Table of Contents

CHAPTER ONE..................................................................................................................1

INTRODUCTION...............................................................................................................1

1.1. Back ground..............................................................................................................1

1.2. Statement of the problem..........................................................................................1

1.3. Significance of the study......................................................................................3

CHAPTER TWO.................................................................................................................4

LITERATURE REVIEW....................................................................................................4

CHAPTER THREE.............................................................................................................9

OBJECTIVES......................................................................................................................9

3.1. General objective......................................................................................................9

3.2. Specific objectives....................................................................................................9

CHAPTER FOUR.............................................................................................................10

METHODS AND MATERIALS......................................................................................10

4.1. Study area...............................................................................................................10

4.2. Study period............................................................................................................10

4.3. Study design............................................................................................................10

4.4. Population...............................................................................................................10

4.4.1. Source population............................................................................................10

4.4.2. Study population..............................................................................................10

4.5. Sampling techniques and sample size.....................................................................10

4.5.1. Sample size......................................................................................................10

4.5.2. Sampling techniques........................................................................................11

4.6. Data collection........................................................................................................11

4.7. Variables and measurements..................................................................................11

1
 4.7.1. Independent variables......................................................................................11

4.7.2. Dependent........................................................................................................12

4.8. Data Analysis..........................................................................................................12

4.9. Limitations and problems encountered...................................................................12

4.10. Ethical considerations...........................................................................................12

4.11. Operational definitions.........................................................................................12

CHAPTER FIVE...............................................................................................................14

RESULTS AND DISCUSSIONS......................................................................................14

5.1. Results.....................................................................................................................14

5.1.1. Socio Demographic Characteristics.................................................................14

5.1.2. Knowledge.......................................................................................................15

5.1.3. Practice............................................................................................................16

5.2. Discussions.............................................................................................................22

CHAPTER SIX..................................................................................................................25

CONCLUSIONS AND RECOMMENDATIONS............................................................25

6.1. Conclusions.............................................................................................................25

6.2. Recommendations...................................................................................................25

References..........................................................................................................................26

2
 CHAPTER ONE
INTRODUCTION

1.1. Back ground

Premarital sexuality is characterized as being unanticipated, inconsistent with
values and personality. Attitude and practice of PMS is common among high
School and college students (1,2,)
Adolescents give different reason for inflation of PMS; desire to maintain
relationship with partner, being carried by passion, to overcome loneliness, peer
influence, rape and substance use like alcohol and chat (3,4)

The consequence of PMS is enormous. It results in unwanted pregnancy,

abortion, HIV/AIDS and other STD and stress (5)

1.2. Statement of the problem

Globally the number of peoples living with HIV (PLWH) continues to grow as does the
number of death from HIV/AIDS. According to UNAIDS report a total of 33.2 million
peoples were living with HIV//AIDS in 2007. This figure includes the estimated 2.1
million adults and 420,000 children’s who were newly infected with HIV in 2011
There were 21 million deaths as a result of HIV/AIDS in the year 2007. There were a
total of 22.5 million (67%) of the global peoples were living with HIV in 2007 in the sub
Sahara Africa (6)

In Ethiopia the adult prevalence of HIV is estimated to be 2.2 % in 2008. The prevalence
among the urban and rural populations during the same period is estimated to be 7.7%
and 0.9% respectively. The total numbers of PLWH in the same period was estimated to
be 1,037,267 adults and 66,136 children.
HIV/AIDS in Ethiopia is mainly transmitted through sexual means (90%) mainly
heterosexual. Currently as emerging westernization (adopting of western culture) the

3
sexual behavior and life of youth have changed a lot. This is especially pronounced
among urban and students (7).
The international labor organization (ILO) estimated that in the absence of increased
access to treatment the number of workers lost due to HIV/will be increased to a million
by 2010 and HIV/AIDS will be increased to 74 million by 2015, making HIV/AIDS one
of the biggest cause of mortality of the world’s workers(5)
Reports shows the incidence of HIV/AIDS among unmarried is frightening in creating
country to increase knowledge about HIV/AIDS and its mode of transmission which is
not translated into appreciable behavior modification (8)

Pre-marriage unsafe sex is not only a high risk factor to HIV/AIDS but also to other
STD/STI, unwanted pregnancy and subsequent dropout from school, illegal abortion and
its complication, social and psychological trauma (9,10)

Different study done here in Ethiopia at AAU and GCMS shows most of the students
were engaged in sexual activity even though they have high awareness of HIV/AIDS
(8,7,11)

Study conducted at GCMS among them showed students revealed that knowledge of
HIV/AIDS was more than average .This study reported 40% of students to have practiced
sexual intercourse and half of that sexual contact to have been with causal individual or
prostitute.

