Article

Research

Assessment of risky sexual behaviours and associated

Mulualem Girma Bizuwork, Awraris Hailu, Mitku Mammo Taderegew, Yonas Girma Bizuwork, Abraham Alebie,
Betregiorgis Zegeye

Corresponding author: Mitku Mammo Taderegew, Department of Biomedical Sciences, College of Medicine and Health
Sciences, Wolkite University, Wolkite, Ethiopia. [email protected]

Received: 31 Aug 2020 - Accepted: 03 Mar 2022 - Published: 31 Mar 2022

Keywords: Adolescent, sexual behaviours, associated factors, Ethiopia

Copyright: Mulualem Girma Bizuwork et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article
distributed under the terms of the Creative Commons Attribution International 4.0 License
(https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any
medium, provided the original work is properly cited.

Cite this article: Mulualem Girma Bizuwork et al. Assessment of risky sexual behaviours and associated factors among
adolescents in Shewa Robit Town, Northeast, Ethiopia: a cross-sectional study. Pan African Medical Journal.
2022;41(264). 10.11604/pamj.2022.41.264.25846

Available online at: https://www.panafrican-med-journal.com//content/article/41/264/full

Assessment of risky sexual behaviours and Sciences, College of Medicine and Health Sciences,
associated factors among adolescents in Shewa Wolkite University, Wolkite, Ethiopia, 4USAID HIV
Robit Town, Northeast, Ethiopia: a cross-sectional Control Grant, Addis Ababa, Ethiopia, 5HaSET
study Maternal and Child Health Research Program,
Shewa Robit Field Office, Shewa Robit, Ethiopia
Mulualem Girma Bizuwork1, Awraris Hailu2, Mitku
&
Mammo Taderegew3,&, Yonas Girma Bizuwork4, Corresponding author
Abraham Alebie5, Betregiorgis Zegeye5 Mitku Mammo Taderegew, Department of
Biomedical Sciences, College of Medicine and
1
Kewot Health Office, Shewa Robit, Ethiopia, Health Sciences, Wolkite University, Wolkite,
2
Department of Public Health, Institute of Medicine Ethiopia
and Health Science, Debre Berhan University,
Debre Berhan, Ethiopia, 3Department of Biomedical
 Article
Abstract world total population. Adolescents are often
exposed to a range of risky behaviours [1]. Such
Introduction: adolescents are at high risk of risky behaviours are highly linked with sexual
engaging in risky sexual behaviours that could abuse, unwanted pregnancies, septic abortions,
predispose them to several health problems. and substance abuse [2-5]. Evidence shows that
Cognizant of these facts, studies addressing the nearly 35% of disease burden in the globe has roots
root causes for risky sexual behaviours in risk areas in adolescence [6]. According to the World Health
like Shewa Robit are mandatory. Therefore, the Organization (WHO) 2016 reports, more than 1.1
study was conducted to assess risky sexual million adolescents aged 10-19 years died annually,
behaviours and its determinants in Shewa Robit mostly from preventable causes related to risky
town, Northeast Ethiopia. Methods: an behaviour [1]. Additionally, due to these risky
institutional-based cross-sectional study was behaviours, there were between 1 million and 4.4
conducted among 349 students using quantitative million abortions annually among young women
and qualitative approaches. For the quantitative and most of these unsafe abortions are with grave
study, data entry and analysis was done by using consequences; the great majority in the sub-
Epidata-3.1 and statistical package for social Saharan African region [7].
sciences (SPSS)-20, respectively. Binary and multiple
Risky sexual behaviour is defined as any sexual
logistic regression analysis was used to identify
activity that may expose an individual to the risk of
factors associated with risky sexual practices. Odds
sexually transmitted infections (STIs) including
ratio with 95% confidence interval (CI) was used for
Human immune deficiency virus (HIV), unplanned
measuring the strength of association. Variables
pregnancies, unsafe abortion, and psychosocial
with P-value of <0.05 were considered statistically
problems. The extent of risky sexual behaviour
significant. Collected data from the qualitative
doesn´t always limit to risk lifestyle, but it also
study was debriefed, categorized, coded and
complemented other risk behaviours such as poor
common themes were generated manually. Finally,
school performance, substance abuse, violence
the findings were triangulated with quantitative
involvement, and impede their health throughout
findings. Results: a total of 338 respondents
the lifecycles ahead [2, 7, 8]. Studies in Ethiopia still
involved in the study. Overall, 168 (49.7%) of
showed that, a considerable number of students
respondents have had risky sexual behaviour.
had practised risk sexual behaviours. This level
Alcohol consumption (Adjusted odd ration
ranges from 23% in Arba Minch [9] to 49% in
(AOR)=5.01, 95%CI; 2.12-11.79), peer pressure
Nekemte [10]. Furthermore, 56.9% and 44.6% of
(AOR=5.82, 95%CI; 2.97-11.41), grade level
them have not used a condom during the first and
(AOR=5.82, 95%CI; 2.06-16.45), and family size
last times of sexual intercourse, respectively in
(AOR=5.19, 95%CI; 2.24-12.01) were significantly
Addis Ababa [11].
associated with risky sexual behaviour. Conclusion:
risky sexual behaviour in the study area was high. Cognizant of the above facts, further studies
Several families and school-level factors were found addressing the root causes of risky sexual
to be major determinants of risky sexual behaviours among adolescents in risk areas like
behaviours. Public health interventions focusing on Shewa Robit are mandatory. Besides, there is no
adolescent sexual health should be targeted to save baseline study conducted so far in the study area
those risky adolescents. through divergent study findings reported in
different parts of Ethiopia and most of them are
Introduction quantitative studies. Therefore, this study is aimed
to assess risky sexual behaviours and its
Adolescence is the age of transition from childhood determinant factors with a mixed approach.
to adulthood and accounts for one in six of the

