Early sexual debut and subsequent rist factors among youth in Rwanda: a secondary data analysis of Rwanda Demographic and Health Survey 2015

Abstract

Introduction: Initiation of sexual intercourse at an early age is one of the well-known risk factors for Human Immunodeficiency Virus, other Sexually Transmitted Infections and reproductive health problems. We aimed to determine the proportion of early sexual debut before 18 years and explore factors associated with this behavior in youth aged 15-24 years in Rwanda. Methods: We performed a secondary data analysis using the Rwanda Demographic and Health Survey (RDHS) 2015. We included 7,532 youth aged 15-24 years, who responded in the RDHS 2015 and youth who reported ever having sex were the subject of our interest. We defined early sexual debut as having sex intercourse before 18 years and we statistically tested demographic, behavioral, socio-economic and biological factors to ascertain their association with early sexual debut among our study population. Variables that were significant in the bivariate analysis with a p-value <= 0.1 were included in the multivariate logistic regression and we considered final results at a p-value at and <= 0.05. Results: Overall 3008 (39.9%) of Rwandan youth aged 15-24 years had ever had sex. About 1375 (45.7%) initiated early sexual intercourse (before the age of 18yrs), 726 (37%) had the first sex with their boy/girlfriends. Among youths who had history of sexual debut at an early age, only 19.4% reported using condom. Multivariate analysis showed that among youth aged 15-24 who ever had sex, those aged 20-24 at the time of the survey were less likely to initiate early sexual intercourse (AOR=0.05; 95%CI [0.01-0.18]) compared to youth aged 15-19. Youth who were ever forced to perform unwanted sexual acts were more than three times likely to initiate sexual intercourse earlier, than those who did not (AOR=3.39); 95%CI [1.66-6.92]) Conclusion: Our study indicates that a considerable proportion of youths engage in sexual activity at an early age and practice risky sexual behaviors. Strengthening already implemented policies aiming on fighting against sexual violence especially in youth is needed as well as educating youth on importance of delaying sexual intercourses Keyword: Early sexual debut, sexual intercourse, associated factors, youth, Rwanda