Similar study done in 2002 in JU participating the whole students show that whole
students have heard about HIV/AIDS, know it is a transmittable disease and major
transmission routes(namely sexual, prenatal and blood transfusion) (9).

4
1.3. Significance of the study
Young people’s are dying of HIV/AIDS as a result of unsafe sexual practices. It is
known that there is no effective cure of HIV/AIDS and the only effective treatment is
prevention. And this can be achieved largely through changing behavior related to
sexuality. Such changes could be reached by studying why peoples are driven by sex in
general and unsafe sex in particular premarital sex

As little is known about sexual behaviors of youth including those attending tertiary
school, and their knowledge of acquiring HIV/AIDS as a result of unsafe sex, health
education message to be given to these group will be in trouble. So in order to address an
effective health education message on un safe sex in general and pre-marital sex as risk
as predisposing to HIV/AIDS in particular, this study can also be used as baseline to
undertake further study on large scale base.

5
 CHAPTER TWO
LITERATURE REVIEW
The term “adolescent and young people” are defined by WHO as the age group 10-19 yrs
and 10-24 yrs respectively. There are 1.2 billion adolescents and 1.7 billion young
people in the world today. Of which 85% of them live in developing country making
nearly 30% of their populations (12).

For many, adolescence is a time to begin experiment with sex. In the course of
experimentation adolescents often encounters high risk situations, such as contracting
STD/HIV/AIDS and often experience un intended pregnancy and illicit abortion. For
some portion the youth adolescence is characterized by recklessness risk seeking, sexual
and drug experimentation and lower perception of vulnerability to the adverse effects of
the above risk by behaviors (3).

Recent research shows an increasing trends in sexual activity among adolescents in both
developed and developing countries. This marked change of sexuality among teenagers
is mainly caused by socio-economic changes as urbanization and modernization,
improved health and nutrition resulting in low age at menarche, earlier sexual maturity,
low level of knowledge concerning human reproduction, liberalization of attitudes
regarding sexuality, relaxation of traditional control over sexuality and ignorance about
sex and family (1).

AIDS was first recognized in USA in summer of 1981.The center for disease control and
prevention (CDC) reported occurrence of opportunistic disease on five previously homo
sexual men in New York and Los Angeles. In 1983 HIV is isolated from a patient with
lymphadenopathy and by 1984 it was demonstrated clearly to be causative agent of AIDS
(13)

Sub-Saharan African has just over 10%of the world populations, but it is home for more
than 60% of people living with HIV. In 2004 an estimated 3.1 million peoples in the
region become newly infected while 2.3 million died of AIDS, among young people’s

6
aged between 15-24 yrs an estimated 6.9% of women and 2.2% of men were living with
HIV at the end of 2004 (5)

The first two sero positive cases were reported in Ethiopia in 1984 from Addis Ababa; in
1986 out of 146 serum samples collected from health individuals (2.74%) were positive
for HIV. (14)

Premarital sexuality is characterized as being unanticipated, unpredictable inconsistent

with values and personality.

Adolescents give different reasons for nearly inflation for sex; desire to maintain
relationship with partner, being carried by passion, to overcome loneliness, physical
affection to the person, peer influence (pressure) alcohol and chat use and rape(3,4).

Though it is the case in other societies, Ethiopian parents dispraise premarital sex.
Significant number of parents thinks their high school attending children are sexually
active. A study done by Eshetu reported that 52% Parents thought high school attending
students to be sexually active. The figure for teachers is 81.5%. Surprisingly enough
40.9% parents said they know nothing about their high school attending children’s
sexual behavior(15)

Regarding attitudes towards pre marital sex, most high school students disproved it .In
one study 61.5% of boys and 63.31% of girls disprove pre marital sex.(15)

Another study conducted at high school in Harar reported among all respondents 77.7%
of girls and 53.2% of boys’ disproved premarital sex and some of them approve if the
couple plans to marry (12). It also revealed male respondents to have significantly higher
approval rate than their female counter parts.(1)

The consequence of premarital sex is enormous. It results in unwanted pregnancy,

abortion, HIV/AIDS and other STD and stress. (20) 11% of all 15-19yers old youth have
one child and highest fertility rate was found among young women.(5)

7
The vast majority of infection occurs through unprotected sexual contact. In Ethiopia the
four important transmission mechanism of HIV are sexual contact prenatal, blood
transfusion and unsafe use of sharp materials. 87%of new HIV infection is due to the
practice of multiple partner sexual contact; premature sex contributes most of them.

