Early sexual debut and associated factors among in-school adolescents in eight African countries

Objective: This report examines early sexual debut (< age 15) among 15-year-old in-school adolescents in eight African countries. Participants: The total sample included 10 070 school children aged 15 years from nationally representative samples from eight African countries. Methods: Univariate and multivariate analyses were conducted to assess the relationship between early sexual debut and alcohol, tobacco and other drug use, mental distress, physical activity, protective factors and socioeconomic status variables. Results: A total of 27.3% had experienced sexual debut before age 15, 38.1% among boys and 15.8% among girls. Boys and girls with sexual debut at less than age 15 were more likely to report alcohol, tobacco and drug use, truancy, poor parental or guardian connectedness, sedentary behaviour, having been in a physical fight and seriously injured, while for girls, mental distress and poor economic status and for boys, bullied and poor parental or guardian supervision were associated with early coital debut. In multivariable analysis, early sexual debut was among boys associated with currently smoking (OR = 4.45, p = 0.002) and truancy (OR = 2.02, p = 0.007) and, among girls, associated with lower education (OR = 0.22, p = 0.004), ever drunk (OR = 3.94, p = 0.016), having no close friends (OR = 3.36, p = 0.014) and poor parental connectedness (OR = 2.43, p = 0.037). Conclusion: The study found a high prevalence of early sexual debut among 15-year-olds in eight African countries. Risk factors identified were consistent with problem behaviour theory in which early onset of adolescent sexual behaviour is shared with other problem behaviours. Prevention programmes should broaden sexual health promotion including problem behaviour such as substance use and mental distress for boys and girls in the preteen years, before sexual debut.