Prevalence and Factors Associated with Early Sexual Debut among Preparatory School Students in Gondar Town, North West Ethiopia 2018

Objective: Early sexual debut increases youth exposure to risky sexual behaviors, STIs including HIV/AIDS, and unsafe abortion. There is study limitation on this specific issue on the study area. Therefore, this study aimed to determine the prevalence and associated factors of early sexual debut among preparatory school students in Gondar town, North West Ethiopia. Results: From a total of 797 students, 750 respondents complete the questionnaire giving a response rate of 94.1%. About 20.5% with 95%CI (17.6, 23.3%) of the respondents had early sexual debut. Had lesson on sexuality education (AOR=2.14, 95%CI 1.15, 3.98), drinking alcohol (AOR= 14.5, 95%CI 7.81, 27.22), had good parental monitoring (AOR=3.6, 95%CI 1.8, 7.45), had discussion on sexual issues with parents (AOR=3.05, 95%CI 1.04, 8.88), and had good academic achievement (AOR=4.2, 95%CI 1.72, 10.26) were found to be significantly associated with early sexual debut. Sexual education programs at earlier life may help to delay sexual debut for school youths and is recommended to incorporate it in the curriculum. words:


Introduction
Early sexual debut is performing sex before the age of 18 years. Early sexual debut increases young people to STIs including HIV/AIDS, early pregnancy, child birth, unsafe abortion, and dropout from school [1,2].
Studies conducted in different parts of the world showed the prevalence of early sexual debut being 9.8% in Malaysia [3], 18 [11], 27.6% in Legehida district [12].
The prevalence as well as the factors associated with early sexual debut varies from place to place and hence it is very difficult to generalize the results of other studies for the current setting. Hence, this study was conducted to determine the prevalence and associated factors of early sexual debut among preparatory school students in Gondar town, North West Ethiopia. Written consent was obtained from each study participants' of age above 18 years after informing them all the purpose, benefits, and risks on participation on the this study. Individual assent and parental consent was obtained for those participants of age below 18 years. In addition participants were informed about the importance of keeping the confidentiality of the responses they provided and the voluntary nature of participants in the study.   (Table 3).

Discussion
The prevalence of early sexual debut in this study was 20.5% with 95% CI influence on young peoples' engagement in early sexual debut. [19].
The odds of early sexual debut is four times more experienced among respondents who had no history of good academic achievement as compared to those who had good academic achievement. This is in line with a study conducted in faggeta Lekoma district of Awi zone [11]. The reason could be those students who have good academic achievement may be engaged more in reading on subject(academic) matters rather than reading on magazines and watching different medias that promote early sexual debut. In addition, those students who had poor academic achievement may be out of school, and may be exposed to different risky behaviors like alcohol drinking, chewing Khat and other substances that may in turn lead youth to practice early sexual debut. Moreover, those students who have poor academic performance usually and may watch different pornographic films that may promote early sexual debut.
The odds of early sexual debut is three times more common among participants who had no history of discussion on sexuality issues with their parents as compared to those who had. This is supported by studies

Declarations Ethics approval and consent to participate
Ethical clearance was obtained from the Institutional Review Board of the Institute of Public Health, University of Gondar. A formal letter request of cooperation was written to Gondar town administration office. Written consent was obtained from each study participants. Confidentiality of information and privacy was maintained.

Consent to publish
Not applicable.

Availability of data and materials
All the datasets used to made the conclusions of the current study are included in the main manuscript.   AOR=Adjusted odds ratio, COR=Crude odds ratio, CI =Confidence interval, *with bold indicate statically significant at p value ≤0.05