In Ethiopia the proportion of AIDS case among the age 15-19year accounted to assess the
prevalence of HIV among high school and college students attending clinics for STD in
Addis Ababa, had shown 19% sero positivity (15). These study show knowledge about
the diseases and its mode of transmission is high especially in urban areas. This
knowledge is not translated in to practice. Peoples still continue to be involved in high
risk Behaviors like unprotected multipartner sexual contact. (16)

There is very little information on the situation of premarital sexual relationship in

Ethiopia. According to the 2000 Ethiopian demographic health survey, currently un
married individuals 12% of women and 17% of men have had sexual intercourse with
more than one partner during the same period. This survey showed that multiple sexual
contact among unmarried person is common, especially among men aged 20 and above
than among aged 15-19 .Among unmarried men sexual intercourse with multiple partner
was now common in the age group 20-49 and men with secondary education or higher .
(17)

Studies in Ethiopia from different region of the country shows adolescents are sexually
active as early as at age of 12 year for men and 14 yrs for females and mean age at
coitarchy is 15.5years and 16.4 years for girls and boys respectively. (7,8,1,4,18). These
studies also found that males to be more sexually active and have its earliest reported age
of first sex. Fellow students were identified of the most frequent partners, teachers and
others are also reported (21).

A study done at high school in Harar showed nearly half (49.2%) of the participants
males and 21% of the females had sexual intercourse. The mean age of first intercourse
was 17.2years (16.9Yrs for girls and 18yers for boys). The same study found that the

8
subjective level of awareness of HIV /AIDS (97.7% for boys and 96.4% for females) and
large proportion of respondents were able to specify common ways of HIV transmission
(19)

Premarital sexual practice among high school students in Nekemte town, East wollega,
showed that one hundred forty five (21.11%) adolescents reported having had pre-marital
sexual intercourse, of which 102(70.3%) was male. The mean age of first sexual
intercourse was 16.2 years. 67(46.2%) of adolescent who had pre-marital sex were from
grade 9 and 78 (53.8%) were attending grade 10.
When relationship of the adolescents to their first sexual partner was examined, the
majority of the partners 77(53.%) were friends, followed by acquaintance 48(33.1%).(21)
The main reason for initiation of sexual intercourse were falling in love which accounted
for 49(33.1%), desire to practice sexual intercourse in 44(30.3%), peer pressure
25(17.2%) and for money or gifts in 11(7.6%) of two case. when the respondents were
asked about the number of sexual partners; 95(65.5%) reported that they have had only a
single sexual partner, while 50(34.5%) had two or more sexual partners in the past 12
months.

The situation among college is not far from the high school students. Different studies
done here in Ethiopia at AAU and GCMS showed that most of the students were engaged
in sexual activities even though they have high awareness of HIV/AIDS (8,11,22)

A study conducted in GCMS among fresh man students revealed that knowledge of
AIDS was more than average.(5) This study reported 40% of the students to have
practiced sexual intercourse and half of the sexual contact to have been with causal
individual or prostitutes. 75% of them didn’t use condom. Another study including the
general student’s populations of GCMS reported 23% of them had a sexual contact with
prostitute and about 40% have used condom.

Another study done by kidane in the same college showed, of the 320 students included
in the study 98.2% were unmarried, 71% were sexually active and 61.4% had one partner
and 36.6% had more than one partner .53% had contact with commercial sex worker and
9
12% had contracted STD in the past 6months preceding the study. Another study in same
college showed 49.5% of boys and 18.3% of girls had premarital sexual intercourse (19)

Condom use is not well accepted in Ethiopian society (19). Peoples give different
reasons for not using condom; negligent, embarrassment in buying from shop or
pharmacy and using condom decrease sexual satisfaction (19).

10
 CHAPTER THREE
OBJECTIVES
3.1. General objective
To determine knowledge, attitude and practice of premarital sexual behavior among
wollega university college of public health and medical sciences

3.2. Specific objectives

 To assess the knowledge of students about premarital sex
 To determine attitude of students to ward pre-marital sex
 To assess practice of premarital sex among students

11
 CHAPTER FOUR
METHODS AND MATERIALS

4.1. Study area

The study was conducted in wollega university, WU is established in 2007 and located in
Nekemte town ,333km west of Addis Ababa

4.2. Study period

The study was conducted from May 10- May 25,2011

4.3. Study design

Cross sectional study was conducted to determine knowledge, attitude and practice of the
premarital sexual behavior among Wollega University College of public health and
medical sciences students.

