Youth who begin early pre-marital sexual activity are more likely to be engaged in unsafe sex. Early sexual debut puts them at increased risk for acquiring or transmitting sexually transmitted infections, including HIV; and makes them highly vulnerable to unwanted pregnancy and its consequences. This study was conducted to assess premarital sexual practices and its predictors among in-school youths in North West Ethiopia.
Effect Of Premarital Sex
A cross-sectional study was carried among 826 in school youths from December; 2011 to January; 2012 in Shendi town. A multistage sampling technique was used to select the study participants. Binary and multiple logistic regression analyses were performed to examine the relationship between premarital sexual practices and selected exposure variables.
Nearly one fifth 157 (19%) of the participants reported having had premarital sexual intercourse, of which 91 (22.7%) were males and 66 (15.5%) were females. The mean (SD) age at first sexual intercourse was 16 .48 (1.59) for males and 15.89 (1.68) for females. More than three - fourth of sexually active in-school youths engaged in premarital sexual relationship before celebrating their 18th birthday. Being greater than 20 years (AOR = 3.67; 95% CI = 1.98, 6.82), living with friends or relatives (AOR = 2.47; 95% CI = 1.46, 4.16), living alone (without parental control (AOR = 2.51; 95% CI = 1.38, 4.55) and watching pornographic movies (AOR = 1.73; 95% CI = 1.18, 2.53) were found to be significantly associated with premarital sexual practices.
A significant number of in-school youths had started premarital sexual activity that might predispose them to different sexual and reproductive health risks. Therefore, various efforts need to be initiated through school-based information, education, and behavioral change communication, interventions, such as life skills education and negotiation.
Early sexual debut increases young peoples' risk for infection with HIV and other STIs. Youth who begin early sexual activity are more likely to be exposed to high-risk sex, often having multiple partners and revealed that premarital sexual practices range from 11.8% to 23.2% among in-school youths.
According to the 2005 Ethiopian behavioral surveillance survey, the prevalence of premarital sexual practices among in-school youths in Amhara Region was 4.5% [4]. Moreover, different studies conducted afterwards in the region showed that premarital sexual practices among in-school youth are increasing. With the higher level of HIV infection and poorer sexual and reproductive health outcomes among youths [5, 6], it is crucial to identify the determinants of sexual activity to inform policy makers and local program managers. However, in-school youth premarital sexual practice and its related health effects were not dealt in-depth within the study area. Besides, most youths in secondary education in Shendi town are living far apart from their families and in an environment away from home without the usual familial control. Therefore, studying premarital sexual practices and its predictors is an essential issue. Thus, this study tried to explore premarital sexual practices and associated factors among in-school youths in Shendi town of North West Ethiopia.
A cross-sectional study with quantitative and qualitative data collection methods was conducted from December 2011 to January 2012 to assess the prevalence of premarital sex and associated sexual and reproductive health risks among in-school youths of Shendi town, West Gojjam Zone, Amhara National Regional State, Ethiopia. The town is located 427 kilo meters to the North West of Addis Ababa. There are 2 high schools in the town - Dejazemach Bekele high school and Mekonnen Shendi preparatory school.
Sample size was calculated using a single population proportion formula based on the assumptions of 20.2% prevalence (P) of premarital sex among in-school youths in Injibara town of Awi zone [5], a 95% confidence level (Za/2), a 4% margin of error (d), a design effect of 2 and a 10% non-response rate. Accordingly, the total sample size calculated was about 851.
The study used premarital sexual practices as the dependent variable and socio demographic characteristics (age, sex, grade, parental education and occupation), peer pressure, substance use (alcohol, cigarette and khat), religion and living arrangement as independent variables.
