Date Published: June 7, 2018
Publisher: Public Library of Science
Author(s): Nigusie Fetene, Wubegzier Mekonnen, Matt A Price.
Risky sexual behaviors adversely affect the health of youth and young adults exposing them to sexually transmitted infections including HIV/AIDS and unwanted pregnancy to females that in turn lead to deleterious health, social and economic consequences. Youth centers inform their clients on sexually transmitted diseases, including HIV/AIDS, unwanted pregnancy, high risk abortion, and other reproductive health problems. Therefore, this study was designed to assess the prevalence of risky sexual behaviors among youth center reproductive health clinic users and non-users in Addis Ababa.
A comparative cross-sectional study design was carried out among 524 youth in Addis Ababa from March to April, 2016. The data was entered in EPI-INFO 7 software; and cleaned and analyzed using SPSS version 16.0. The prevalence was computed. Binary and multivariable logistic regression was done to determine the strength, direction and significance of association between youth center reproductive health clinic utilization and risky sexual behavior and to control confounder variables respectively.
A total of 524 youth with the response rate of 92% participated in the study. The overall prevalence of risky sexual behavior was 226 (43.1%) (With statistically significant difference in prevalence among users 101 (38.5%) and non-users 125 (47.7%) of youth center clinics, (p-value = 0.04). The odds of reporting risky sexual behavior was 60% higher among volunteers who did not use the reproductive health clinic, relative to those who did (AOR = 1.60; 95%CI = 1.08, 2.37). Teenagers aged 15–19 years were (AOR = 0.08; 95%CI = 0.05, 0.15) 92% less likely to practice risky sexual behavior compared to those aged 25–29 years old.
Risky sexual behavior was statistically significantly higher among non-users of the youth center reproductive health clinic compared with the users. In addition, a substantial proportion of the youth engaged in different risky sexual behaviors that are evidenced by the existence of multiple sexual partners, sexual practice without condom and early sexual debut that might predispose youth to STIs including HIV infection and unwanted pregnancy. The ministry of health and its partners should strengthen youth center reproductive health clinics in urban, semi-urban and rural parts of Ethiopia.
Although there is no international consensus, the United Nations (UN) defines the youth as individuals between 15 and 24 years of age . The UN estimated that around 1.2 billion people in the world are the youth aged 15–24 years which accounts 17.6% of the total population. More than 80% of them live in developing countries [2, 3]. Youth make up the greatest proportion of the population in Sub-Saharan Africa (SSA), with almost one-third of the population between the ages of 15 and 24. Sub- Saharan Africa is the only region of the world in which the number of youth continues to grow substantially .
The prevalence of risky sexual behavior was significantly higher among non-users of the youth center reproductive health clinics compared with users of such health facilities Age and educational status of the youth were possible predictors of risky sexual behavior in this study. More specifically, early sexual debut was statistically associated with reproductive health clinics utilization status, age, sex and educational status of youth. Having multiple sexual partners was associated with age, educational status, marital status and living arrangement of the youth. This study also revealed that a high proportion of study participants were sexually active. It was higher than the studies conducted in Tanzania and Nigeria [17, 30]. In addition to this, our finding was higher than the studies conducted in different parts of Ethiopia [18, 19, 21, 23 and 26]. However, it was lower than the finding of a study among Wollega University students and high school students in East Gojjam zone of Amhara region [20, 25]. This difference might be due to the difference in educational and exposure status of the youth. Regarding to sexuality of the youth, the findings of this study was consistent with the findings of other studies [25, 31].
This study has shown that a considerable proportion of non-users of the youth center reproductive health clinic youth engage in risky sexual behaviors than users of the youth center reproductive health clinic. The study also shown that majority of youth were engaged in risky sexual behaviors that are evidenced by the existence of multiple sexual partners, sexual practice without using condom, early sexual debut, having sex with commercial sex workers (for males) or being a commercial sex worker (for females) that might predispose to STIs including HIV infection and unwanted pregnancy. In addition to this, reproductive health clinic utilization status, age and educational status of youth are independent predictors of risky sexual behaviors. Therefore, there should be consistent health education message for the wider public to reduce risky sexual behaviors. The urban youth center reproductive health clinics should be strengthened. Moreover, an effort should be made to scale this program in semi-urban and rural communities in Ethiopia.