4.4. Population

4.4.1. Source population

The source population was wollega university, college of public health and medical
sciences students

4.4.2. Study population

Sampled students from wollega university college of public health and medical sciences

4.5. Sampling techniques and sample size

4.5.1. Sample size

The sample size was calculated by the formula:
no = z12 -2/2 p (1-p)
d2
Where no=Minimal sample size required
P= an estimate of prevalence rate for the population (50%)
d= the margin of sampling error tolerated
z1-2/2= standard normal score at 95% confidence interval = 1.96

12
 no = (1-96)2 x 0.5(1-2.5)
(0.05)2
= 384

This will be adjusted by;

nf = no Where, N= total source population (1370)
1+no nf= corrected final sample size
N

nf = 384
1+384 = 300
1370
The non-response rate of 5%, so, nf=300+5/100 X 300 = 315

4.5.2. Sampling techniques

A stratified random sampling technique was used, where each departments were taken
as stratum and sample size was allocated proportionally to all departments in all
academic years (year I –Year IV) and then simple random sampling techniques was used
to select the candidates for the study using their alphabetical list.

4.6. Data collection

Data was collected by using pretested self administered questionnaires. Students from
each department was explained about the confidentiality of the study while distribution
and collecting the questionnaires. Questionnaires were distributed in envelopes which
was sealed after completion of the questionnaires by the candidate themselves.

4.7. Variables and measurements

4.7.1. Independent variables

 Faculty and departments

 Age
 Sex
 Marital status

13
  Ethnicity
 Sexual partner with whom condom was used
 Known methods of HIV protection
 Number of Sexual partner
 Life time sexual experience

4.7.2. Dependent

 Attitude toward premarital sex

 Practice of premarital sex
 Knowledge of students about the risk of premarital sex in relation to HIV/AIDS

4.8. Data Analysis

Data was cleaned, edited and it was analyzed using SPSS version16.0 program and
interpreted in the form of tables.

4.9. Limitations and problems encountered

 Some of the students are absent during data collection

 Some of the questionnaires were not complete

4.10. Ethical considerations

Formal letter was written from JU to Wollega University before commitment of the
study and consent was obtained from each study participant. Honesty and confidentiality
was maintained throughout the study

4.11. Operational definitions

1. Premarital sex (PMS)- Any vaginal, anal and oral sexual intercourse practiced
before marriage
2. Unsafe sex – sex practiced with multiple sexual partner and /or without using
condom
3. Life time sexual partner(LTSP)- the number of sexual partner he/she had since
his /her initiation of sexual intercourse

14
4. Coitarch – The age at first sexual intercourse
5. Approve PMS- he/she want to have sex before marriage

15
 CHAPTER FIVE
RESULTS AND DISCUSSIONS

5.1. Results

5.1.1. Socio Demographic Characteristics

Out of 298 respondents 212(71.1%) were male and 231(77.5%) of them
having average age range between 20-24 years.
108(36.2%) of the respondents were orthodox and 95(31.9%) were
protestant. 177(59.4%) were Oromo and 60(20.1%) were Amhara in
ethnicity.28495.4% of them were single and 10(3.4%) were married and
2(0.7%) were divorced. (table1)
Table:1 Socio demographic characteristics of WU College of public health and medical sciences
students, May 2011 Western Ethiopia
Variables number percentage
Sex Male 156 71.1
Female 116 28.9
Total 272 100
Age 15-19 90 9.7
20-24 122 77.5
25-29 57 11.7
30+ 3 1
Marital status Single 262 95.5
Married 9 3.4
Widowed 0 0.7
Divorced 1 0.7
Religion Orthodox 96 36.2
Protestant 67 31.9
Muslim 73 23.5
Catholic 67 2.7
Waaqeffataa 0 2.7
Other 10 2.7
Ethnicity Oromo 142 59.4
Amhara 65 20.1
Tigre 11 8.7
Sidama 24 6.7
Others(Gurage,Wolayita,Konso…) 30 5