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Methods The lists of all students (9-12 grades) were prepared
from the students´ registration book of each school
Study setting and design: a descriptive institution and grade as a sampling frame. Then, the number
based cross-sectional study was conducted among of male and female students who were selected
adolescents attending high school and preparatory from each grade was determined proportionally.
school in Shewa Robit town, Northeast of Ethiopia Finally, a simple random sampling (lottery) method
from April 1 to 30/ 2020. Shewa Robit town is was used to select each study participants (Figure
located in 220 km Northeast of Addis Ababa, the 1A). For the qualitative method, the study
capital city of Ethiopia. According to the local participants were selected through a purposive
government authority report, Shewa Robit town sampling method by considering their work
has an estimated population of 74, 886 of whom, experience, willingness to take part in the
39063 were male and 35, 595 females. Its weather discussion, and accessibility. A total of four FGD and
condition is very hot and belongs to lowland with six in-depth interviews have been carried out
longitude and latitude of 10˚00' N 39˚54´E with an among teachers/principal directors, students,
elevation of 1280m above sea level. In the area, health administrative officers, and Shewa Robit
adolescents account for 30% of the total figure. A town administrative women affairs office. The
total of 3566 (2046 male and 1520 female) students information saturation level ultimately determines
are enrolled in 2019/2020 fascia year. In terms of whether to end in-depth interviews and FGDs
infrastructure facilities, there are two primary (Figure 1B).
schools, one secondary school, and one
Data collection procedures: both quantitative and
preparatory school.
qualitative data collection methods were
Study population and sample size determination: employed. For the quantitative part, a pre-tested,
all adolescents attending high school and self-administered structured questionnaire was
preparatory schools in Shewa Robit town were the used for collecting the data. The tool was adapted
source population and all selected adolescents from Sexual and Reproductive Health (SRH)
attending high school and preparatory schools questionnaires of the WHO +9 [1]. The
were the study population. All in-school questionnaire was originally prepared in English
adolescents attending secondary and preparatory and then was translated to the local language,
school regularly or at day time were eligible for the Amharic, and then back-translated to the English
study, whereas adolescents who were severely ill language to check for its consistency. Then the final
during data collection, extension students, and Amharic form of the questionnaire was used to
those who were not capable of participating were collect the data. Information on socio-demographic
excluded. The required sample size for the characteristics (age, religion, ethnicity, grade level,
quantitative study was determined using a family educational status, monthly income of the
confidence level of 95%, marginal error 5%, and by family, and family marital status), substance abuse
considering a 27% proportion from the previous (alcohol consumption, chat chewing, and tobacco
study [8]. Finally, by considering a 15% non- smoking), sexual behaviours, peer and media
response rate, the final sample size was 349. For related factors were incorporated.
the qualitative data, a total of 4 focus group
The questionnaire was pretested on 7% of the
discussions (FGDs) and 6 in-depth interviews have
sample size in Armanya secondary school which is
been carried out based on the information
not part of the actual data collection site.
saturation level.
Accordingly, all the necessary modification and
Sampling techniques: for the quantitative method, correction measures were applied. A total of five
initially identification of the details of the number diploma nurses data collectors and two supervisors
of schools, classes, and sections were conducted. (public health professional) were recruited to

