Factor Associated with Sexual Behaviours among Adolescents in a Rural Tanzania: Evidence from the African Research, Implementation Science, and Education (ARISE) Network

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Consequently, there has been an increase in unsafe sexual practice behaviour. We assessed sexual behaviours and their associated factors among adolescents using African Research, Implementation Science, and Education (ARISE) Network data. Subject and Methods: We utilise data from the ARISE Network’s Adolescent Health Study, a cross-sectional study in six countries in sub-Saharan Africa involving rural adolescents aged 10–19 years. Participant information, health and sexual behaviours were collected through an interview-administered questionnaire. Both univariate and multivariate Poisson regression analyses were used to assess the factors associated with ever having sex. Results The proportion of adolescents who had sexual intercourse was 21.1% (95% CI: 18.9–23.5). Of those, 45.6% reported having more than one sexual partner. Being female was inversely associated with ever having sexual intercourse (APR: 0.37; 95% CI: 0.29–0.47). Age was significantly associated with ever having sexual intercourse (APR: 1.17; 95% CI:1.12–1.23). Living with a colleague (APR: 2.92; 95% CI: 1.96–436), adolescents who have been employed within the past year (APR: 1.34; 95% CI: 1.09–1.65), being exposed to pornography (APR: 2.07; 95% CI: 1.64–2.60) and receiving a sex joke, (APR: 1.84; 95% CI: 1.51–2.24) were significantly associated with ever having sexual intercourse among adolescents. Conclusion The findings highlight factors impacting sexual behaviour among adolescents. Promoting adolescents’ sexual health and well-being requires community-based interventions, family involvement, and comprehensive sexual education programs. Efforts must be made to raise public understanding of good sexual practice behaviour. Introduction During adolescence, a child undergoes several physiological, psychological, and social growth and development changes, with sexual and reproductive growth and development being among the remarkable changes ( 1 ). The report shows more than 1.2 billion adolescents worldwide, and 90% live in middle- and low-income countries, according to 2022 UNICEF Statistics ( 2 ). Among all those adolescents, studies have revealed the influence of sociological and cultural environments in shaping sexual behaviour in both urban and rural settings. These environments lead adolescents to face several preventable health problems in their transition to adulthood ( 3 ). Almost 13% of adolescent girls globally present with early childbearing, with the majority being not aware of contraceptive methods and safe sex practices ( 4 ). UNICEF report showed a low uptake of HIV testing among adolescents despite early sexual debut. One-quarter of adolescent girls and 17% of adolescent boys in East and Southern Africa were tested for HIV and received results. The trend shows an increase in new HIV infections among adolescents ( 2 ). The number of adolescents is increasing, which poses a need for updated information and status regarding their sexual behaviour. In Tanzania, half of the population is aged less than 19 years ( 5 ). Currently, there is a dynamic shift in the growth of rural adolescents. They face several challenges to sexual health, including limited access to sexual education, contraceptives, and other healthcare services ( 6 ). These challenges are coupled with traditional norms and cultural beliefs, which are strongly upheld in the rural area. The high level of poverty increases the vulnerability of these adolescents to sexual health. As a result, most start to work early and live independent lives that are out of their parents’ watch ( 7 ). Some of these adolescents tend to have unprotected sexual intercourse and multiple sexual affairs, all of which expose them to unintended pregnancy and sexually transmitted infections (STIs), including HIV infection ( 8 , 9 ). Despite the risks mentioned above, only 15% of young women aged 15–19 in developing countries use contraceptives, whether married or not ( 10 ). In Tanzania, only 18.4% of sexually active women aged 15–19 have been reported to use any contraception method ( 11 ). Poor access to medical facilities, stigma towards sexual health discussion, and other taboos related to sexuality lead to an upsurge of unhealthy sexual lifestyles among adolescents in rural settings ( 12 , 13 ). Understanding sexual behaviour is critical among adolescents, especially those in