Vol. 10(12), pp.

429-442, December 2018

DOI: 10.5897/JPHE2018.1073
Article Number: 950451759572
ISSN: 2141-2316
Copyright ©2018
Author(s) retain the copyright of this article Journal of Public Health and Epidemiology
http://www.academicjournals.org/JPHE

Full Length Research Paper

Risky sexual behaviors and associated factors among

preparatory school students in Arba Minch town,
Southern Ethiopia
Abera Mersha1*, Kedir Teji2, Rasha Darghawth3, Woiynshet Gebretsadik1, Shitaye Shibiru1,
Agegnehu Bante1, Tilahun Worku1, Adanech Merdekios1, Alemu Kassaye1, Asegahegn
Girma1, Brehan Goitom1 and Natinael Abayneh1
1
Department of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
2
School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
3
Business Development Officer with CARE Ethiopia and Cuso International, Ethiopia.
Received 29 August 2018; Accepted 31 October, 2018

There is growing evidence suggesting that young people in school are practicing risky sexual
behaviors. Ethiopian people aged 10 to 24 years have emerged as the segments of the population
most vulnerable to a broad spectrum of serious sexual health problems. Therefore, the main aim of
this study was to assess risky sexual behaviors and associated factors among preparatory school
students in Arba Minch, Southern Ethiopia. An institution based cross sectional study was conducted
among 465 study participants from April 20 to June 2, 2018. A self-administered pre-tested
questionnaire was used to collect the data. Bivariate and multivariate analysis was done using binary
logistic regression. In this study, 22.4% (95%CI: 18.6%, 26.2%) of study participants had risky sexual
behaviors. Marital status, education and occupational status of the father, occupation of the mother,
watching pornographic movies, drinking alcohol, using hashish/shisha and knowledge about
HIV/AIDS were significantly associated with odds (AOR=3.28, 95%CI: 1.24, 8.70), (AOR=5.96, 95%CI:
1.35, 26.25), (AOR=0.33, 95%CI: 0.12, 0.93), (AOR=0.22, 95%CI: 0.09, 0.51), (AOR=8.80, 95%CI: 4.04,
19.17), (AOR=2.71, 95%CI: 1.35, 5.46), (AOR=14.88, 95%CI: 4.52, 48.96) and (AOR=2.89, 95%CI: 1.42,
5.88), respectively. This finding noted that significant numbers of students were engaged in risky
sexual behaviours. Those students had multiple sexual partners, used condoms inconsistently, had
sex with risky individuals, and an early sexual start. Watching pornographic movies, substance abuse
and a knowledge gap on HIV/AIDS were some of the significant factors. Awareness creation for
youths to reduce substance abuses, HIV/AIDS and sexual and reproductive health in the school
community is recommended.

Key words: Risky sexual behaviors, sexual and reproductive health problems, youths.

INTRODUCTION

There is currently no universal acceptable definition of persons between 15 and 24 years; WHO, 10 and 24
youth. The United Nations (UN) defines the youth as years; and the Ethiopian Social Security and
430 J. Public Health Epidemiol.