16
5.1.2. Knowledge
All of the respondents knew that HIV/AIDS is transmittable disease. All of them knew
HIV/AIDS is sexually transmittable disease, but only 277(92.95%) knew transmission
through blood transfusion, 277(92.6%) knew that it is transmitted from mother to child
and 283(95%) knew HIV/AIDS is transmitted through usage of sharp objectives. (table2)
Table: 2 Knowledge and Route of transmission of HIV known by WU College of public
health and medical sciences students, May 2011 Western Ethiopia
Sex No Yes
Sexually Mother to child Blood Sharp Others
transfusion objective
Male 0 150 167 170 200
Female 0 122 100 102 72
Total 0 272 267 272 272

17
 5.1.3. Practice

Out of 298 respondents 107(35.9%) approved premarital sex and 191(64.1%)

disapproved PMS, 75(70.9%) male and 32(29.9%) females approve it. Out of 107(35.9%)
who approved PMS, 61(57%) of them had the reason to maintain relationship for having
sex, 43(40.18%) of them had plan to marry, 28(26.16%) of them for pleasure and
27(25.23%) of them had PMS by chance (accidentally).(table3)

Sex No Yes(Reasons)
Desire Peer Plan to For By Driven by As a Rape
to influence marry pleasure chance alcohol/chat source of
maintai income
n
relation
ship
Male 13 39 31 32 27 20 10 2 0
7
Female 32 22 14 11 1 7 0 2 1
Total 19 61 45 43 28 27 10 4 1
1
Table: 3 premarital sex practice and Reasons for having sex before marriage by WU
College of public health and medical sciences students, May 2011 Western Ethiopia

Out of 191(64.1%) those disapproved PMS majority of them 115 (60.2%) disproved PMS
due to religious reason. Morally and personally unacceptable and socially condemned
were other reasons. But only 52(27.2%) disapproved for fear of HIV. (table4)

Table: 4 Reasons for not having sex before marriage by WU college of public health
and medical sciences students, May 2011 Western Ethiopia

Sex Reasons
Fear of Religious Socially Morally, Others
HIV reasons condemned personally
unacceptable
Male 52 115 30 40 11
Female 15 45 11 17 0

18
Total 67 160 41 57 11

Of 111 those who had sexual intercourse 45(18.1%) of them had their 1st
sexual intercourse before 18 years and 66(22.1%) had it at age of 18 and
above. (table5)

Table: 5 Distribution of Age at first sexual intercourse of WU College of public health

and medical sciences students, May 2011 Western Ethiopia
.

Age in year
Sex <18 >=18 total
Male 30 48 78
Female 15 18 33
Total 45 66 111

52(17.4%) had single sexual partner and 59(19.8%) of them had more than one partner
and 32(10.7%) had four or more sexual partner. 77(69.4%) had students as sexual
partner, followed by 34(30.6%) government employee and 13 (11.7%) had commercial
sex workers as their sexual partner.(table 6,7.)

Table: 6 Distribution of number of sexual partners among WU College of public health

and medical sciences students who had premarital sex May2011, Western Ethiopia
.
Numbers of sexual partners
Sex 1 2 3 4+ Total
Male 37 11 5 25 78
Fem 15 6 5 7 33
ale
Tota 52 17 10 32 111
l

19
 Table: 7 Occupation of sexual partners of WU College of public health and medical
sciences students who had premarital sex May 2011, Western Ethiopia
.

Occupations of sexual partners

Sex Students Government Merchants Commercial Others
employee sex workers
Male 59 19 8 13 0
Female 18 15 6 O 0
Total 77 34 14 13 0

Out of those who had a sex up to now 83(27.9%) have used condom and 28(9.4%) didn’t
used it. 293(98.3%) of them knew that condom protects HIV transmission,39(47%) of
them used condom always and 26(31.32%) of them used it occasionally,49(59.1%) of
them used condom with everybody and all of those had sex with commercial sex workers
used condom. (table8)

Table: 8 Distribution of condom use among WU College of public health and medical
sciences students , May 2011, Western Ethiopia
.

Variables Numbers Percentage

Condom use Yes 83 27.9

NO 28 9.4
Condom protect Yes 293 98.3
HIV transmission
No 5 1.7

20
 How often did you Always 39 13.1
use Most of the 18 6
time
Occasionally 26 8.7
With whom did you Any body 49 16.4
use With causal 18 6
partner
Suspicious 12 12
Commercial 13 4.4
sex workers

Of 28(25.2%) respondents who didn’t use condom during sex, 12(42.9%) of them were
ashamed to buy it from shop/pharmacy, 6(21.4%) of them said that condom decrease
sexual pleasure and 3(10.7%) of them didn’t used it because of partner disapproval.
(table9)

Table: 9 Distribution of reason for not using condom among WU College of public
health and medical sciences students, May 2011, Western Ethiopia
.