rural settings where access to healthcare and education is limited. The early debut of sexual intercourse has been seen among rural adolescents, which predisposes them to have a higher number of lifetime sexual partners ( 14 – 18 ). Recently, the Dodoma region has been growing into a large cosmopolitan city with all the socio-economic stratification predisposing adolescents to a higher risk of early sexual exposure. As these young people’s population keeps growing, it is vital to comprehend their ever-changing reproductive health needs. Despite the need to address adolescent sexual health, little has been done to investigate the particular sexual practices and difficulties of young people in rural areas with limited resources. This knowledge gap hinders the creation of focused interventions and policies meant to encourage healthy sexual behaviours and lessen the incidence of STIs and unwanted pregnancies among adolescents. This secondary analysis aims to fill the gap by examining adolescent sexual behaviour in a rural setting with limited resources. We aimed to provide research-supported strategies customised to the specific requirements of rural adolescents by identifying patterns, drivers, and contextual factors impacting sexual behaviours. Methods Study design and setting This study employed a household-based cross-sectional design. We used data from The Adolescent Health Study of the ARISE Network, which was carried out across seven locations in sub-Saharan African countries. This collaborative effort was undertaken in partnership with various esteemed institutions, including the Africa Academy for Public Health in Tanzania, the Centre de Recherche en Santé de Nouna in Burkina Faso, Haramaya University in Ethiopia, Muhimbili University of Health and Allied Sciences in Tanzania, the University of Dodoma in Tanzania, the University of Ghana in Ghana, the University of Ibadan in Nigeria, and the University of Swaziland in Swaziland. Our analysis used a dataset from Dodoma, Tanzania. We included household members who lived in the study area for at least four months. Sample size and sampling ARISE Network included 7,662 adolescents from eight sites in six countries participating in the survey. This study included three urban locations, Dar es Salaam (Tanzania), Harar (Ethiopia) and Ibadan (Nigeria), as well as five areas: Dodoma (Tanzania), Iganga/Mayuge (Uganda), Kersa (Ethiopia), Ningo Prampram (Ghana) and Nouna (Burkina Faso). The principal aim was to collect household-based data on health-related activities and the associated risk factors among teenagers to identify disease loads and potential areas for medical solutions. The current study involved an analysis of 1,226 participants who had completed a survey in the Chamwino district, Dodoma, Tanzania. Communities were selected randomly, taking advantage of cohorts of the current population under the supervision of health and demographic surveillance systems (HDSSs). Teenagers aged 10–19 years were randomly selected from each household, and each household was limited to one participant only. Data collection tool and procedure Data was collected from April to December 2017 in the rural Chamwino district. Participants voluntarily agreed to participate, and the trained research assistant collected information through interviewer-administered questionnaires. We used the Global School-based Health Survey (GSHS) and the Health Behaviour School-aged Children Survey (HBSC), which covered different aspects of health and socio-demographic and economic background information. This study focused on sexual behaviours and practices questions originating from the health-related quality of life (HRQOL), the HBSC symptom checklist, and questions on sexual assault adapted from the Life Events Checklist (LEC) for Diagnostic Statistical Manual (DSM-5). More information about the methodology is found in the published methodology paper ( 19 ). Variable measurement The outcome variable for this study was the experience of sexual intercourse. The independent variables included demographics (age, sex, education level/status, living arrangement, life status of a biological parent, and if the participant has ever worked before) and other sexual characteristics (condom use at last sexual encounter, used another family planning method, pregnancy history, wanted the previous pregnancy, the outcome of last pregnancy, self-reported of ever had sexually transmitted infection, and places to get condoms). Statistical analysis We analysed data using STATA version 17 (Stata Corp, College