Development Policy, 15 and 24 years. However, youth 24. Among women, HIV prevalence increases from 0.8%
policy of Ethiopia under minister of youth, sport and those with one lifetime sexual partner to 7.0% among
culture defines it to include parts of the society who are those with 10 or more, and increases from 0.3% among
between 15 and 29 years of age (MYSC, 2014; men with 1 lifetime sexual partner to 2.9% among those
UNESCO, 2013). with 10 or more. In Ethiopia, 24% of women aged 15 to
The world's population is young: 42% of people are 24 and 39% of men aged 15 to 24 have comprehensive
under the age of 25. In South Asia and sub-Saharan knowledge of HIV (CSA, 2018). A study conducted
Africa, the number of people aged 12 to 24 has steadily among youth in Botswana stated that correct knowledge
risen to 525 million in 2015, almost half the global youth about prevention of HIV transmission is also low with
population (SDGs, 2017). Ethiopia is a developing only 16.3% (14.1-18.4) of students displaying adequate
country with the youth population aged 15 to 24 years knowledge about the prevention of HIV transmission
old, with the most productive force representing 20.11% (Majelantle et al., 2014).
of total population (CIA, 2018). Dramatic shift in sexual Sexual behaviors in high HIV/AIDS prevalence
behavior among youths concedes with the rapid countries have generally been unfavorable over the last
disseminations of HIV/ADIS and STIs (Yohannes et al., decade (UNAIDS, 2013). Studies conducted in
2016). Many young people engage in risky sexual developing countries showed that 75% of males aged 15
behavior and experiences that can result in unintended to 24 years who reported having sexual intercourse in
health outcomes (CDC, 2018). Risky sexual behaviors the 12 months preceding the survey engaged in higher-
place youth at risk for HIV infection, other sexually risk sex. The proportion of higher-risk sex among male
transmitted diseases (STDs), unwanted and unintended youth, aged 15 to 19 years was nearly 90% in 21 of the
pregnancy, abortion, and psychological distress (Cherie 26 countries (Berhan and Berhan, 2015).
and Berhanie, 2015; Tadesse and Yakob, 2015; Adeomi Recent surveys in several countries in sub-Saharan
et al., 2014; Alamrew et al., 2013; HWS, 2017). Africa have detected decreases in condom use and/or
Evidences from different studies stated that, risky sexual an increase in the number of sexual partners. The
behaviors include having more than one sexual partner, overall proportion of condom use during youths‟ most
early sexual initiation, inconsistent use of condom, recent higher-risk sexual encounter was 40 and 51%
having sex with commercial sex workers, use of among 15 to 19 year olds and 20 to 24 year olds,
substances during sexy, and alcohol use (Cherie and respectively (UNAIDS, 2013; Berhan Yand Berhan,
Berhanie, 2015; Tadesse and Yakob, 2015; Adeomi et 2015).
al., 2014; Alamrew et al., 2013; HWS, 2017; Adera et al., Most of the risks for sexually transmitted infections
2015; Asrese and Mekonnen, 2018). (STIs) and HIV infection were identified with an attention
AIDS is the second leading cause of death among seeking magnitudes. More than half of the students were
people worldwide. An estimated 36.9 million people were at risk for STIs and/or HIV infection due to their varying
living with HIV worldwide in 2017. Of these, 3.0 million levels of sexual behaviors such as having multiple
were children and adolescents under 20 (UNAIDS, 2013, sexual partners, regular casual sexual sex and sex with
2015). Adolescent girls and young women aged 15 to 24 risk commercial sexual workers (CSWs) (Mengistu et al.,
years are at particularly high risk of HIV infection, 2013). One of the studies conducted in Ethiopia stated
accounting for 20% of new HIV infections among adults that more than one third of in-school youths (37.1%)
globally in 2015 (UNAIDS, 2016). However, AIDS is now reported having two or more than two lifetime sexual
the leading cause of death among young people in partners (Negeri, 2014). A considerable proportion of
Africa. Majority of young people living with HIV are in school youths were involved in risky sexual practice like
low- and middle-income countries, with 84% in sub- early sexual initiation (by age 13 to 14), having multiple
Saharan Africa. In sub-Saharan Africa, adolescent girls sexual partners and inconsistent condom use which
and young women account for 25% of new HIV predispose them to sexual related health (SRH)
infections among adults, and women account for 56% of problems (Mariam et al., 2018). A study conducted in
new HIV infections among adults (UNAIDS, 2013, 2015, Southeast Ethiopia showed that more than half of the
2016). The Ethiopian Demographic Health Survey HIV students were at risk for STIs and/or HIV infection.
report showed that HIV prevalence is 0.3% among Additionally, it showed that engaging in casual sex with
young women and 0.1% among young men, aged 15 to first sexual partner and having multiple sexual partners

*Corresponding author. E-mail: mershaabera@gmail.com

Author(s) agree that this article remain permanently open access under the terms of the Creative Commons Attribution
License 4.0 International License
 Mersha et al. 431

Figure 1. Map of Arba Minch town, South Nations and Nationalities and Peoples Republic, Southern Ethiopia, 2018.

