Early sexual debut and associated factors among students in Ethiopia: A systematic review and meta-analysis (2020)

. 2020 Jul 28; 9(3): 1795.
Published online 2020 Jul 22. doi: 10.4081/jphr.2020.1795
PMCID: PMC7445439
PMID: 32874965

Abstract

Students with early sexual debut are exposed to risky sexual behaviours. For effective intervention on early sexual debut and its consequences, determination of its magnitude and identifications of associated factors is important. Therefore, this systematic review and meta-analysis aims to estimate the pooled prevalence and the associated factors of early sexual debut among students in Ethiopia. Relevant articles were identified through databases such as PubMed, Global Health, HINARI, Google advance search, Scopus, and EMBASE from March 10th to April 3rd. The data was extracted using a standardized data extraction form and exported to STATA 11 for analysis. The overall pooled prevalence of early sexual debut among students was estimated using a randomeffects meta-analysis. Presence of association was determined using an odds ratio with a corresponding 95% CI. A total of 9 studies with 4,217 participants were involved in this meta-analysis. The estimated pooled prevalence of early sexual debut among students in Ethiopia was 27.53% (95% CI: 20.52, 34.54). Being female (OR: 3.64, 95% CI: 1.67, 5.61), watching pornography (OR: 3.8, 95% CI: 2.10, 5.50) and having boyfriend or girlfriend (OR: 2.72, 95% CI: 1.24, 5.96) were found to be significantly associated with early sexual debut. More than one fourth of students practiced early sexual debut. The finding suggests the need of strengthening prevention strategies, effective intervention, and programs in educational institutions to reduce early sexual debut and its consequences. Furthermore, special attention should be given to female students and students who watch pornography.

Significance for public health

Early sexual debut is associated with risky sexual behaviours such as unprotected sexual intercourse, multiple sexual partners and incorrect or inconsistent condom use leading to HIV/AIDS, sexually transmitted infection (STIs), unwanted pregnancies, unsafe abortion, early childbirth, and psychosocial problems. The pooled prevalence of early sexual debut among students in Ethiopia was 27.53% which implies the need of educational institutions based public health interventions. Among many factors, female gender, watching pornography and having boyfriend/girlfriend were identified as factors significantly associated with early sexual debut. Determination of the magnitude of early sexual debut among students and the identification of its associated factors is very important for public health interventions. The findings of this meta-analysis will help to design appropriate interventions and policies that target early sexual debut in educational institutions with collaborative effort of policy makers, stakeholders and other concerned institutions.

Key words: Early sexual debut, students, meta-analysis, systematic review, Ethiopia