Prevalence and associated factors of early initiation of sexual intercourse among youth in Ethiopia: systematic review and meta-analysis

Natnael Kebede; Fekade Demeke Bayou; Fanos Yeshanew Ayele; Bereket Kefale; Asnakew Molla Mekonen; Anteneh Mengist Dessie; Yawkal Tsega

doi:10.1186/s12889-023-16968-y

Prevalence and associated factors of early initiation of sexual intercourse among youth in Ethiopia: systematic review and meta-analysis

BMC Public Health. 2023 Oct 23;23(1):2072. doi: 10.1186/s12889-023-16968-y.

Authors

Natnael Kebede¹, Fekade Demeke Bayou², Fanos Yeshanew Ayele³, Bereket Kefale⁴, Asnakew Molla Mekonen⁵, Anteneh Mengist Dessie⁶, Yawkal Tsega⁵

Affiliations

¹ Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia. natnaelkebedete@gmail.com.
² Department of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia.
³ Department of Public Health Nutrition, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia.
⁴ Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia.
⁵ School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie City, Ethiopia.
⁶ Department of Public Health, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.

Abstract

Background: Early sexual initiation refers to engaging in sexual activity at a young age, typically before the age of 18. Even though many studies have been conducted in Ethiopia, the result is inconsistent between studies. In the study area, the pooled prevalence and associated factors of early initiation of sexual intercourse among youth were not done before. Therefore, this study aimed to determine the pooled prevalence and associated factors of early initiation of sexual intercourse among Youth in Ethiopia.

Methods: This study used a systematic review and meta-analysis of studies conducted from 2008 to 2022, in Ethiopia. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. PubMed, Cochrane Library, Hinari, and Google Scholar electronic databases were searched. The analysis was performed using STATA 17 software. Heterogeneity and publication bias were assessed using forest plots, I²_, Cochran's Q statistics and Funnel plots, Egger test, and Begg rank tests respectively. Duval and Tweedie's 'trim and fill' method was also performed to adjust the pooled estimate. Pooled analysis was conducted using the inverse-variance fixed-effects model.

Results: A total of 10 articles were included in this systematic review and meta-analysis. The pooled prevalence of early initiation of sexual intercourse among youth in Ethiopia was 24.7% (95%CI: 10.4, 38.9). Being female (AOR = 3.57; 95% CI: 1.387, 5.743), having poor knowledge of HIV/AIDS prevention (AOR = 3.65; 95% CI: 1.981,5.309), alcohol use (AOR = 2.05; 95% CI: 1.415, 2.679), khat chewing (AOR = 3.03; 95% CI: 1.800, 4.254), Viewed pornographic film(AOR = 4.21, 95% CI: 2.135, 6.283), Cigarette smoking (AOR = 2.74; 95% CI: 2.102, 3.370) and Poor family controls (AOR = 4.39; 95% CI: 2.572, 6.199)were associated factors of early initiation of sexual intercourse.

Conclusions: The pooled prevalence of early initiation of sexual intercourse among Youth in Ethiopia was high. Being female, poor knowledge of HIV/AIDS prevention, alcohol use, khat chewing, Viewing pornographic films, Cigarette smoking, and poor family controls were associated factors of early initiation of sexual intercourse. It is recommended that targeted interventions be put in place to address the high prevalence of early initiation of sexual intercourse among youth in Ethiopia. These interventions should focus on addressing the associated factors such as poor knowledge of HIV/AIDS prevention, alcohol use, khat chewing, viewing pornographic films, cigarette smoking, and poor family controls. It is important that these interventions are gender-sensitive and take into consideration the unique challenges faced by females in accessing sexual and reproductive health services.

Keywords: Early initiation of sexual intercourse; Ethiopia; Meta-analysis; Systematic review; Youth.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Acquired Immunodeficiency Syndrome*
Adolescent
Catha
Coitus
Ethiopia / epidemiology
Female
Humans
Male
Prevalence
Sexual Behavior