in the last 12 months (four and above sexual partners) of these studies were conducted in major towns and
were independent risk predictors of STIs and/or HIV used different categories of population. Therefore, the
infections (Mengistu et al., 2013). main aim of this study was to assess risky sexual
Peer pressure, alcohol consumption, watching behaviors and associated factors in Arba Minch town,
pornographic materials, early sexual initiation, multiple Southern Ethiopia.
sexual partnerships, inconsistence use of condoms,
chewing „khat‟ and substance use, depression, poor
living arrangement, educational status of parents, family MATERIALS AND METHODS
connectedness, having sex with CSWs, and poor
knowledge towards HIV/AIDS are the major predictors of Study setting and period
risky sexual behaviors among youths (Tadesse and
This study was conducted using preparatory schools students of
Yakob, 2015; Alamrew et al., 2013; Arba Minch town from 20th April to 2nd June, 2018. Arba Minch
Mariam et al., 2018; Nigatu et al., 2018; Fentahun and town is the administrative and trading center of the Gamo Gofa
Mamo, 2014; Abebe et al., 2013; Manee and Aria, 2018; Zone, located at 505 km from Addis Ababa the capital city of
Mullu et al., 2016). Alternatively, interpersonal processes Ethiopia and 275 km southwest of Hawassa, the regional town of
like succumbing to peer-norms, intergenerational gaps South Nations Nationalities and Peoples Republic. The topography
of the land is characterized by undulating feature that favors for the
regarding beliefs about sexual behavior, the socio- existence of different climatic zones. The general elevation of the
economic context of students, and the interplay between zone ranges from 680 to 4207 m above sea level. Mount Gughe,
desiring love. Also, included are material gain, power, the highest mountain peak in the zone as well as in the SNNPR
and social status, HIV/AIDS messaging and programs, stretches 4207 m above sea level. The climate here is tropical. In
and the gendered nature of sex information played a winter, there is less rainfall in Arba Minch than in summer. The
great role in sexual risk-taking and exposure to risky climate here is classified as Aw by the Köppen-Geiger system
(Figure 1). According to the 2007 Census conducted by the
sexual behaviors (Ndumiso et al., 2016). Central Statistical Authority (CSA), the town has a total population
Very few studies have assessed youth and particularly of 74,879, of whom 39,208 are men and 35,671 women. The
preparatory school student‟s risky sexual behavior. Most annual population growth rate is found to be 4.8% with 15 years
432 J. Public Health Epidemiol.

doubling time and the population density of the town is 13 people the local language “Amharic” by a languages expert and finally
per hectare. before data entry again re-translated back to English in order to
ensure consistency and quality. Questionnaires were pre-tested in
an area with similar characteristics and possible modifications and
Study design amendments were done before actual data collection. Data were
checked for completeness, accuracy, clarity and consistency at
An institution-based cross-sectional study design was used to spot by data collections, after data collection by supervisors and
address the objectives. before entry into software by principal investigator. Proper coding
and categorization of data were maintained for the quality of the
data to be analyzed. Double data entry was done for its validity
Study population and sample collection and compared to the original data (data entered by the other data
clerk).
All preparatory school students (grades 11 and 12) of Arba Minch
town were the source population and those selected were study
population for this study. Those students who were attending class Data processing, management and analysis
during data collection period were included; whereas those who
were seriously ill and unable to respond were excluded from this The data were coded and entered into Epi data version 3.1 in
study. The sample size for this study was calculated using Epi order to maintain logical errors and skipping patterns. Then, the
info7 software Stat Cal. Sample size for each objective was data were exported to SPSS window version 22 for cleaning,
determined separately. For the first objective (to determine the editing and analysis. A descriptive analysis was done by
status of risky sexual behaviors), single population proportion and computing proportions and summary statistics. The information
identify associated factors with two sample comparison proportion was presented using simple frequencies, summary measures,
was used. The sample size used for this study was 495, after tables and figures. Bi-variate s and multivariate analysis was done
adding 10% to the larger sample size from two objectives. The to see the association between each independent variable and the
calculated sample size of this study was proportionally allocated to outcome variable using binary logistic regression. The goodness of
each preparatory school based on the number of students in each fit was tested by Hosmer-Lemeshow statistic and Omnibus tests.
school. Then, separate sampling frame (student list from director‟s All variables with P<0.2 in the bivariate analysis were included in
office) was used to select the study participants from each grade the final model of multivariate analysis in order to control all
(grades 11 and 12) as well as each section. Finally, study possible confounders. In addition, variables that were significant in
participants for this study were selected using a systematic previous studies and from context point of view included in the final
random sampling method. model even if the aforementioned criteria was not followed. During
multivariate analysis, backward logistic regression was used. Multi
co-linearity test was carried out to see the correlation between
Data collection methods
independent variables using standard error and collinearity
statistics. The direction and strength of statistical association was
A structured pretested self-administered questionnaire, adapted
measured by odds ratio with 95% CI. Adjusted odds ratio along
and modified from other similar studies was used to collect data.
with 95% CI was estimated to identify associated factors for risky
The tool had four main parts: socio-demographic, sexual and
sexual behaviors. In this study, P-value < 0.05 was considered to
reproductive history, substance abuse and knowledge about
declare a result as statistically significant association.
HIV/AIDS. Four BSc holder nurses who are fluent in the local
language, after taking informed consent, collected the data. Two
MSc holder nurses supervised them. A three-day extensive
Ethical considerations
training regarding the objectives of the study, ethical issues on
research and data collection procedures was given for both data
Ethical clearance was obtained from Arba Minch University,
collectors as well as supervisors.
College of Medicine and Health Sciences, Institutional Ethical
Review Committee (AMU-IERC). All the study participants were
Measurements informed about the purpose of the study, their right to refuse and
the signed voluntary consent was obtained from all study
Respondents have risky sexual behaviors if they had at least one participants prior to offering the data collection instruments. The
of the following: multiple sexual partners; early sexual start, before respondents were also been told that the information obtained
the age of 18; inconsistent use of condom (incorrect use of from them was treated with complete confidentiality and will not
condom or failure to use condom at least once during sexual inflict any harm on them.
intercourse); and sexual intercourse with commercial sex workers
(Tadesse and Yakob, 2015; Alamrew et al., 2013; Mullu et al.,
2016). Respondents, who mentioned three or more transmission RESULTS
and prevention ways of HIV/AIDS in addition to the other HIV/AIDS
related questions correctly, were categorized to have good Socio-demographic characteristics of study
knowledge; while those who mentioned below were classified as participants
having poor knowledge towards HIV/AIDS.
Of the total questionnaire, 465 participants responded
Data quality control with a response rate of 93.9%. From the total
respondents, 255 (54.8%) were male. Regarding marital
The questionnaires were first drafted in English then translated to status, 421 (90.5%) were single, while 44 were married
 Mersha et al. 433