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facilitate data collection. Two-days training was used for measuring the strength of association.
given for data collectors and supervisors by the Variables with a P-value of <0.05 was considered as
principal investigator on the objectives of the study, statistically significant.
data collection procedure, data collection tools,
and confidentiality of information. The principal Ethics approval and consent to participate: ethical
investigator closely supervised the overall data clearance was obtained from the Ethical Review
collection environment and process. Moreover, the Board (IRB) Debre Berhan University. Then
collected data were reviewed daily to safeguard its Permission and supportive letter to carry out the
completeness. study was also obtained from each school. Before
the actual data collection, written informed
For the qualitative part, a semi-structured consent was obtained from the study participants
questionnaire guide or checklist was used. One aged 18 years and above. However, some study
master of public health (MPH) holder moderator participants were children (under 18 years of age).
was hired to moderate FGDs. Interviews and FGDs Thus, written informed consent was taken from
were held in quiet settings. All the discussions and their parents through referring the letter to them
interviews were tape-recorded. At the end of each at home, and also assent was obtained from those
FGD and interview, the collected information was participants age less than 18 years. Detail
debriefed, cleaned, and expanded before clarification about the purpose and advantage of
proceeding to the next. Finally, common themes the study was explained to the study participant to
and sub-themes were synthesized and triangulated safeguard their full collaboration. Confidentiality of
with quantitative findings. collected information from each study participant
was ensured throughout the study. This is an
Operational definitions original study that has not been published before
and that is not currently under consideration by any
Risky sexual behaviour: if a student owns at least other journal.
one of the following: had multiple sexual partners,
had sex without a condom with a casual partner,
used condom inconsistently with a casual partner
Results
in the past 12 months, had sex before the age of 18.
Socio-demographic characteristics of the study
Consistent condom use: using a condom during or participants: a total of 349 students were invited
at every sexual encounter. and 338 of them were volunteered to participate in
the study, yielding the response rate 96.8%. The
Data processing and analysis: the collected data mean age of respondents was 16.38 (±1.27) years.
was carefully counted and checked at the end of More than half (55.6%) of the respondents were
data collection. Then, it was cleaned, coded, and male. The majority (86.4%) of respondents were
entered into Epidata version 3.1 and imported into Amhara by ethnicity and two hundred twenty-six
statical package for social sciences (SPSS) version (66.9%) were Orthodox Christian followers.
20 for analysis. Descriptive statistics including Regarding marital status, almost all (97%) were
frequencies, means, range, and standard deviations single. The family size of respondents ranged from
were used to summarize the variables. Binary 3 to 15 with a mean size of 7.71 (±1.97) (Table 1). A
logistic regression analysis was used to assess the total of 37 and six participants whose ages ranged
association between the outcome and independent from 18 to 40 years old were involved in FGDs or in-
variables. All independent variables with a p-value depth interviews, respectively. The majority of the
of <0.25 in the unadjusted model of logistic FGD participants had educational level at least high
regression analysis were included in the school.
multivariate model. Odds ratio with 95% CI was