Sex Condom Trust Partner Ashamed Unaware Other Total

decrease partner disapproval to buy of s
sexual appropriate
pleasure use
Male 3 3 1 6 1 2 16
Female 3 1 2 6 0 0 12
Total 6 4 3 12 1 2 28

21
Considering association; age at first sexual intercourse and practice of condom uses are
not statistically associated with socio demographic characteristics of the students.
(table10, 11,12,)

Table: 10 Comparison of sex before marriage with socio demographic characteristics of

us college of public health and medical science students, May 10-May 25
Western Ethiopia

Variables Sex before marriage

Yes No X2 P-value

Sex Male 75 136 0.481 0.786

Female 32 54
Ethnicity Oromo 49 127
Amhara 28 32 15.8 0.445
Tigre 15 11
Sidama 10 10
Others 5 10

Table:11 Comparison of age at first sexual intercourse with socio demographic

characteristics of WU, college of public health and medical sciences, May
2011.

Variables Age at 1st sexual inter course

<18 years >18years X2 P-value

Sex Male 30 48 0.47 0.49

Female 15 18
Ethnicity Oromo 21 32
Amhara 7 21 7.44 0.11
Tigre 8 7
Sidama 5 5
Others 4 1

22
Table 12 Comparison of condom using price with socio demographic characteristics
of WU, college of public health and medical sciences, May 2011.

Variables Condom use

Yes No X2 P-value

Sex Male 62 16
Female 21 12 3.08 0.079
Age category 15-19 4 1
20-24 63 21 0.19 0.97
25-29 14 5
30+ 2 1
Ethnicity Oromo 41 12
Amhara 24 4 6.32 0.177
Tigre 10 5
Sidama 5 5
Others 3 2

23
5.2. Discussions
According to this study, all of the respondents knew that HIV/AIDS is transmittable
disease and all of them knew that it is sexually transmittable disease, but only 277(93%)
of them knew that it is transmitted through blood transfusion and 283(95%) of them knew
that it can be transmitted from mother to child. In comparison with the research done at
Harar high school, which said subjective level of awareness of HIV is 97.7% for boys
and 96.4% for girls, there is high level of awareness (100% for both boys and girls).the
discrepancy can be explained by increased in source of information about route of
transmission and prevention of HIV/AIDS.(1)

Regarding PMS practice, in this study 107(35.9%) of the respondents approved it and
191(64.1%) disproved PMS. Of those who approve PMS 75(70.1%) were male and
32(29.9%) were female. But 137(64.6%) of male and 32(62.2%) of females disproved
PMS. The result is comparable with the result from Horn of Africa, journal of AIDS vol.
1(11)2006, which said 61.5% of boys and 63.3% of girls disproved PMS.(23), but there is
high approval rate compared with the result from research conducted at Harar high
school in 1999 which said 77.7% of girls and 53.2% of boys disproved PMS.(1)

And premarital sexual practice among high school students in Nekemte town showed
that 21.1% of adolescents reported having PMS, of which 102(70.3%) was male. These
increments in PMS practice can be explained by advancement in sexual intercourse
correlated with modernization and departure from the family in college students, which
may increase freedom of students.(20)

Another study conducted in GCMS showed that 49.5% of boys and 18.3% of girls had
PMS, which is low compared to this study. This high approval rate may be due to
modernization and early appearance of secondary sexual characteristics because of
improvement in economic status of the population.(2)

24
Of those who approved PMS 61(35.9%) of them had reason to maintain relationship for
having sex and 43(40.18%) of them had plan to marry and 28(26.16%) of them did it for
pleasure and 27(25.23%) of them had sex accidentally. It was similar compared to the
research done in 2001 by Zelalem Fekadu and Fisseha Eshetu in the same year.(3,4)

Out of those who disproved PMS majority of them is due to religious reason, morally
and personally unacceptable and socially condemned are other reasons. Only 52(10.7%)
disproved PMS for fear of HIV/AIDS. 52(17.4%) had single sexual partner, 59(19.8%) of
them had more than one sexual partner and 32(10.7%) had four or more sexual partner.
77(69.4%) had students as sexual partner, followed by 34(30.6%) government employ
and 13(11.7%) have commercial sex workers as their sexual partner. According to 2000
Ethiopian DHS, 12% of women and 17% of men have had sexual intercourse more than
one partner, which is slightly the same for male and higher for female, which is 20.9% in
this study. This may be due to females were more influenced by their class mate students
and teachers to be asexual partner.(17)