(9.5%). The mean age of study participants was 17.92 multivariate model marital status, educational and
(±1.34SD). Protestant religion followers constituted 306 occupational status of father, occupation of the mother,
(65.8%), 413 (88.8%) lived with family and 412 (88.6%) watching pornographic movies, drinking alcohol, using
had participated in religious education. Table 1 shows hashish/shisha and knowledge about HIV/AIDS were
the other socio-demographic characteristics. significantly associated with risky sexual behaviors.
However, sex, age, grade level, educational status of
mother, living with family, participation in religious
Sexual and reproductive history of respondents education, chewing chat and smoking cigarette were not.
Married respondents were 3.28 times more likely and
Out of the total respondents, 122 (26.2%) had sexual students with fathers with a low educational status as
intercourses and 52 (42.6%) started sex for personal compared to others were 5.96 times more likely to be
desire. Ninety-four (77%) of the respondents started sex engaged in risky sexual behaviors (AOR=3.28, 95%CI:
before the age of 18 years, with mean age of 1.24, 8.70) and (AOR=5.96, 95%CI: 1.35, 26.25),
16.18±1.81. Ninety-three (76.2%) had first sex with their respectively. Students with fathers who were employed
partners. From those who had sexual intercourses, 11 in government were 67% more likely, and those whose
(9%) had sex with CSWs. Seventy two (59%) had 1 mother‟s occupational were merchants as compared to
sexual partner in their lifetime and 74 (66.7%) had sex others were 78% less likely to be engaged in risky
within 12 months prior to study period. Those who sexual behaviors. The odds of engaging in risky sexual
watched pornographic movies made up 213 (45.8%). behaviors were 8.8 among respondents who watch
One hundred forty seven (31.6%) had discussed about pornographic movies (AOR=8.80, 95%CI: 4.04, 19.17)
sexual intercourse with a family member, relatives and and 2.71 among respondents consuming alcohol
friends (Table 2). (AOR=2.71, 95%CI: 1.35, 5.46). Study participants who
Of the respondents who had sexual intercourse, 93 had used hashish/shisha were 14.88 times more likely to
(76.2%) had used condom in lifetime and 91(82%) used practice risky sexual behaviors. Additionally, those who
condom for the sexual intercourse within 12 months prior had poor knowledge about HIV/AIDS were 2.89 times
to study period. From those who sometimes used, 45 more likely to practice risky sexual behaviors
(49.4%), 4 (4.4%) and 42 (46.2%) used often, constantly (AOR=14.88, 95%CI: 4.52, 48.96) and (AOR=2.89,
and consistently, respectively. Forty-three (62.3%) 95%CI: 1.42, 5.88), respectively (Table 5).
stated that using a condom decreases satisfaction
(Figure 2).
Regarding family planning, 77 (16.6%) used any type DISCUSSION
of method for family planning, while 67 (87%) used
condom (Figure 3). Overall, in this study, 22.4% (95% In this study, the prevalence of risky sexual behaviours
CI: 18.6, 26.2) study participants had risky sexual was 22.4% (95%CI: 18.6, 26.2). Married respondents
behaviors (Figure 4). One hundred fifty one (32.5%) had were 28% and respondents with educational status with
drinking alcohol (Table 3). the ability read and write were 96% to be engaged in
risky sexual behaviors. The odds of practice of risky
sexual behaviors were 0.33 among respondents, whose
Knowledge about HIV/AIDS among respondents fathers were employed by the government and 0.22
among those whose mothers were merchants. Study
All the study participants displayed basic knowledge participants who watch pornographic movies were 8.8
about HIV/AIDS, transmission and prevention ways. As times more likely to be engaged in risky sexual
regards to testing knowledge of transmission, 447 behaviors and those who consume alcohol were 2.71
(96.1%) stated unprotected sexual intercourse and 397 times more likely to be engaged in risky sexual
(85.4%) stated needles. Thirty three (7.1%) of the study behaviors. The odds of practice of risky sexual behaviors
participants had reported that HIV/AIDS is curable and were 14.88 and 2.89 among respondents who use
253 (54.4%) thought that healthy looking individuals may hashish/shisha and poor knowledge about HIV/AIDS,
have HIV. Overall, 142 (30.5%) respondents had poor respectively.
knowledge about HIV/AIDS (Table 4). The status of risky sexual behaviors was in line with
some of the studies done in Ethiopia and Nigeria. This
finding was low, compared to different studies conducted
Factors associated with risky sexual behaviors in Ethiopia, Spain and Iranian. However, it was
among study participants inconsistent with some studies conducted in parts of
Ethiopia (Cherie and Berhanie, 2015; Tadesse and
After controlling for possible cofounders in the Yakob, 2015; Adeomi et al., 2014; Alamrew et al., 2013;
434 J. Public Health Epidemiol.

