Factors associated with early sexual debut among high school adolescents boys and girls in dagoretti district

Abstract

BACKGROUND Early sexual debut puts adolescents at high risk of sexually transmitted infections, HIV/AIDS, unintended pregnancies, unsafe abortions, early marriages, gender based violence and cancer of the cervix. In Sub-Saharan Africa, the onset of sexual activity typically occurs by age 20 with the median age at first intercourse ranging from 16-19 years. Despite continued investments in adolescent sexual and reproductive health, challenges still exist in meeting the reproductive health needs of adolescents. Effective prevention interventions and policies to support postponement of sexual debut to the adult years will need to be evidence based. OBJECTIVE To identify factors associated with sexual debut at or before age 18 years among high school adolescent boys and girls aged 16-19 years in Dagoretti District. METHODOLOGY A Cross-Sectional survey was conducted amongst high schools students within Dagoretti District, Nairobi County. Participants were selected through a stratified multistage purposeful random selection of schools that ensured representation of public and private schools, day and boarding schools and gender. Participants were eligible if they were 16-19 years of age. A self administered structured questionnaire was administered to all eligible students to determine their sociodemographic, individual, family and environmental predictors of early sexual initiation. 2 RESULTS A total 464 students, 220 (47%) male, and 244 (53%) female with a mean age of 17 years were recruited. Overall, 201(43%; 95% CI 39 – 48%) students reported ever having sex and 185(40%; 95% CI 35 – 44%) reported having had their first sexual encounter before the age of 18 years. Sixty percent of the respondents with early sexual debut were male. Girls were more likely to report sexual debut with partners older than themselves compared to boys (91% vs. 40% P<0.001).Personal choice was found to be the main reason why adolescents engage in sex with need to feel rebellious cited by 13.9% of respondents. Compared to when students reported that their main source of information on sex was their parents, the likelihood of early sexual debut increased three times when it was mass media (OR 2.94, 95% CI: 1.17 – 7.35), four times when it was friends (OR 3.92, 95% CI 1.77 – 8.64) and seven times when it was internet (OR 7.0, 95% CI 3.12 – 15.69). Knowledge of family planning was reported by 385(91%) of the respondents with 21% reporting family planning use. Condom use was reported in 68% of respondents with hospitals being the main source of family planning. CONCLUSION Parent modeling and involvement and parent guided sexual education were found to delay sexual initiation among adolescents. RECOMMENDATION There is need for parents to be actively engaged in child upbringing and to adopt healthy recreation for adolescents during school holidays