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Sexual behaviours of respondents: more than half consumption, chewing chat, smoking cigarette,
(52.7%) of the students had ever engaged in sexual peer pressure, watching pornographic videos, age
intercourse. Of whom, 95 (53.4%) were males while of respondent, living arrangement and having
83 (46.6%) were females. The mean age at first information about sexuality. However, upon
sexual engagement was 15.65 (±0.95) years old. multivariate logistic regression, predictors of risky
Nearly half (49.4%) of sexually active adolescents sexual behaviours remained: respondent grade
were below 18 years at the time of sexual initiation. level, alcohol consumption, peer pressure, and
Among sexually active respondents, 59 (33.1%) of family size in the household (Table 2).
them have had more than one sexual partner in the
past 12 months. Main reasons for having multiple The odd of students under peer pressure or
sexual partners were perceiving all partners are influence were approximately six times more likely
health 34 (57.6%), to have better sexual experience in engaging in risky sexual behaviour (AOR=5.82,
14 (23.7%), and the difference in sexual pleasure 11 95% CI; 2.97-11.41) than students who had no peer
(18.7%). One hundred eighteen (34.9%) pressure or peer influence. Peer influence was cited
respondents have had sex without a condom in the by all the participants as the most important factor
past 12 months. Overall, about 168 (49.7%) of that influenced students´ sexual risk-taking
respondents had practised risky sexual behaviours. behaviour. The respondents suggested that their
Two hundred seventy-five (81.4%) of respondents behaviour was a means of gaining entry and
believed that there are no adequate sexual and certification into a social peer group. Part of being
reproductive health programs in the study area. accepted by peers was to emulate their behaviour;
Peer pressure 60 (33.7%) and the influence of in this instance, sexual behaviour was perceived as
substance use 29 (16.3%) were among the main an official group membership “stamp”.
reasons for the initiation of sexual engagement
(Figure 2). “The greater influence is friends because it´s like
when your friends tell you I have done that, you also
The majority of the key informants and FGD want to try it. We trust our friends so much in things
participants have a similar opinion that sexual that we shouldn´t even trust them with. Especially
practice among adolescent students was very high. here in our schools, people make you feel like you
However, concerning sexual initiation, some are abnormal if you are not having sex, for some
supported that students start sexual intercourse reason. Unfortunately, being a virgin now a day is
before coming to high schools; whereas, most of treated as an insult.” (19 years old, female prep
them argued that most of the students start sexual group).
practice after coming to high school and more
pronounced among preparatory students because There was consensus among the interviewees that
of lack of parental control, feeling of independence, seeking advice from their peers regarding sexual
and self-confidence for their action. Most of the behaviour was easier than going to an adult. They
respondents also explained that having multiple found it stress-free to converse confidently with
sexual partners is very common among students. As friends of the same age group. The respondents
they explained, the students need different highlighted culture and religion as a barrier to
benefits, including academic as well as economic. talking about sex and sexuality with older health
practitioners and older community members. They
Factors Associated with risky sexual behaviours: further expressed fear of being judged by adults
bivariate analysis revealed that significant factors when seeking health advice, therefore relied on
associated with adolescent risky sexual behaviours friends for such. The odd of respondents with more
were respondent grade level, family size, perceived than seven family sizes in the household were
economic status, attending religious approximately five times more in instigating risky
institution/programs, parental monitoring, alcohol sexual behaviours (AOR=5.19, 95% CI; 2.24, 12.01)

