Background: Early sexual initiation is often considered risky sexual behavior because of its adverse effects like sexually transmitted infection or unintended pregnancy. Thus, in this study, we aimed to assess spatial patterns, and determinants of early age sexual initiation among reproductive women to provide information for the policymakers. Methods: We used cross-sectional data from the 2005-2016 EDHS. We considered all nine regions and two city administrations. We applied multi-level logistic regression for determinants and spatial analysis for their distribution. We used a p-value of less than0.25 to include variables before modeling and a p-value less than0.05 with 95 Percentage CI to declare association. Results: The trend prevalence of early sexual initiation was decreased from 72.90 Percentage to 66.95 Percentage from 2005 to 2016 over the three surveys. Amhara, Afar, Tigray, Benshangul, and Gambella region were hotspots in all 2005, 2011, and 2016 surveys. Eastern Oromia,and Somali had hotspot in 2016 survey. Age, marital status, education, ever had chewed khat, region, and residence were significantly associated with early sexual initiation among reproductive age women. Conclusion: Although we saw decreased early sexual initiation over the three surveys, the problem remained profound in the country and factors like age, marital status, education, ever chewed khat, region, and residence were associated. Enlightening access to education, promotion, and behavioral change among substance users and early marriage were forwarded for improvement by the team to the region holding the problem like in Amhara, Tigray, Afar, and Beneshangul regions.
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