Prevalence and Factors Associated With Risky Sexual Behaviors Among Young People in Ethiopia: Systematic Review and Meta-Analysis
Belete Feyera Olkaba, Dejene Hailu Kassa, Desalegn Wirtu, Meseret Robi Tura, Lema Mideksa Egu, Wubet Tazeb Wondie, Gemechu Gelan Bekele, Ebisa Zerihun, Belay Tafa Regassa, Solomon Seyife Alemu, Nimona AmenaIntroduction
Young people are likely to experience a variety of social and health issues; they might engage in sexual activity without the necessary information and skills for protection, which consequently leads to unintended pregnancy, unsafe abortion, and contracting STDs like HIV/AIDS and others. Moreover, risky sexual behaviors such as unprotected sex and transactional sex were common in early adolescents among high-risk groups and early unprotected sexual activities. Therefore, this systematic review and meta-analysis will be essential to estimate the pooled prevalence of risky sexual behaviors and related determinants among Ethiopian Young people.
Methods
A systematic review and meta-analysis of cross-sectional studies was conducted from November 1, 2014, to October 31, 2024. We searched major databases like Cochrane Library, PubMed, Scopus, Web of Science, Embase, CINAHL, PsycINFO, and also searched Google Scholar for missed articles. The JBI critical appraisal checklist for cross-sectional studies was used to assess risk of bias. The key data were extracted into a structured Excel form and analyzed using STATA version 17 software. The analysis includes 15415 people and 22 articles in total.
Result
The pooled estimate of risky sexual behavior in Ethiopia was 44.19% with 95%CI [34.18-54.21].
Male young people were 4.05 times more likely to engage in risky sexual behaviors OR 4.05[1.30-6.81]. Young people who use alcohol are 2.67 times more likely to engage in risky sexual behaviors OR 2.67[1.99-3.36]. Shisha use was significantly associated with risky sexual behaviors among young people in Ethiopia as a risk factor at OR 2.72[1.64-3.79]. The pooled prevalence of risky sexual behaviors among young people over the last ten years in Ethiopia was high. Gender differences, alcohol consumption, watching pornography, and peer pressure were factors for risky sexual behaviors among young people in Ethiopia.
Conclusion
Nearly half of the adolescents engaged in risky sexual behaviors, indicating the importance of early intervention to reduce social and environmental drivers of risky sexual behaviors among young people. The Ethiopian Ministry of Health and other concerned stakeholders should give due concern to mitigate engagement of adolescents in risky sexual behaviors; Comprehensive sexuality education and interventional planning are required to reduce the engagement of young people in risky sexual behaviors as well as to reduce risk factors. Furthermore, the future researcher should find a comprehensive and effective prevention method that addresses individual, family, peer, and school factors rather than concentrating solely on personal decisions.