Sexual activity among adolescent school girls in Kisumu County
Background: Adolescents are beginning sexual activity at a young age; most of them have no knowledge on dangers of having unprotected sex. Understanding motives that drive young girls to begin having sex is crucial as it will help in implementing evidence based policies on adolescent reproductive health. Objective: To describe the circumstance and determinants of sexual debut and activity among school girls aged 13-15years in rural set up. Design: Cross-sectional descriptive study. Setting: Primary and Secondary schools in low socio economic (rural) area of Kisumu County. Participants: School going girls between 13-15years. Methods: Eligible girls who gave adolescent assent had their height and weight taken (for B.M.I), breast Tanner staging was done in a private area with a chaperon then the girls were allowed to answer a self administered questionnaire. Results: Sexual activity was generally low, only 22% of the participants had begun sexual activities. Seventy nine percent of sexual debuts took place in home set ups. Sexual debut with neighbors was the most common at 42% while only 4% of sexually experienced girls reported having sexual debut with a stranger. Whereas sex; suggestions (P value = 0.003), opinions about sexual status of their friends (P value <0.001) and drug use (P value = 0.02) were found to increase likelihood of engagement in sexual activities, religiosity (P value = 0.491) and single parented families (P value = 0.326) were. found not to have any risk reduction in this study. Contraceptive use among the sexual debutants was found to be low, only 22.1 % of the sexually active girls recalled using any form of contraception at sexual debut. Age of partners at sexual debut was on average two years older. Seventy nine percent of girls reported having been promised items during sexual debut, with money being the most promised item at 49%. Conclusion: Sexual activity among this age group was generally low. Contraceptive use at sexual debut was also low. Predictors of sexual activities included drut, use, suggestion from friends to have sex and opinion about their peers' sexual status. Peer influence was a big determinant of sexual activity. Sexual debut with strangers is rare. Partners of sexual debutant girls were on average 2 years older. Recommendations: Since the studied population was highly religious as shown by the number of times religious meetings were attended in the preceding month to this study, introduction of sex education in religious meetings from as early as preadolescent could provide an alternative way of educating this population. Drug use by teenagers has to be addressed as an urgent issue and priority Political good will in addressing issues like drug use and implementation of existing laws. An interesting finding in this study was the venue of sexual debut which has not been reported in many studies on adolescent sexuality hence, need for further studies specifically designed to investigate why homes were the preferred venues of sexual debut. Educating mothers on how to handle adolescent reproductive health issues should be encouraged as parents and more so mothers are the primary socializes of their adolescent daughters and need to have skills on how to handle the adolescent reproductive health matters. Promotion of awareness and utilization of youth friendly services to reduce idleness and engage in productive time spending activities.