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than the family size of less than five in the Discussion
household. The qualitative finding also supported
this result. In this institution-based cross-sectional study, the
magnitude of sexually risky behaviour and
“Family socioeconomic status and large family size
influencing factors among students has been
in the household was also cited in this regard and
conducted with a quantitative and qualitative
highlighted as playing a key role in risky sexual
approach. It was found that nearly half of the
behaviours. Students from low socioeconomic
students were engaged in risky sexual behaviours.
status and large family size are subjected to higher
It also found that alcohol consumption, peer
sexual encounters due to the resource and time
pressure, student grade level, and family size were
constraints of their parents because of their big
the main identified influencing factors for risky
family size and caring for their children and other
sexual behaviour.
house workloads. For that matter, students from
such households have limited parental control and Accordingly, the present study revealed that the
may use sex as a source of income generation as coverage of adolescent risky sexual behaviours was
well.” [Health professional, 32 years old]. highest compared to findings from Gondar city,
Northwest Ethiopia (12.8%) [8], Arba Minch
The odd of students who attended grade 12 were
(23%) [9], East Gojam (26%) [12], Bodity southern
approximately six times more at risk for sexual
Ethiopia (17.9%) [13] and Mizan Aman (31%) [14].
behaviour compared to grade 9 students
On the other hand, it was relatively consistent with
(AOR=5.82, 95%CI; 2.06-16.45). This was also
the report in Nekemte (49%) [10], and Nigeria
supported by the qualitative finding that majority
(47.4%) [15]. This could be due to the absence or
expressed that both high school and preparatory
lack of enabling conditions for adolescents to
school students are active in our area. Yet, it was
receive health education on sexuality. About 81.4%
more pronounced among preparatory students
of respondents in this study also reported that
was leading to engage in sexual intercourse and to
there are no adequate and comprehensive sexual
have multiple sexual partners as they feel seniority.
and reproductive health programs in the area.
A 19 years old student stated:
Nearly 35% of respondents commenced sex
“…one of my friends had no experience of sexual
without a condom in the past 12 months. This
practices before he came to preparatory, but later
finding is somewhat comparable to 44.6% of the
on after abstaining for two years, he started sexual
adolescents who have not used a condom during
practice with high school students.”
the last times of sexual intercourse in Addis
The odd of students who consumed alcohol had Ababa [11]. This might be due to their immature
five times higher in engaging in risky sexual unplanned and emotional motives just not to miss
behaviour compared to those who didn´t consume opportunities. So, to use their best opportunity, no
alcohol (AOR=5.01, 95% CI; 2.12, 11.79). Almost all concern is considered on using a condom.
interviewees spontaneously viewed alcohol as a Moreover, they might also feel ashamed and fear
cornerstone of students´ life and it was viewed as to buy a condom from the drug store.
playing a key role in facilitating sexual intercourse.
Respondent grade level was found to be one of a
In particular, participants were of the view that the
significant predictor for risky sexual behaviours.
dis-inhibition effect of alcohol and the strategic use
This finding is in line with the study done in
of alcohol to facilitate sexual encounters were
Bahirdar [3] and inconsistent with findings from
major contributors to students engaging in risky
Addis Ababa [8]. This might be due to the study
activities such as unprotected sex.
setting and socio-demographic variation. Higher
grade levels may also think themselves as senior