Station, TX). Descriptive statistics were summarised and presented in frequency and percentages for categorical variables, mean (standard deviation) for continuous variables, and Confidence Intervals (CI) estimated precision. The crude and adjusted prevalence ratios were calculated using the Poisson regression model with robust standard errors. Prevalence ratios were used because of the high prevalence of the dependent variable ‘ever had sex’. Crude and adjusted prevalence ratios with corresponding 95% confidence intervals (CIs) were reported. A p-value of less than 0.05 was considered statistically significant. Results Adolescent characteristics In total, 1,226 adolescents were included in the study conducted in the rural part of the Dodoma region (Chamwino district). Among the sample, 66.7% of adolescents were between the ages of 10 and 14, and 33.3% were between the ages of 15 and 19, with a mean age of 13.7 (SD±2.3). Over half of the adolescents were girls (55.3%), and almost one-third (69.5%) had completed primary education. (Table 1) Table 1: Socio-economic and demographic characteristics among adolescents in Dodoma, 2017 (N=1,226) Characteristics Frequency (n) Percent (95% CI) Age group (years) 10-14 818 66.7 (64.0-69.4) 15-19 408 33.3 (30.7-35.9) Mean (Standard deviation) 13.7 (±2.3) (13.6-13.8) Sex Male 548 44.7 (41.9-47.5) Female 678 55.3 (52.5-58.1) Education status* No formal education 7 0.8 (0.4-1.6) Primary education 624 69.5 (66.4-72.4) Secondary/Higher education 267 29.7 (26.8-32.8) Living arrangements Both parents 753 61.4 (58.7-64.1) Single parents 245 20.0 (17.8-22.3) Guardians 202 16.5 (14.5-18.7) Cohabiting 11 0.9 (0.5-1.6) By self/with colleagues 15 1.2 (0.7-2.0) Life status of biological parents Both alive 1,089 88.8 (86.9-90.5) Single parent alive 122 10.0 (8.4-11.8) Both not alive 15 1.2 (0.7-2.0) Ever worked in the last 12 months No 797 65.0 (62.3-67.6) Yes 429 35.0 (32.4-37.7) * Frequency does not tally due to missing values Sexual practices among sexually active adolescents Overall, the proportion of adolescents who ‘ever had sex’ was 21.1% ((95% CI: 18.9-23.5). The mean age of the individuals who were having intercourse was found to be 15.3 (±2.4) years. Of the adolescents, 45.6% said they had more than one sexual partner. More than a quarter (27.4%) reported condom usage during their most recent sexual experience. The majority (86.5%) reported not utilising any other form of family planning. Three in five adolescents (61.2%) have never been pregnant. It’s interesting to note that most (87.1%) of pregnant adolescents wanted to have it. Of those who were pregnant, 77.4% had a live birth, while 22.6% are now pregnant. Furthermore, 99.4% of adolescents did not self-report having ever experienced a sexually transmitted infection. (Table 2) Table 2: Sexual practices among sexually among adolescents in Dodoma, 2017 (N=1,226) Characteristics Frequency (n) Percent (95% CI) Mean age (Standard deviation) 15.3 (2.4) (15.02-15.61) Number of sexual partners One partner 141 54.4 (48.3-60.4) More than one partner 118 45.6 (39.6-51.7) Condom use at the last sexual encounter No 188 72.6 (66.7-77.7) Yes 71 27.4 (22.3-33.2) Used another FP method No 224 86.5 (81.7-90.2) Yes 35 13.5 (9.8-18.3) Pregnancy history No 49 61.2 (50.0-71.5) Yes, one time 28 35.0 (25.2-46.3) Yes, more than once 3 3.8 (1.2-11.2) Wanted the last pregnancy? I wanted it 27 87.1 (68.9-95.4) I did not want it 4 12.9 (4.6-31.1) The outcome of the last pregnancy Currently pregnant 7 22.6 (10.7-41.6) Live birth 24 77.4 (58.4-89.3) Self-reported of ever had STI No 651 99.4 (98.4-99.7) Yes 4 0.6 (0.2-1.6) Places to get condoms Shop 14 40.0 (24.7-57.6) Pharmacy 15 42.9 (27.1-60.3) Government Clinic 6 17.1 (7.6-34.2) * Frequency does not tally due to missing values Factors associated with having ever had sexual intercourse among adolescents Females were inversely associated with ever having sexual intercourse (APR: 0.37; 95% CI: 0.29-0.47). Age was positively related to the likelihood of ever having sexual intercourse (APR: 1.17; 95% CI: 1.12-1.23). There is a notable positive association between an adolescent who is living with a spouse and ever having sexual intercourse (APR: 4.77; 95% CI: 3.08-7.38) and also among those living with a colleague (APR: 2.92; 95% CI: 1.96-436). Being employed within the past year increased the likelihood of engaging in sexual activity by 1.34 times (APR: 1.34, 95% CI: 1.09-1.65). Our finding indicated a strong association between being exposed to pornography and ever having sexual intercourse (APR: 2.07; 95% CI: 