Table 1. Socio-demographic characteristics of respondents among preparatory school

students in Arba Minch town, Southern Ethiopia, 2018 (n=465).

Variable Frequency Percentage

Age
15-19 407 87.5
20-29 58 12.5

Religion
Orthodox 140 30.1
Protestant 306 65.8
Muslim 13 2.8
Catholic 6 1.3

Educational status of father

Cannot read and write 41 8.8
Read and write 23 4.9
Primary ( grade 1-8) 74 15.9
Secondary (grade 9-12) 171 36.8
College and above 156 33.5

Occupation of father
Government employer 153 32.9
Merchant 64 13.8
Farmer 163 35.1
Daily labor 23 4.9
Private worker 40 8.6
Other† 22 4.7

Educational status of mother

Cannot read and write 45 9.7
Read and write 27 5.8
Primary ( grade 1-8) 45 9.7
Secondary (grade 9-12) 221 47.5
College and above 127 27.3

Occupation of mother
Governmental employer 91 19.6
Merchant 130 28
Farmer 89 19.1
Daily labor 13 2.8
Private worker 41 8.8
House wife 101 21.7

Number of sisters/brothers
1-3 116 24.9
4-6 211 45.4
>6 138 29.7
†Driver and wavier
 Mersha et al. 435

Table 2. Sexual and reproductive history of respondents among preparatory school students in Arba Minch town,
Southern Ethiopia, 2018 (n=465).