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and at that level substance use getting into social best group. In these groups, sexual activity
nightclubs and engaging in a range of unprotected was regarded as a point of entry, thus making it
sex may be misperceived as a sign of classicality or hard for students to negotiate sexual abstinence.
civilization. It is also further explained by the fact
that in recent years, there have been extensive Respondents with more than seven family sizes in
social media exposures and the effect of the household were also more likely to instigate to
globalization that would increase the unlimited risky sexual behaviours than family size of less than
transfer of sexual information´s that in return might five in the household. This could be a family having
lead adolescents towards active sexual more than seven children are difficult to track or
involvement and behaviours. monitor their child´s behaviour and attitude rather
they concern about how to feed them.
Interviewees further explained that preparatory Furthermore, they devote more emphasis to those
students are at the stage of transforming into a under 10 children and the rest could be considered
higher educational institution. As a result, they as they are capable of differentiating what is good
would like to engage in a variety of friendship and bad/right or wrong. Students from such
moods, declare their independence, and decide a congested family members may be enforced to
wide range of issues including sexuality by engage in unprotected sexual intercourse with
themselves. In this study, respondents who drink those who have good economic status and use it as
alcohol were at higher risk to involve in risky sexual a proven means of income generation.
behaviour. As a result, individuals with alcohol
influence decide without analysing consequences The strength of the study is that the study used a
to be followed after having sex and this could be mixed approach, which made the finding to be a
more pronounced among adolescents. This finding more comprehensive and complete understanding
is in agreement with studies in Bahir Dar [3], of the factors. The study also has some limitations
Gondar city, Northwest Ethiopia [8], Kenya [2], and since it was a school-based study, might not
Brazil [16]. represent adolescents not attended the school.
Second, since it was self-reported, the result might
Respondents under peer pressure were more likely be affected by recall bias. And lastly, due to its
engaged in risky sexual behaviour than students cross-sectional nature, the causal inference might
who had no peer pressure or influence. These not be possible.
finding is consistent with findings in the Western
Zone of Tigray, Northwest Ethiopia [4], Aksum Conclusion
Northern Ethiopia [17], Addis Ababa Ethiopia [17],
and Nigeria [7]. This could be due to adolescents This study demonstrated that risky sexual
spending most of their time with their peers so that behaviour in the study area was very high.
peers are the most influential socializing agent for Meantime, respondent grade level, alcohol
sexuality. Those who had sexually active peers have consumption, peer pressure, and family size in the
a great chance of dealing with sexuality on a daily household were found to be major determinants of
basis. Also, abstinence from sex and focusing on risky sexual behaviours. Similarly, considering as
education alone could be considered as a sign of modern and feeling as senior, friends influence and
conservative that would subject adolescents to become poor are commonly raised reasons for risky
many critics by their peers. sexual behaviour by in-depth interview and FGD
participants.
The qualitative finding also adds to this growing
literature by highlighting peer pressure as a What is known about this topic
dominant factor influencing risky sexual decision-  Prevalence of risky sexual behaviour in
making. Students reported a desire to belong to a different areas have been assessed;

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 Predictors for practice of risky sexual Table 2: logistic regression analysis of factors
behaviour have been assessed in different associated with risky sexual behaviours among the
areas. study participants in Shewa Robit Town, 2020
(n=338)
What this study adds Figure 1: schematic representation of sampling
 The study provide data regarding burden of procedures for quantitative and qualitative
risky sexual behaviours among adolescents methods
in the study area, which was not studied yet; Figure 2: reason for sexual initiation among the
 The study provides predictors of risky sexual study participants
behaviour (alcohol consumption, peer
pressure, grade level, and family size) in the References
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Table 1: socio-demographic characteristics of the respondents in Shewa Robit town, Northeast Ethiopia,
2020 (n= 338)
Variables Categories Frequency Percent
Sex Male 188 55.6
Female 150 44.4
Religion Orthodox 226 66.9
Muslim 74 21.9
Protestant 38 11.2
Age of respondent (years) 13 to 16 184 54.4
17 to 19 154 45.6
Age at first sex (years) Below 18 66 39.8
18 and above 100 60.2
Family size Below 5 129 38.2
5 to 7 102 30.2
Above 7 107 31.6
Ethnicity Amahara 292 86.4
Others* 46 13.6
Marital Single 328 97.0
Married 10 3.0
Grade level Grade 9 137 40.5
Grade 10 85 25.2
Grade 11 68 20.1
Grade 12 48 14.2
Perceived economic status related to neighbor Poor 85 25.1
Medium 178 52.7
Rich 75 22.2
Living arrangement With father and mother 132 39.0
With father or mother 105 31.1
With relatives 70 20.7
Alone 31 9.2
Note: Others* include Argoba, Oromo, and Tigre