Study done in Nekemte high school showed that 65.5% of those having sex had only a
single sexual partner and 34.5% had two or more sexual partner. In this study 52(46.8%)
have had a single sexual partner and 59(53%) 44.1% have had two or more sexual partner
which shows high MSP. This may be due to change in residential place of the students
because of educational reason, which may predispose them to have another sexual
partner. (20)
Another study done by Kidane in GCMS showed 61.4% had one partner and 36.6% had
more than one partner and 53% had contact with commercial sex workers. (2)

Studies in Ethiopia from different regions showed fellow students were identified most
frequent partner followed by teachers. And this is the same to the result of this study.
(19)

Of 111 those who had sexual intercourse 45(18.1%) had their first sexual intercourse
before 18 years and 66(22.1%) had their first sexual intercourse at 18 and above. The

25
average age at first sexual intercourse in general is 17.61years and 17.45yaers for female
and 17.68years for male. The lowest age at first sexual intercourse is 10years and
maximum age is 24years.
The result is similar to result obtained from research done at Harar high school, which
showed average age at first sexual intercourse is17.2years and 16.9years for girls and
18years for boys.(12)

But the research done in Nekemte high school showed mean age at first sexual
intercourse is 16.2years, which is lower. (20)

Out of those who had sexual intercourse 83(74.5%) had used condom and 28(25.5%) did
not use it during sex. This result is high compared to research conducted at GCMS which
showed 75% of those having sex did not use condom. The improvement in condom use
may be due to an increased awareness on use of condom by population especially
students due to high access to information from both governmental and nongovernmental
organization. (8)

28 students did not use condom during sexual intercourse and they gave the following
reason for not using condom; 12(42.9%) of them are ashamed to buy it from
shop/pharmacy,6(21.4%) of them said condom decrease sexual pleasure and 3(10.7%) of
them didn’t used it due to partner disapproval. Federal MOH of Ethiopia dec.2007
documents that condom use in country is not well accepted and the reasons are;
negligent, embarrassment in buying it from shop/pharmacy and condom decrease sexual
pleasure (satisfaction). Even though condom using practice is increasing, still the reason
for not using it is the same. (21)

26
 CHAPTER SIX
CONCLUSIONS AND RECOMMENDATIONS

6.1. Conclusions
There was;
High awareness about HIV/AIDS
High prevalence of MSP
Average at first sexual intercourse is below 18 years.
Fellow students are the most common sexual partner
High awareness on condom use
Ashamed to buy from shop/pharmacy is the most common obstacle to condom
use

6.2. Recommendations
To each individuals in order to have a healthy sexual behavior to limit the
number of sexual partner to one
To each individual, government and nongovernmental organization to
provide appropriate education and contraceptive use in order to prevent
unwanted pregnancy and acquisition of HIV/AIDS and other STD
To NGO and governmental organization, in order to provide easiest way to get
condom rather than buying from shop/pharmacy

27
References

1. Antene korra, Mesfin Haile, sexual behavior and Level of awareness on

reproductive health among youths Evidence from Harar eastern Ethiopia, Ethiopia
J.H eal dev. 199913(2) 107-113
2. Hailegnew E. knowledge and feelings of some peoples about condom use in
relation to HIV/AID S in A.S Eth. J. Heal. Dev. 1994, 5 (2) 81-82
3. Zelalem Fekedu, casual sex-debuts among female adolescents in AA, Ethiopia, J
health Dev.2001 15(2) 109-116
4. Fisseha Esletu, Attitudes of student’s parents and teachers to wards the-22, c-2001
promotion of condom for adolescents Eth. Heal. Dev. 199: 11(1) 17
5. UNAIDS,WHO, AIDS epidemic update, Dec.2004,19-26
6. UNAIDS, December 2009 report
7. Ismail’s, high risk sexual behavior for STD/AIDS, pregnancies, and contraception
among high school students in rural town, North west Ethiopia, Ethi J .Aecl Dec
1997
8. Kidane G/Kidane, survey of condom use among college students Eth. J. Hel.
Dev.1995, 9(1) 7-11
9. Gage S.S and meeker. D. (1993) sexual activity before marriage in sub-srlaran
African, soc.Bio,14-60
10. Okumum . onegoll, 1994 female adolescents health and sexuality in Kenya
secondary school, A survey report AMEERF, Nairobi 1994
11. Petro’s B.AIDS and college students in AA, a study of knowledge, attitude and
behavior Eth, health Dev 1997 11(2) 115-135
12. Zera’i kassaye sexual experience and their correlates among JU students, Jimma,
Ethiopia these Sci, 2005, 15(11) 1-17
13. Harrison, principles of internal medicine 17th ed