Variable Frequency Percentage

Had sexual intercourse
Yes 122 26.2
No 343 73.8

Reason to start sexual intercourse

Marriage 36 29.5
Peer pressure 34 27.9
Personal desire 52 42.6

Age at first sex

<18 years old 94 77
≥18 years old 28 23

First sexual intercourse with

Girl/boy friend 93 76.2
Husband/wife 29 23.8

Number sexual partner in life time

One 72 59
Two 39 32
Three or more 11 9

Had sexual intercourse within 12 month

Yes 111 91
No 11 9

Number of sexual partner within 12 month

One 74 66.7
Two 27 24.3
Three or more 10 9

Asrese and Mekonnen, 2018; Mariam et al., 2018; Nigeria and Ethiopia (Mullu et al., 2016; Ali, 2017). This
Abebe et al., 2013; Manee and Aria, 2018; Mullu et al., incongruence may be due to socio-cultural and
2016; Abdu et al., 2017; Dadi and Teklu, 2014; Kahsay environmental factors and advance in different factors
et al., 2017; Mamo et al., 2016; Ali, 2017). The reason that promote early sexual start (peer pressure, visiting
for this discrepancy is due to the difference in the study night clubs, watching different moves and substance
area and period difference, socio-cultural factors and abuse).
difference in methodological aspects. This finding indicated that 41% of participants had
In this study, 26.2% study participants had sexual multiple sexual partners having more than one partner in
intercourse and of them, 91% had sexual intercourse lifetime and 33.3% had within twelve month. This finding
within the last twelve months. This was incongruent with was comparable with some studies done in Ethiopia
some of the studies done in different parts of the world (Furry, 2015; Regassa et al., 2016). However, it was low
(Cherie and Berhanie, 2015; Adeomi et al., 2014; Asrese when compared with other studies done in Ethiopia and
and Mekonnen, 2018; Dadi and Teklu, 2014). Regarding Nigeria (Cherie and Berhanie, 2015; Tadesse and
sexual start, 77% of respondents began before the age Yakob, 2015; Alamrew et al., 2013; Asrese and
of 18 years. This was inconsistent with studies done in Mekonnen, 2018; Mengistu et al., 2013; Kahsay et al.,
436 J. Public Health Epidemiol.

70.0%
70.0%
62.3%
62.3%
60.0%
60.0%

50.0%
50.0% 46.4%
46.4%
Percentage

40.0%
40.0%
31.9%
31.9%
30.0%
30.0%

20.0%
20.0% 17.4%
17.4%

10.0%
10.0%

0.0%
0.0%
I hate condom
I hate condom I trust my my
I trust friend
friend Condom
Condom decrease
decrease Other†
Other†
satisfaction
satisfaction

Figure 2. Reasons for not using condom among preparatory school students in Arba Minch
town, Southern Ethiopia, 2018 (n=465). †Sexual partner is not volunteer and does not have
access to condom during that time.
Percentage

Figure 3. Types of family planning used among preparatory school students in Arba Minch
town, Southern Ethiopia, 2018 (n=465).

2017; Mamo et al., 2016; Ifeadike et al., 2018; Teferra Kahsay et al., 2017). However, it was inconsistent with
et al., 2015) and high as compared to some studies studies conducted in Ghana and Ethiopia (Fentahun and
done elsewhere (Negeri, 2014; Abebe et al., 2013). The Mamo, 2014; Abebe et al., 2013; Amoah, 2017; Gizaw et
reason for this may be the fact that lives in risky place or al., 2018; Henok et al., 2015; Mavhandu-Mudzusi and
environments (urban with a number of nightclubs), Asgedom 2016). This may be due to an awareness gap,
luxuries life style and substance abuses. As stated in lack of access to sexual and reproductive health
this study, 82% of respondents had used condom for sex services in friendly way and environmental factors. In
and from them only 46.2% used constantly and this study, only 9% had contact with high risky individual
consistently. This finding was congruent with studies or commercial sex workers (CSWs). This was more or
done in parts of Ethiopia (Cherie and Berhanie, 2015; less congruent with one of the study done in Ethiopia
 Mersha et al. 437

Figure 4. Risky sexual behaviors among preparatory school students in Arba

Minch town, Southern Ethiopia, 2018 (n=465)

Table 3. Substance abuse among preparatory school students in Arba Minch town,
Southern Ethiopia, 2018 (n=465).