1.64-2.60). (Table 3) Table 3: Factors associated with having ever had sexual intercourse among adolescents in Dodoma, 20 (N=1,226) Characteristics Ever had sex Unadjusted Adjusted n (%) PR (95% CI) p-value PR (95% CI) p-value Sex Male 179 (32.7) 1.00 1.00 Female 80 (11.8) 0.36 (0.28-0.46) <0.001 0.37 (0.29-0.47) <0.001 Age 1.34 (1.28-1.39) <0.001 1.17 (1.12-1.23) <0.001 Living arrangements Both parents 144 (19.1) 1.00 1.00 Single parents 54 (22.0) 1.15 (0.78-1.52) 0.316 0.97 (0.74-1.28) 0.842 Guardians 35 (17.3) 0.91 (0.65-1.27) 0.564 0.90 (0.65-1.24) 0.517 With spouse 15 (100.0) 5.23 (4.51-6.05) <0.001 4.77 (3.08-7.38) <0.001 By self/with colleagues 11 (100.0) 5.23 (4.51-6.06) <0.001 2.92 (1.96-4.36) <0.001 Biological parents Both alive 223 (20.5) 1.00 1.00 Single parent alive 34 (27.9) 1.36 (0.99-1.85) 0.050 1.06 (0.77-1.47) 0.699 Both not alive 2 (13.3) 0.65 (0.18-2.38) 0.516 0.65 (0.23-1.83) 0.416 Ever worked in the last year No 118 (14.8) 1.00 1.00 Yes 141 (32.9) 2.22 (1.79-2.75) <0.001 1.34 (1.09-1.65) <0.001 Ever been bullied No 185 (19.4) 1.00 1.00 Yes 74 (27.2) 1.40 (1.11-1.77) 0.005 1.04 (0.84-1.29) 0.704 Ever sent or received a sext No 238 (19.8) 1.00 1.00 Yes 21 (87.5) 4.42 (3.66-5.34) <0.001 1.52 (1.12-2.04) 0.007 Ever watch porn No 104 (11.5) 1.00 1.00 Yes 155 (47.8) 4.15 (3.35-5.14) <0.001 2.07 (1.64-2.60) <0.001 Ever received a sex joke No 154 (15.9) 1.00 1.00 Yes 105 (40.4) 2.53 (2.06-3.12) <0.001 1.84 (1.51-2.24) <0.001 Physical attack No 214 (21.6) 1.00 1.00 Yes 45 (19.1) 0.88 (0.66-1.18) 0.394 0.89 (0.69-1.15) 0.388 *PR=Prevalence ratio CI: Confidence interval Discussion We aimed to study the sexual behaviour among adolescents and the factors associated with ever having sexual intercourse. This study found the majority of participants start early sexual intercourse as the majority cannot give proper consent. A population-based study showed the same mean age as in our study ( 20 ). The majority of adolescents had multiple partners with poor condom use, which can be attributed to their young age and not being aware of the risky behaviour. The same finding was also noted in the study conducted in the National Longitudinal Study of Adolescent to Adult Health (Add Health) ( 21 ). The majority of participants reported not using family planning methods while they have initiated sexual activities, which results in teen pregnancy. The same findings were noted in the study conducted in Sierra Leone and Liberia ( 22 ). This misuse can be due to a lack of understanding and awareness ( 23 ). These findings call for an immediate targeted health education intervention among adolescents to increase awareness of risky sexual behaviours. Pedagogical health education can be shared with school-going and non-school-going adolescents to raise awareness and prevent teen pregnancies. Several factors were assessed to see how they influence the sexual behaviour of an adolescent. Female adolescents were seen not to engage early in sexual activities as compared to males. This finding showed the critical aspect of gender disparities in sexual behaviour. Our findings were supported by another study, which showed that boys were more likely to engage in sexual intercourse early compared to girls ( 22 ). Another study also revealed more boys participated in early initiation of sexual intercourse than girls ( 20 ). Further qualitative studies need to be performed to explore more individual factors which can provide more insight into targeted interventions like sexual health education, which will improve adolescents’ sexual well-being. Another factor was the age of the respondent, where the increase in age was associated with the likelihood of engaging in sexual activities. This finding was supported by a population-based study which was conducted for 14 years and found the probability of an increase in age to increase engagement in sexual activities ( 20 ). Another piece of evidence from baseline data of a randomised control trial in Tanzania among adolescents showed most of them were okay to initiate sexual intercourse early, before 18 years, and the practice increased with age ( 24 ). This association show how age is an essential factor when exploring sexual behaviours among adolescents. Additionally, our findings can be used to guide age-directed intervention to promote sexual health decision-making among adolescents. Additionally, those who were working in the past year were also associated with having sexual intercourse more than those who had never worked before. Working adolescents are exposed to older peers in the