Social network correlates of risky sexual behavior among adolescents in Bahir Dar and Mecha Districts, North West Ethiopia: an institution-based study

Background: Behaviors established during adolescence such as risky sexual behaviors have negative effects on future health and well-being. Extant literature indicated that individual attributes such as peer pressure and substance use have impacts on healthy development of young peoples' sexual behavior. The patterns of relationships (social network structure) and the social network content (members' norm regarding sexual practice) established by adolescents' network on adolescents' risky sexual behaviors are not well investigated. Methods: This cross-sectional study assessed the roles of social networks on sexual behavior of high school adolescents in Bahir Dar and Mecha district, North West Ethiopia. Data were collected from 806 high school adolescents using a pretested anonymously self administered questionnaire. Hierarchical logistic regression model was used for analysis. Results: The results indicated that more than 13% had risky sexual behavior. Taking social networks into account improved the explanation of risky sexual behavior over individual attributes. Adolescents embedded within increasing sexual practice approving norm (AOR 1.61; 95% CI: 1.04 - 2.50), increasing network tie strength (AOR 1.12; 95% CI: 1.06 - 1.19), and homogeneous networks (AOR 1.58; 95% CI:.98 - 2.55) were more likely to had risky sexual behavior. Engaging within increasing number of sexuality discussion networks was found protective of risky sexual behavior (AOR.84; 95% CI:.72 - .97). Conclusion: Social networks better predict adolescent's risky sexual behavior than individual attributes. The findings indicated the circumstances or contexts that social networks exert risks or protective effects on adolescents' sexual behavior. Programs designed to reduce school adolescents' sexual risk behavior should consider their patterns of social relationships.