Variable Frequency Percentage

Chewing chat
Yes 63 13.5
No 402 86.5

Drinking alcohol
Yes 151 32.5
No 314 67.5

Smoking cigarette
Yes 33 7.1
No 432 92.9

Using hashish/shisha
Yes 32 6.9
No 433 93.1

(Mamo et al., 2016). stability and environmental factors in favor of socio-

In this study, marital status, those of whose fathers cultural factors. Exposure to pornographic movies was
had low educational status and occupational status of one factor that promotes unhealthy sexual relationship
governmental employer and mother‟s educational status and this study showed those who had exposure were
of merchant were significantly associated with risky more likely to practice risky sexual behaviors. This result
sexual behaviors. This was in line with studies done in was supported by different studies done in Tanzania and
Ethiopia (Tadesse and Yakob, 2015; Alamrew et al., parts of Ethiopia (Tadesse and Yakob, 2015; Mariam et
2013). However, it was inconsistent with Nigeria and al., 2018; Nigatu et al., 2018; Kahsay et al., 2017; Yarro
Ethiopia studies (Ali, 2017; Ifeadike et al., 2018). The and Kafanabo, 2016). Nevertheless, contradictory to
reason for these controversies is socio-economic some studies done in Ethiopia (Alamrew et al., 2013; Ali,
438 J. Public Health Epidemiol.

Table 4. Knowledge about HIV/AIDS among preparatory school students in Arba Minch town, Southern Ethiopia, 2018 (n=465).

Variable Frequency Percentage

Transmission ways
Unprotected sexual intercourse
Yes 447 96.1
No 18 3.9

Sharing needles
Yes 397 85.4
No 68 14.6

Breastfeeding
Yes 351 75.5
No 114 24.5

Blood contact
Yes 363 78.1
No 102 21.9

Prevention ways
Using condom
Yes 443 95.3
No 22 4.7

Do not eating together

Yes 0 0
No 465 100

Do not sharing needles

Yes 374 80.4
No 91 19.6

HIV/AIDS is curable
Yes 33 7.1
No 432 92.9

Do you think that healthy looking individuals have HIV

Yes 253 54.4
No 212 45.6

Knowledge about HIV/AIDS

Good 323 69.5
Poor 142 30.5

2017). Drinking alcohol and using hashish/shisha result with studies done in parts of Ethiopia, in three Asian
in inappropriate judgments and unwanted outcomes. countries (Hanoi, Shanghai, and Taipei) and Nigeria
This study speculated that those individuals were more (Negeri, 2014; Mariam et al., 2018; Nigatu et al., 2018;
prone to risky sexual behavior. This finding correlates Fentahun and Mamo, 2014; Kahsay et al., 2017; Ifeadike
 Mersha et al. 439

Table 5. Bivariate and multivariate analysis of factors associated with risky sexual behaviors among preparatory school students in
Arba Minch town, Southern Ethiopia, 2018 (n=465).

Risky sexual behavior (95% CI)

Variable
No (%) Yes (%) Crude OR Adjusted OR
Sex
Male 183 (71.8) 72 (28.2) 1
Female 178 (84.8) 32 (15.2) 0.46 (0.29-0.73)

Age
15-19 322 (79.1) 85 (20.9) 1
20-29 39 (67.2) 19 (32.8) 1.85 (1.02-3.36)

Marital status
Single 348 (82.7) 73 (17.3) 1 1
Married 13 (29.5) 31 (70.5) 11.37 (5.67-22.78) 3.28 (1.24-8.70)***

Grade level
Grade 11 175 (73.8) 62 (26.2) 1
Grade 12 186 (81.6) 42 (18.4) 0.64 (0.41-0.99)

Educational status of father

Cannot read and write 32 (78) 9 (22) 1 1
Read and write 13 (56.5) 10 (43.5) 2.74 (0.90-8.28) 5.96 (1.35-26.25)**
Primary 51 (68.9) 23 (31.1) 1.60 (0.66-3.89) 3.12 (0.90-10.77)
Secondary and above 265 (81) 62 (19) 0.83 (0.38-1.83) 1.35 (0.44-4.14)

Occupational status of father

Government employer 131 (85.6) 22 (14.4) 0.63 (0.31-1.25) 0.33 (0.12-0.93)*
Merchant 46 (71.9) 18 (28.1) 1.46 (0.69-3.09) 1.39 (0.51-3.81)
Farmer 117 (71.8) 46 (28.2) 1.46 (0.79-2.73) 0.86 (0.33-2.23)
Other† 67 (78.8) 18 (21.2) 1 1

