Prevalence and Associated Factors of Early Sexual Initiation among female youth in Tanzania: a nationwide survey

Abstract Background: Early sexual initiation among female youth in Tanzania presents a significant public health concern, as it is associated with increased risks of unintended pregnancies, sexually transmitted infections (STIs), and adverse socio-economic consequences.​ This study aimed to determine the prevalence and associated factors of early sexual initiation among female youth in Tanzania. Methods: We used data from the 2022 Tanzania Demographic and Health Survey, which was conducted between February 24 and July 21, 2022. The sampling frame was stratified by geographic region and urban/rural areas, using a two-stage sampling method that selected primary sampling units based on census enumeration areas, followed by household selection using probability systematic sampling. Data management and analysis were performed using STATA version 18.5, descriptive statistics and a weighted logistic regression model to determine factors associated with early sexual initiation. Odds ratios (OR) and 95% Confidence interval (CI) were used to estimate the strength of association. Results: The overall prevalence of early sexual initiation among female youth in Tanzania was 17.4% (95%CI: 15.77-19.24). In the adjusted analysis, female youth with no formal education were more likely to have early sexual initiation (aOR=3.28, 95%CI: 2.22-4.86). Additionally, female youth who were working were more likely to have early sexual initiation (aOR=0.77, 95%CI: 0.59-0.99). Women aged 20 to 24 showed a decrease in the likelihood of early sexual initiation (aOR=0.69, 95% CI: 0.56-0.85). Conclusion: This study found a significant proportion of AGYW who had early sexual debut. Addressing early sexual debut among Tanzanian youth requires a multifaceted approach that includes educational reforms and comprehensive economic strengthening while addressing structural inequalities that increase their sexual vulnerability.​ Prioritizing access to quality education, empowerment, and comprehensive sexual health education is essential to mitigate the risks associated with early sexual initiation.