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14. Eshetu H.Tefera sailu. The progression of HIV/AIDS in Ethiopia. Eth J.Heal.
Dev.1996,10(3) 179-190
15. Horn of Africa, Journal of AIDS vol.1(11) 2006-36
16. Solomon B. assessments of HIV among students of High school and college
attending clinics for STDS in A,A M.S.C their department of virology, AAU,
1992:92
17. Control statistical authority, Ethiopian demographic health survey 2000,central
statistical authority A.A Ethiopia 2000
18. Eyob Tadese, A survey of adolescent reproductive health in the city of A.A eth.
J. Heal Dev.1996, 10 (1) 35-39
19. Hailu N. kaidoner in L. and Bekeles, AIDS cases in Ethiopia )abstract) the XXVI
annual conference of EMA,1990, AA. Ethiopia
20. Asefa S and Desalegn W. premarital sexual practice among school adolescents in
Nekemte town, East wollega Ethiopia J. health Dev 2008, 22
21. Federal MOH of Ethiopia Dec. 2007,1-2
22. Bethelium T .Tilahun, Explaining college students attitudes and knowledge of
HIV/AIDS, preliminary study (abstract) 27th annual medical conference of EMA
23-25 may 1991, AA. Ethiopia.
23. WU, office of registrar

29
 Jimma University
College of Public health and medical sciences.
School of medicine and HO- coordinating office
A self administered questioner to assess Knowledge, attitude and practice of students
towards premarital sex.

A stratified random sampling method will be used to select participant but only
volunteer will participate in the study. Every participant will be kindly requested to give
genuine information. His/ her information will be the core point to reach on conclusion.

I. Identification and general information

1.1. Department _____
1.2. Age ______
1.3. Sex _____ a. male b, female
1.4. Marital status a. Single b. Divorced c. Married d. Other
specify
1.5. Religion a, orthodox b. Muslim c. protestant
d. catholic e. Other specify
1.6 Ethnicity a. Oromo b. Amhara c. Tigre
d. sidama d. Other specify
II. Knowledge Questions
2.1. Do you know HIV/ ADIS is transmittable disease?
a. yes b No
2.2. If yes to Q 2.1 which mode of transmission do you know?(more than one is
possible)
A . Sexually b. Blood transfusion c. mother to child d. unsafe use of sharp
objectives E . Other specify

30
2.3 Do you know condom can protect from acquiring HIV/ infection?
A yes b No
2.4 Do you have sex before marriage?
A yes b No

2.5. If yes q 2.4 in what condition?

A, If you plan to marry
b. If you Have girl or boy friend
c. Accidentally
d. Other specify______
2.6. If no to Q 2.4 why: / more than one answer is possible
a. fear of acquiring HIV infection
b. For religious reasons
c. Because it is socially condemned
d. Is morally, personally unacceptable
e. Other specify _________
III . Practice questions
3.1. Have you ever had a sex? a. yes b. no
3.2 If yes to Q 3.1 what was your reason for having sex?
a. Desire to maintain relationship with boy/ girl friend
b. Physical attraction
c. peer influence
d. for pleasure
e. As means of income
f. Driven by alcohol or chat use
g Rape
h. other specify_______
3.3. At what age do you have your first penetrative sexual Intercourse?___________

31
3.4. How many sexual partner you had up to now?
a. 1 b.2 c. 3 d. 4 and above
3.5. Did you use condom during sex? a. yes b. No
3.6. If yes to Q.3.5 how often?
a. always b. Most of the time c. occasionally
d. other specify _______________
3.7. To which of the following groups, your sexual partner is categorized
a. Students b. Commercial sex worker c. Government employee
d. Merchant e. Other specify
3.8. Did you use condom in Last 3 months?
a. Yes b. No
3.9 With whom did you use condom?
a. anybody b. causal partner c. with suspicious
d. commercial sex worker
3.10. If no to Q 3.5 Why?
a. Condom decreases sexual pleasure
b. partner disapproval
c. you trust your partner
d. you ashamed to buy
e. Unaware of appropriate use
f .other, specify

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1