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Table 2: logistic regression analysis of factors associated with risky sexual behaviours among the study
participants in Shewa Robit Town, 2020 (n=338)
Variable Category Risky sexual behavior COR (95% CI) AOR (95% CI)
No (%) Yes (%)
Alcohol consumption No 142 (74.0) 50 (26.0) 1 1
Yes 28 (19.2) 118 (80.8) 11.97 (6.91- 5.01 (2.12-
19.63)* 11.79)*
Peer pressure No 136 (74.7) 46 (25.3) 1 1
Yes 34 (21.8) 122 (78.2) 10.61 (6.22- 5.82 (2.97-
17.07)* 11.41)*
Parental monitoring Low 40 (33.3) 80 (66.7) 1 1
Medium 56 (63.2) 31 (36.8) 2.59 (1.55-4.33)* 1.11 (0.49-2.52)
High 74 (56.5) 57 (43.5) 0.75 (0.43-1.31) 0.42 (0.17-1.04)
Living with Father and 79 (59.8) 53 (40.2) 1 1
mother
Father or mother 48 (45.7) 57 (54.2)
1.77 (1.09-3.09)* 1.45 (0.67-3.15)
Relatives 29 (41.4) 41 (58.6)
2.10 (1.16-3.79)* 1.32 (0.54-3.23)
Alone 14 (45.2) 17 (54.8)
1.81 (0.82-3.98) 0.54 (0.14-2.01)
Information on No 36 (66.7) 18 (33.3)
1 1
sexuality Yes 134 (47.2) 150 (52.8)
2.27 (1.23-4.18)* 1.36 (0.54-3.39)
Cigarette smoking No 134 (65.7) 70 (34.3)
1 1
Yes 36 (26.9) 98 (73.1)
5.21 (3.16- 1.28 (0.59-2.79)
8.22)**
Grade Grade 9th 46 (68.7) 21 (31.3) 1 1
Grade 10th 35 (87.5) 5 (12.5) 0.31 (0.10, 0.53 (0.14-2.05)
0.91)*
Grade 11th 74 (46.8) 84 (53.2) 2.48 (1.36, 1.47 (0.64-3.38)
4.54)*
Grade 12th 15 (20.5) 58 (79.5) 8.47 (4.23- 5.82 (2.06-
20.10)* 16.45)*
Chewing chat No 112 (64.7) 61 (35.3) 1 1
Yes 58 (35.2) 107 (64.8) 3.39 (2.22-5.44)* 1.11 (0.50-2.44)
Watching porn video No 163 (57.6) 120 (42.4) 1 1
Yes 7 (12.7) 48 (87.3) 9.31 (4.60- 3.40 (0.87-
26.74)* 13.21)
Family size ≤5 88 (68.2) 41 (31.8) 1 1
6-7 61 (59.8) 41 (40.2) 1.44 (0.83-2.48) 0.81 (0.37-1.76)
>7 21 (19.6) 86 (80.4) 8.79 (5.06- 5.19 (2.24-
17.20)* 12.01)*
Respondent's age 13-16 116 (63.0) 68 (37.0) 1 1
17-19 54 (35.1) 100 (64.9) 3.16 (1.97-4.82)* 1.60 (0.81-3.14)
Economic status Poor 56 (47.9) 61 (52.1) 2.19 (1.23-3.92)* 0.63 (0.27-1.46)
Middle 59 (49.6) 60 (50.4) 1.01 (0.60-1.70) 1.44 (0.64-3.23)
Rich 55 (54.5) 46 (45.5) 1 1
N.B: *Significant at p-value <0.05

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Figure 1: schematic representation of sampling procedures for quantitative and qualitative

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Figure 2: reason for sexual initiation among the study participants

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