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Does Youth-Friendly Service Intervention Reduce Risky Sexual Behavior in Unmarried Adolescents? A Comparative Study in West Gojjam Zone, Northwest Ethiopia

Authors Mekonnen Munea A, Alene GD, Debelew GT

Received 20 March 2020

Accepted for publication 25 June 2020

Published 31 July 2020 Volume 2020:13 Pages 941—954

DOI https://doi.org/10.2147/RMHP.S254685

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Marco Carotenuto


Alemtsehay Mekonnen Munea,1 Getu Degu Alene,1 Gurmesa Tura Debelew2

1School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia; 2Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia

Correspondence: Alemtsehay Mekonnen Munea Email alemtsehay21@yahoo.com

Background: Risky sexual behavior established during adolescence adversely affect young people’s health and well-being. Youth-friendly services (YFS) programs are believed to improve the sexual and reproductive health of adolescents. Little is known about the effect of YFS programs on adolescents’ sexual behavior in Ethiopia. Therefore, this study assessed the sexual behavior of unmarried adolescents in YFS-program and nonprogram areas and factors contributing to their sexual behavior in West Gojjam Zone, Northwest Ethiopia.
Methods: This community-based comparative cross-sectional study was conducted among 1,125 randomly selected unmarried adolescents (545 from program areas and 580 from nonprogram areas) in June 2018. Data were collected in face-to-face interviews using a pretested questionnaire and analyzed using SPSS version 21. Between groups, comparisons were made using χ2 and t-tests. A hierarchical logistic regression model was employed to identify important variables explaining risky sexual behavior.
Results: Of all respondents, 305 (27.1%) had risky sexual behavior, which was comparable between the YFS-program and nonprogram areas (25.0% vs 29.1%, p=0.12). Including YFS program-related variables in the hierarchical regression model did not improve the explanation of risky sexual behavior over the individual attributes. On the other hand, including interpersonal-related variables (eg, with parents) significantly improved the explanation of risky sexual behavior over and above individual attributes and YFS program–related variables. A point increase in parent–adolescent communication score reduced risky sexual behavior by 20% (AOR 0.80, 95% CI 0.75– 0.85). Being female, being older, having knowledge on family planning and HIV, out of school, and watching pornography were associated with higher odds of engaging in risky sexual behavior.
Conclusion: Risky sexual behavior was comparable between settings. Parent–adolescent communication about sexual and reproductive health issues is more important in predicting adolescents’ risky sexual behavior than other variables. Therefore, interventions should give emphasis to parent–adolescent communication to reduce adolescents’ risky sexual behavior.

Keywords: risky sexual behavior, parent–adolescent communication, youth-friendly services

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