Socio-demographic characteristics
A total of 644 individuals were participated in the study with a response rate of 97.7%. More than half 55% (354) of the study participants were female students. The majority of participants, 78.6% (506) of study participants were orthodox Christian followers by religion. Regarding educational levels of students, 53.2% (336) were grade nine students and the rest 47.8% (308) of them were grade ten students. One third (67.1 %) of the study participants were from urban in their residence. (Table 1)
Table 1: socio-demographic characteristics of adolescents at high schools in Aksum town, Tigray, Ethiopia, 2019
Variables
|
Category
|
Frequency
|
percentage
|
Sex
|
Male
|
290
|
45
|
Female
|
354
|
55
|
Educational level
|
Grade 9
|
336
|
52.2
|
Grade 10
|
308
|
47.8
|
Religion
|
Orthodox
|
512
|
79.5
|
Muslim
|
106
|
16.5
|
protestant
|
26
|
4
|
Residence
|
Urban
|
432
|
67.1
|
Rural
|
212
|
32.9
|
Fathers’ educational status
|
Illiterate
|
86
|
13.4
|
1-4thgrade
|
169
|
26.2
|
5-8thgrade
|
146
|
22.7
|
9-12thgrade
|
113
|
17.5
|
Certificate and above
|
130
|
20.2
|
Mothers’ educational status
|
Illiterate
|
180
|
28
|
1-4thgrade
|
143
|
22.2
|
5-8thgrade
|
128
|
19.9
|
9-12thgrade
|
121
|
18.8
|
Certificate and above
|
72
|
11.2
|
Fathers’ occupation
|
Farmer
|
228
|
35.4
|
Daily laborer
|
34
|
5.3
|
Merchant
|
114
|
17.7
|
Governmental/private employee
|
268
|
41.6
|
Mothers’ occupation
|
Farmer
|
182
|
28.3
|
Daily laborer
|
38
|
5.9
|
Merchant
|
78
|
12.1
|
Governmental/private employee
|
203
|
31.6
|
Housewife
|
143
|
22.2
|
Family size
|
1-5
|
378
|
58.7
|
>5
|
266
|
41.3
|
Social support related factor
As measured by the three-item Oslo social support scale, 46.4% (299) of adolescents lay in the poor social support level followed by moderate social support which was 32% (206). The rest have been found to lay in a strong or good social support level. (Figure 1)
Figure 1: distribution of social support related factors among adolescents at high schools in Aksum town, Tigray Ethiopia, 2019
Substance use-related factors
Among participants of this study, most students used alcoholic beverages both in their lifetime and within the last three months of the study time. (Figure 2)
Figure 2: Distribution of substance use-related factors among adolescents at high schools in Aksum town, Tigray Ethiopia, 2019
Clinically related factors
Among the total participants of this study, 28.9% of them have been found to have possible depression as screened by PHQ-9. Parental treatments towards adolescents were also screened and the result indicated about 36.5% of the students reported as they are neglected by their parents, caregivers or guardians due the study time.
Prevalence of risky sexual behavior and associated Factors
According to our study, the overall prevalence of risky sexual behavior among adolescents at high schools in Aksum town were found to be 17.2% (95% CI; 14.3%, 20.2%). Among the total 354 female participants, risky sexual behavior is 16.1% (57/354) whereas it is found to be 18.6% (54/290) in males. A high degree of occurrence in the prevalence of risky sexual behavior has been observed among those who were following grade nine when compared to those who were following grade ten during the study period. On the contrary, almost the same degree of occurrence of risky sexual behavior has been observed between those who were from urban and rural. (Figure 3)
Figure 3: distribution of prevalence of risky sexual behavior with sex of participants among adolescents at high schools in Aksum town, Tigray Ethiopia, 2019
Regarding factors associated with risky sexual behavior of study participants, bivariate logistic regression was done to identify candidate factors for multivariate logistic regression analysis. These factors have been selected at p-value <0.25. after controlling for confounding effect by multivariate logistic regression, factors like poor social support, living out of the family, experiencing parental neglect and current alcohol use are associated with risky sexual behavior of study participants at p-value <0.05.
Those adolescent students who have poor social support were 5.59 times more likely to participate in risky sexual behavior as compared to those who have strong social support [AOR=5.59, 95% CI: 2.71-11.53]. Another variable that was found to be associated with risky sexual behavior was living without a family member. Students who were living out of their family members were 1.93 times more likely to participate in risky sexual behavior when compared to those who were living with their family [AOR=1.93, 95% CI: 1.21-3.07].
Adolescent students who experienced parental neglect by their primary caregivers were also among those who were found to have a significant association with risky sexual behavior. The probability of participating in risky sexual behavior found to be increased by 87% in those who experienced parental neglect when compared to those students who didn’t experience [AOR=1.87, 95% CI: 1.18-2.94].
Those who were drinking alcoholic beverages were 2.55 times more likely to have risky sexual behavior than those who didn’t drink [AOR=2.55, 95% CI: 1.55-4.20]. (Table 2)
Table 2፡ bivariate and multivariate logistic analysis of factors associated with risky sexual behavior among adolescents at high schools in Aksum town, Tigray, Ethiopia, 2019
Variables
|
Category
|
Risky sexual behavior
|
COR (95% C.I.)
|
AOR (95% C.I.)
|
Yes
|
No
|
Educational level
|
Grade 9
|
65
|
271
|
1
|
1
|
Grade 10
|
46
|
262
|
0.73(0.49, 1.11)
|
0.72(0.49, 1.13)
|
Social support
|
Poor
|
214
|
85
|
5.12(2.57, 10.22)
|
5.59(2.71, 11.53)***
|
Moderate
|
190
|
16
|
1.09(0.48, 2.47)
|
1.27(0.54, 2.97)
|
Strong
|
129
|
10
|
1
|
1
|
Living with family member
|
Yes
|
63
|
381
|
1
|
1
|
No
|
48
|
152
|
1.91(1.26, 2.91)
|
1.93(1.21, 3.07)**
|
Depression
|
Yes
|
42
|
144
|
1.64(1.07, 2.52)
|
1.21(0.74, 1.98)
|
No
|
69
|
389
|
1
|
1
|
Parental neglect
|
Yes
|
54
|
181
|
1.84(1.22, 2.79
|
1.87(1.18, 2.94)**
|
No
|
57
|
352
|
1
|
1
|
Current Alcohol use
|
Yes
|
41
|
104
|
2.42(1.56, 3.76)
|
2.55(1.55, 4.20)***
|
No
|
70
|
429
|
1
|
1
|
Lifetime cigarette smoking
|
Yes
|
12
|
14
|
4.94(2.02, 10.01)
|
4.52(0.92, 22.19)
|
No
|
99
|
519
|
1
|
1
|
Current cigarette smoking
|
Yes
|
8
|
12
|
3.37(1.35, 8.46)
|
0.29(0.05, 1.83)
|
No
|
103
|
521
|
1
|
1
|
Fathers’ educational status
|
Illiterate
|
15
|
71
|
1.75(0.80, 3.84)
|
0.86(0.36, 2.04)
|
1-4 grade
|
27
|
142
|
1.58(0.79, 3.14)
|
1.04(0.49, 2.18)
|
5-8 grade
|
26
|
120
|
1.80(0.89, 3.61)
|
1.15(0.54, 2.44)
|
9-12 grade
|
29
|
84
|
2.86(1.43, 5.74)
|
1.92(0.89, 4.14)
|
Certificate & above
|
14
|
116
|
1
|
1
|
** P-value< 0.01 *** P-value<0.001