Educational status of mother

Cannot read and write 32 (71.1) 13 (28.9) 1
Read and write 16 (59.3) 11 (40.7) 1.69 (0.62-4.61)
Primary 35 (77.8) 10 (22.2) 0.70 (0.27-1.83) -
Secondary and above 278 (79.9) 70 (20.1) 0.62 (0.31-1.24)

Occupational status of mother

Government employer 75 (82.4) 16 (17.6) 0.56 (0.29-1.06) 0.60 (0.22-1.63)
Merchant 111 (85.4) 19 (14.6) 0.45 (0.25-0.81) 0.22 (0.09-0.51)******
Farmer 63 (70.8) 26 (29.2) 1.08 (0.60-1.91) 0.58 (0.25-1.35)
Other†† 112 (72.3) 43 (27.7) 1 1

Living with family

Yes 333 (80.6) 80 (19.4) 0.28 (0.15-0.51) -
No 28 (53.8) 24 (46.2) 1
440 J. Public Health Epidemiol.

Table 5 Contd.

Watching pornographic movies

Yes 126 (59.2) 87 (40.8) 9.54 (5.44-16.76) 8.80 (4.04-19.17)******
No 235 (93.3) 17 (6.7) 1 1

Participation in religious education

Yes 331 (80.3) 81 (19.7) 0.32 (0.18-0.58) -
No 30 (56.6) 23 (43.4) 1

Chewing chat
Yes 35 (55.6) 28 (44.4) 3.43 (1.97-5.98) -
No 326 (81.1) 76 (18.9) 1

Drinking alcohol
Yes 84 (55.6) 67 (44.4) 5.97 (3.73-9.55) 2.71 (1.35-5.46)****
No 277 (88.2) 37 (11.8) 1 1

Smoking cigarette
Yes 13 (39.4) 20 (60.6) 6.37 (3.05-13.33)
No 348 (80.6) 84 (19.4) 1

Using hashish/shisha
Yes 13 (40.6) 19 (59.4) 5.98 (2.84-12.59) 14.88 (4.52-48.96)******
No 348 (80.4) 85 (19.6) 1 1

Knowledge about HIV/AIDS

Good 268 (83) 55 (17) 1 1
Poor 93 (65.5) 49 (34.5) 2.57 (1.64-4.03) 2.89 (1.42-5.88)*****
† ††
Daily labor, private worker, driver and wavier. House wife, daily labor and private worker. *P=0.037, **P=0.018, ***P=0.017, ****P=0.005,
*****P=0.003 and ******P<0.001.

et al., 2018; Mavhandu-Mudzusi and Asgedom, 2016); 2017; Ifeadike et al., 2018; Wang et al., 2015). Maternal
however, inconsistent with some studies done elsewhere educational status was not a significant contributing
(Alamrew et al., 2013, Dadi and Teklu, 2014). For this factor to student‟s risky sexual behaviors. This agreed
discrepancy, methodological aspects over weight other with studies done in Cambodia and Ethiopia (Derbie et
situations. In general, knowledge gap can be a major al., 2016). In addition, chewing chat and smoking
factor that results in sexual and reproductive health cigarettes were not significant after controlling for
problems. In this finding those students who had poor confounders in this study.
knowledge about HIV/AIDS was significantly associated
with risky sexual behaviors. This is in line with a study
conducted in Ethiopia (Mullu et al., 2016). Conclusion
Sex, current age of participants, grade level, live with
family and participation in religious education were not This finding noted that significant numbers of students
significantly associated with risky sexual behaviors. This were engaged in risky sexual behaviours. Those students
was congruent with studies conducted in Ethiopia had multiple sexual partners, inconsistent use of
(Negeri, 2014; Mariam et al., 2018; Mullu et al., 2016; condoms, sex with risky individuals and an early sexual
Ali, 2017). However, it contradicts studies conducted in start (by ages 13 to 14). Marital status, educational and
three Asian countries (Hanoi, Shanghai, and Taipei), occupational status of father‟s, occupational status of
Nigeria, Bahamas, Cambodia and else were in Ethiopia mother‟s, watching pornographic movies, drinking
(Nigatu et al., 2018; Dadi and Teklu, 2014; Kahsay et al., alcohol and using shisha/hashish and poor knowledge
 Mersha et al. 441

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