Geographical variations of early age sexual initiation among reproductive-age women in Ethiopia: evidence from EDHS 2016

Abstract

Background: The early age of sexual initiation contribute a lot for various risks such as mistimed pregnancy followed by insecure termination, developing fistula and contracting sexually transmitted infections which are currently the major public health concerns for low-income countries. Therefore, the purpose of this study was to detect spatial clusters and identify factors associated with an early age sexual initiation of women in the reproductive age group. Methods: We used a population-based nationwide representative Ethiopian Demographic and Health Survey (EDHS) 2016 data.. A total of 12,033 respondents of reproductive age (15-49 years) women who had at least one event of sexual intercourse was retrieved and included for the analysis. Spatial cluster detection and autocorrelation analysis were also done to explore the patterns of early age sexual initiation. Results: The median age at first sexual intercourse among respondents was 16 (±3.3) years and more than half (66.2%) had their first sexual intercourse before the age of 18 years. The spatial variations of the age of sexual initiation was nonrandom and clustered with a Moran's I = 0.413 (P-value < 0.001). In addition, five significant spatial clusters were also identified. Moreover, the probability of starting sex at an earlier age was associated with the respondent's residence, marital status, educational attainment and wealth index. Conclusion: This study found a higher proportion of an early age sexual initiation of women. Respondent's residence, marital status, educational attainment and wealth index were significantly associated with early sexual initiation. The SaTScan analysis identified five statistical significant spatial clusters which indicate that there were geographical variations. Therefore, integrated interventions focusing on the identified high spot clustered areas are recommended to reduce early age sexual initiation.

Prevalence and associated factors of early sexual initiation among female youth in East Africa: further analysis of recent demographic and health survey

“…Female youth from middle and high-income households were less likely to participate in early sex than youth from lower-income households. This is consistent with the study conducted in Africa [28,39,44]. This might be females from low-income families may participate in earlier sexual relations to obtain money and other benefits, whereas rich people have good health-seeking behavior, awareness of lifestyle determinants, and family traits.…”

“…As the level of education increases, the likelihood of experiencing early sexual initiation decreases. The result was supported by previous studies [39][40][41]. The possible explanation is that when youth have a better educational level, they are more aware of the potential problems associated with early sexual intercourse and may prevent themselves from involvement.…”

“…Being married had higher odds of early sexual initiation than youth who were not in a union. This finding was supported by a studies done in Africa [39,42,43]. This could be engaged in early marriage before the age of 15 years, which is a potential situation for female to experience sexual activity at an early age.…”

Influences of parental monitoring and school connectedness on age at first sexual debut among unmarried female youth in Bedele town, Ethiopia: A survival analysis of timing using accelerated failure time model

“…All sex performances that are penetrative penile to Vagina and considered early if they experience before 18 years of age [ 13 , 42 , 43 ] .…”

“…This indicates women engage in sex before marriage. More than half (66.2%) of those who had their first sexual intercourse was early sexual debut according to 2016 Ethiopian Demographic and Health Survey (EDHS) [ 13 ].…”