Sexual behavior amongst Youth in Colleges and Youth Centers in Mombasa
Background: Sexual behavior of the youth is an important issue, as it affects many reproductive health and social outcomes. Young age at first sex exposes both male and female youth to multiple adverse health outcomes such as, sexually transmitted infections, HIV/AIDS and negative outcomes of early pregnancy and unsafe abortions .This results in negative social consequences which include premature school dropout and early marriage. The unmet need for contraceptives among the youth in Sub Saharan Africa is more than 40%. In Kenya the youth make up a third of the population. By 19yrs of age 46 % of the Youth have began child-bearing, half of all new HIV infections occur among young people aged 15-24 years and girls are 2-3 times more likely to infected than young men. Sexual of behavior is inadequately studied and understood. This study was designed to address these issues in Mombasa which is an unstudied area. Knowledge on sexual behavior of the youth and associated factors, will allow targeted public health interventions. Objectives: To determine sexual behavior among youth aged 15-24yrs in colleges and youth centers in Mombasa, at sexual debut and subsequent extent of high risk sexual behavior, gender differences in relation to sexual behavior and role of socio economical factors on sexual debut and behavior. Study design: This was a descriptive cross sectional study. Study setting and population: The study was conducted in two colleges and two youth centres in Mombasa District. The study population consisted of youth aged 15-24 years both male and female in post secondary learning institutions and youth centers Method: Following ethical approval by The KNH Ethics and Research Committee, eligible participants were enrolled into the study. Using a structured questionnaire, data was collected, and stored in a password protected computer under custody of the principal investigator 2 Data management: Data was entered using microsoft Access in a password protected computer. The data was thereafter transferred to Stata version 10 (StataCorp, Texas) statistical analysis software for analysis. Results: A total of 190 youth were enrolled in the study, 70% had prior sexual experience. Of the youth enrolled, 48.4% were from youth centers and 51.5% from colleges. Their median age was 22 years .The median age for sexual debut was 17 years among youth enrolled in youth centers and 19 years among college attendants. The majority (89%) of youth initiated sex between ages 15-21 years. Sexual penetration was primarily vaginal but with significant oral (10.4%) and anal (4.4%) penetration reported. A significant proportion of women (16.9%) reported rape and financial gains (13.6%) as reasons for sexual debut. Fifty two percent of youth reported using a condom at last sex and 54% at sexual coitarche. Alcohol use at last sex was reported by 20.7% of the youth. Among the 59 sexually active females, 20(34%) had experienced pregnancy, 10(50%) were unwanted, with 4(20%) reporting procurement of an abortion. Sex in exchange for favors was reported by 11.8% of the youth both male (4.2%) and female (7%) Conclusion: High risk sexual behavior among the youth is prevalent, with low age of sexual debut for male and female. Youth indulge in many high risk behaviors: non traditional methods of penetration, sex in exchange for favors, alcohol use. Youth especially female are at high risk of rape and coercion into sex. On the whole no measures are taken to prevent HIV, STIs and pregnancies. Recommendations: There is need for interventions to curb high risk sexual behavior amongst the youth that should target both male and female equally. Young girls need to be empowered and educated to resist coercion.