The quantitative data were first entered into Epi Info version 3.5.1 and later exported to and analyzed using SPSS version 16.0. Descriptive statistics was computed to determine the frequencies of the dependent and independent variables. Bivariate analyses were done to evaluate associations of each independent variable with the outcome variables. Variables which showed significant association with the outcome variables in the bivariate analyses were entered into multiple logistic regression model to control for confounding and identify independent predictors of premarital sexual practices. Statistical significance was set at a P value of
Little more than half 426 (51.6%) of the study participants reported to have ever seen pornographic movies or read some pornographic magazines, while nearly one-third 257 (31%) of the students reported having had boy/girlfriends. Of the total study participants, 157 (19%) reported to have had premarital sexual intercourse at the time of the survey of which 66 (42%) were females. The mean age (SD) at first sexual intercourse was 16.5 (1.6) for males and 15.9 (1.7) for females. Out of all sexually active youths, 20 (12.7%) had their first sexual intercourse before the age of 15 years.
There was a positive association between age, living arrangement and watching pornographic movies with ever having premarital sex. Youths aged 20 years or more were nearly four times more likely to experience premarital sex compared to younger ones (AOR = 3.79, 95%CI = 2.04,7.02). Youths living with their friends or relatives were more than two times more likely to experience premarital sex compared to youths living with both biological parents (AOR = 2.53, 95% CI = 1.50, 4.29). Similarly in-school youths who reported to live alone were more than two times more likely to exercise premarital sex compared to youths living with both biological parents (AOR = 2.62, 95% CI = 1.44, 4.77). The study also showed that youths who reported watching pornographic movies were about two times more likely to experience premarital sex than those who didn't (AOR = 1.74, 95% CI = 1.19, 2.54) (Table 4).
Most students recognize problems associated with premarital sexual practices but they are involved on it. They just practice it because they observe others practicing it. One of the female discussants said,
Majority of the focus group discussants agreed that early sexual initiation and having multiple sexual partners is a common phenomenon in the study area. They emphasized that early and premarital sexual practices are the basis for STIs and HIV/AIDS transmission, unwanted pregnancy, abortion, school dropout and premature death. An 11th grade female student sadly explained how she lost her closest friend:-
The results of this study showed that, among nonsexual risky behaviors, like viewing pornographic materials at earlier age was an independent predictor of premarital sexual initiation. This finding was in agreement with the study conducted in North East Ethiopia [12]. Moreover, premarital sexual activity was found to be significantly more common among youths coming from rural areas compared with in-school youth living in a relatively urban area. The result is consistent with earlier study findings conducted in Nekemte and Tanzania [10, 13]. The most likely explanation is due to a difference in living arrangement, i.e. youth coming from rural areas often live with relatives instead of their biological parents, and thus lack familial control, and lack of adequate knowledge about sexual and reproductive health risks.
Forced sex was most commonly reported in the Amhara region (14.9%) [4]. This particular study was also witnessed that nearly one in six (15.9%) of female students reported forced sexual initiation. Performing premarital sexual practices are statistically significant with age, living arrangement, and watching pornographic movies.
In conclusion, this particular study indicated that a substantial proportion of in-school youths were practicing premarital sexual practices. Being greater than 20 years, students living arrangement (i.e. living with their relatives, friends or alone), and watching pornographic movies were found to be the significant and independent predictors of premarital sexual practice. Also, a significant number of in-school youths had started sexual intercourse very early and are involved with high-risk sexual practices, including multiple sexual partner, unprotected sex and sex with commercial sex workers. Therefore, health care authorities in the different hierarchy should give attention to the identified problems in order to promote the sexual and reproductive health of in-school youth.
Sex differences in CSA and the relationship between CSA and PSP were significant among this large sample of middle school students in Luzhou (China). The findings suggest that experiencing CSA may be closely related to youth attitudes toward premarital sex, especially among males. Therefore, it is important to emphasize the prevention of CSA and provide adolescent reproductive health programs to reduce the impact of CSA on sexual cognition and attitude, prevent premarital sex and promote positive attitudes toward sexual equality for middle school students.
A total of 2396 students were surveyed, and 2292 responses were valid. The sociodemographic characteristics of the respondents are shown in Table 1. More than 50% of the students lived in rural areas. One-third of the respondents had previously dated or fallen in love with somebody. Nearly 70% of respondents reported that their parents and friends did not object to premarital sex, and 16% of the respondents had accessed pornographic content on electronic media (Table 1). 2ff7e9595c
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