenane K., Mesfin H. Sexual behaviour and level of awareness on reproductive health among youths: Evidence from Harar, EasternEthiopia. Ethiop. J. Health Dev.1999;13(2):107-113
[35] YeshalemMulugeta.andYemane B. Factors associated with pre-marital sexual debut among unmarried high school female students in bahir Dar town, Ethiopia: cross- sectional study. Reproductive Health 2014, 11:40. http://www.reproductive-health-journal.com/content/11/1/40.
[36] Fekadu M., Alemayehu W. Age at sexual initiation and factors associated with it among youths in North East Ethiopia. Ethiop J Health Dev 2009; 23(2):154–162.
[37] Shiferaw Y., Alemu A., Girma A., Getahun F., Kassa A., Gashaw A. et al. Assessment of knowledge, attitude and risk behaviors towards HIV/AIDS and other sexual transmitted infection among preparatory students of Gondar Northwest Ethiopia. BMC research notes 2011; 4:505.
[38] Abraha T. and Berhanu M. Knowledge, attitude and practice regarding HIV/AIDS among secondary school students in Mekelle City, Ethiopia. Afr. J. AIDS 2013;1(1) :001-007.
[39] Lemessa O., Yemane B. and Alemayehu W. Pre-marital sexual debut and its associated factors among in-school adolescents in eastern Ethiopia. BMC Public Health 2012; 12:375. http://www.biomedcentral.com/1471-2458/12/375
[40] R. j. Diclemente, G.M. Wingood, C.SioneAn, R. Crosby, K. Harrington, S. Davies, et al. Association of Adolescents’ History of Sexually Transmitted Disease (STD) and Their Current High-Risk Behavior andSTD Status A Case for Intensifying Clinic-Based Prevention Efforts. Sexually Transmitted Diseases September 2002; 29;9
[41] Marelign T. and Gistane A. Factors associated with age at first sexual initiation among youths in Gamo Gofa, South West Ethiopia:a cross sectional study. BMC Public Health 2013; 13:622. http://www.biomedcentral.com/1471-2458/13/622.
[42] Ronan V. R., Hans B., Charlotte V. T. AIDS knowledge and sexual activity among Flemish secondary school students: a multilevel analysis of the effects of type of education. BMC Public Health 2010, 10:30. http://www.biomedcentral.com/1471-2458/10/30.
[43] Young H. K., Nam C. P., Hyun J. P., Eun Y. Y. Factors Associated with the Timing of First Sexual Intercourse Among College Students in Busan, Korea. Korean J Androl. August 2011; 29 (2). http://dx .d oi.org/10.5534 /k ja .2 011.29.2.134.
[44] Vera P., Gabriela C., Gustavo V., Rita D., Grupo de E.dP., Sexualidade A. Age and condom use at first sexual intercourse of Brazilian Adolescents. Rev SaúdePública 2008;42(l. 1)
[45] Mitike M., Yemane B., BerntL.Traditional values of virginity and sexual behavior in rural Ethiopian youth: results from a cross-sectional study. BMC Publ Health 2008; 8:9.
[46] Getachew M. K., Emebet B. W.&Nurilign A. M. Prevalence of Premarital Sexual Practice and Associated Factors among Alamata High School and Preparatory School Adolescents, Northern Ethiopia. Global Journal of Medical research: k Interdisciplinary 2014; 14 (3) : 1
[47] Eric W.O., Richard J.B., Jill C.M., Rory C.R. The impact of internet pornography on adolescents: a review of the research. Sex Addict Compuls J Treat Prev 2012, 19(1–2):99–122.
[48] Solomon S., Woldaregay E., Girmay M. and Desalegn W. Perception of High School Students on risk for acquiring HIV and utilization of Voluntary Counseling and Testing (VCT) service for HIV in Debre-berhan Town, Ethiopia: a quantitative cross-sectional study. BMC Research Notes 2014, 7:518. http://www.biomedcentral.com/1756-0500/7/518
[49] Donatella P., Daniela A., Cecilia T., Francesca C., Piero L.L., Paolo B., et al. Sexual behavior and risk factors for the acquisition of human papillomavirus infections in young people in Italy: suggestions for future vaccination policies. BMC Public Health 2012; 12:623. http://www.biomedcentral.com/1471-2458/12/623
[50] Ismail S., Bitsuamlak H., Alemu K. High Risk Sexual Behaviors for STD/HIV, Pregnancies and Contraception among High School Students in a Rural Town, North Western Ethiopia. Ethiop J Health Dev 1997; 11(1):29–36.
[51] M. Nyirenda, V. Hosegood, M-L Newell. Age at first sex in rural South Africa. Sex Transm Infect 2009; 85(Suppl I):i49–i55.
[52] Derege K., Atalay A., Getnet M., Fikre E., Frehiwot B., Yigeremu A., et al. Khat and alcohol use and risky sex behaviour among in-school and out-of-school youth in Ethiopia BMC Public Health 2005, 5:109 doi:10.1186/1471-2458-5-109
[53] Moges T.Substance abuse and sexual HIV-risk behaviour among Dilla University students, Ethiopia. Educational Research (ISSN: 2141-5161) November 2014; 5(9):368-374. http://www.interesjournals.org/ER
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    Habtamu Mellie Bizuayehu, Direslgne Misker Abyu, Hailu Fekadu Demessie. (2014). Assessment of Time of Sexual Initiation and Its Associated Factors among Students in Northwest Ethiopia. Science Journal of Public Health, 3(1), 10-18. https://doi.org/10.11648/j.sjph.20150301.13

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    Habtamu Mellie Bizuayehu; Direslgne Misker Abyu; Hailu Fekadu Demessie. Assessment of Time of Sexual Initiation and Its Associated Factors among Students in Northwest Ethiopia. Sci. J. Public Health 2014, 3(1), 10-18. doi: 10.11648/j.sjph.20150301.13

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    AMA Style

    Habtamu Mellie Bizuayehu, Direslgne Misker Abyu, Hailu Fekadu Demessie. Assessment of Time of Sexual Initiation and Its Associated Factors among Students in Northwest Ethiopia. Sci J Public Health. 2014;3(1):10-18. doi: 10.11648/j.sjph.20150301.13

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  • @article{10.11648/j.sjph.20150301.13,
      author = {Habtamu Mellie Bizuayehu and Direslgne Misker Abyu and Hailu Fekadu Demessie},
      title = {Assessment of Time of Sexual Initiation and Its Associated Factors among Students in Northwest Ethiopia},
      journal = {Science Journal of Public Health},
      volume = {3},
      number = {1},
      pages = {10-18},
      doi = {10.11648/j.sjph.20150301.13},
      url = {https://doi.org/10.11648/j.sjph.20150301.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20150301.13},
      abstract = {Introduction: As many evidences showed, commencing sex at younger age was risk for acquiring HIV (Human Immunodeficiency Virus) and other sexually transmitted infections (STIs) and of experiencing unplanned Pregnancy due to practicing of it without plan/ not using protective materials. In North East Ethiopia, of half (51.3%) of youths initiated sex at median age of 17 years, 39.1% of them were practicing without plan, three quarter (73.1%) were not discussing about contraception and half of them were having more than one sexual partner. In northwest Ethiopian students, the prevalence of HIV infection, and other STIs was 1.1%, and 10.7% respectively and a quarter (24.3%) of students was experiencing pregnancy that was ended with abortion (89%). In parallel, about half of students in similar area was commencing sex at mean age of about 17 years and about half (47.2%) students were having more than one sexual partner though less than half (45.2%) of them were using condom during sexual practice. In the presence of earlier sexual onset and its consequences, there is no prior local evidence. Therefore the current study is aimed to calculate time of sexual debut and to determine its associated factors. Methodology: The study was conducted among 326 systematically selected day time regular Debre Markos preparatory (grade 11-12th) students. Data was collected by pretested Amharic (local language) version self-administered questionnaire. A coded questionnaire was entered by EpiData version 3.1 and analyzed by SPSS version 20. Time of sexual onset was estimated using the actuarial life table and Kaplan Meier survival. Log rank test was used to compare age of sexual debut across categories of categorical variable. Cox proportional-hazard model was used to calculate hazard rate and to determine independent predictors of outcome. Result: Above one third (37.7%) participants were commencing sex. The median time of sexual initiation was 16 years. Of those beginning sex, about 40.7% were not using condom during sex. In multivariate Cox proportional hazard model, predictors that are risk for younger age sexual onset were being female, rural resident, smoker, alcohol drinker, and watching pornography movies. Thus organizations working on school youths should further work to enhance age of sexual onset by giving especial attention for risk groups.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Assessment of Time of Sexual Initiation and Its Associated Factors among Students in Northwest Ethiopia
    AU  - Habtamu Mellie Bizuayehu
    AU  - Direslgne Misker Abyu
    AU  - Hailu Fekadu Demessie
    Y1  - 2014/12/27
    PY  - 2014
    N1  - https://doi.org/10.11648/j.sjph.20150301.13
    DO  - 10.11648/j.sjph.20150301.13
    T2  - Science Journal of Public Health
    JF  - Science Journal of Public Health
    JO  - Science Journal of Public Health
    SP  - 10
    EP  - 18
    PB  - Science Publishing Group
    SN  - 2328-7950
    UR  - https://doi.org/10.11648/j.sjph.20150301.13
    AB  - Introduction: As many evidences showed, commencing sex at younger age was risk for acquiring HIV (Human Immunodeficiency Virus) and other sexually transmitted infections (STIs) and of experiencing unplanned Pregnancy due to practicing of it without plan/ not using protective materials. In North East Ethiopia, of half (51.3%) of youths initiated sex at median age of 17 years, 39.1% of them were practicing without plan, three quarter (73.1%) were not discussing about contraception and half of them were having more than one sexual partner. In northwest Ethiopian students, the prevalence of HIV infection, and other STIs was 1.1%, and 10.7% respectively and a quarter (24.3%) of students was experiencing pregnancy that was ended with abortion (89%). In parallel, about half of students in similar area was commencing sex at mean age of about 17 years and about half (47.2%) students were having more than one sexual partner though less than half (45.2%) of them were using condom during sexual practice. In the presence of earlier sexual onset and its consequences, there is no prior local evidence. Therefore the current study is aimed to calculate time of sexual debut and to determine its associated factors. Methodology: The study was conducted among 326 systematically selected day time regular Debre Markos preparatory (grade 11-12th) students. Data was collected by pretested Amharic (local language) version self-administered questionnaire. A coded questionnaire was entered by EpiData version 3.1 and analyzed by SPSS version 20. Time of sexual onset was estimated using the actuarial life table and Kaplan Meier survival. Log rank test was used to compare age of sexual debut across categories of categorical variable. Cox proportional-hazard model was used to calculate hazard rate and to determine independent predictors of outcome. Result: Above one third (37.7%) participants were commencing sex. The median time of sexual initiation was 16 years. Of those beginning sex, about 40.7% were not using condom during sex. In multivariate Cox proportional hazard model, predictors that are risk for younger age sexual onset were being female, rural resident, smoker, alcohol drinker, and watching pornography movies. Thus organizations working on school youths should further work to enhance age of sexual onset by giving especial attention for risk groups.
    VL  - 3
    IS  - 1
    ER  - 

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Author Information
  • Debre Markos University, College of medicine and health science, public health department, Debre Markos, Ethiopia

  • Arba Minch University, Department of Public Health, Arba Minch, Ethiopia

  • Adama University, Department of Public Health, Asela, Ethiopia

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