workplace and less parental control. Our finding was supported by another finding, which showed that the working environment gave adolescents a sense of overconfidence and responsibility, providing them with increased independence ( 25 ). These findings highlight the need to establish targeted health promotion interventions that will reduce risky sexual behaviour among adolescents. Adolescents who watched pornographic content were more likely to engage in sexual intercourse. This finding showed the influence of pornography on adolescents’ sexual lives and other related behaviours. The same findings were also seen in the systematic review conducted by Pathmendra et al. ( 26 ). Another study also showed pornography to be a predictor of the early debut of sexual intercourse and increased other sexual behaviour ( 27 ). Comprehensive sexual education should be directed towards adolescents on the impact of pornography, sex jokes, psychological and other social influences surrounding sexual health and related behaviour. This study presents some strengths and limitations. The study involved village adolescents, including non- and school-going adolescents, strengthening the coverage. Also, this study included younger ages of 10 to 14, whereas most surveys in Sub-Saharan countries included 15 to 18 years. However, shortcomings were noted as some information was not discovered from adolescents, producing missing values. Most of the findings were self-reported by participants, which may result in recall bias. These findings can be interpreted cautiously due to the nature of the observational study, and the sensitive topic might influence the participant’s responses. Conclusion This study aimed to understand adolescent sexual behaviour and its associated factors, which underscore the need for targeted health education intervention to increase awareness and promote sound and healthy sexual behaviour among adolescents living in rural areas. Global initiatives have to be directed also to remote places in the limited resource setting to increase sexual health among adolescents. In the future, comprehensive programs for sexual education that are specifically designed to address the needs and challenges faced by adolescents must be put into place. In addition to teaching about family planning and contraception, these programs should emphasise the value of consent, wholesome relationships, and the risks of making their sexual debut too young. It is also essential to work with community organisations, schools, and parents to help adolescents make educated decisions about their sexual health. A further qualitative study needs to be conducted to explore in detail the reasons for unhealthy sexual behaviour to have information that will help in designing proper interventions. Abbreviations ARISE – African Research, Implementation Science, and Education APR – Adjusted Prevalence Rate CI – Confidence Interval DSM-5 – Diagnostic Statistical Manual 5 GSHS – Global School-based Health Survey HDSS – Health and demographic surveillance systems HRQOL – Health-related quality of life HBSC – Health Behaviour in School-aged Children LEC – Life Events Checklist TDHS – Tanzania Demographic Health Survey STI – Sexually transmitted infections STATA – Statistics and Data Declarations Ethics approval The existing public domain survey ARISE Network datasets that are openly accessible online and stripped of all identifying information served as the study’s foundation. Therefore, we obtained permission to use ARISE Network data. All methods were carried out following the relevant guidelines and regulations. Consent for publication Not applicable Availability of data and materials The data presented in this study are available on request from the corresponding author due to their ownership by the ARISE Network. Competing Interests The authors declare that they have no competing interests. Funding There were no funds for this secondary analysis. Author Contributions EE, MB, JH, YT, MM, AZ and YL participated in the analysis plan, framework, data analysis, and final manuscript. All authors read and approved the final manuscript. Acknowledgement This effort’s success is mainly due to our respondents, whom we thank. Knowledge produced after careful analysis may not always represent the opinions of the researcher or respondents’ views. References Hegde A, Chandran S, Pattnaik JI. Understanding Adolescent Sexuality: A Developmental Perspective. https://doi.org/101177/26318318221107598. 2022 Jul 1;4(4):237–42. 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Corrigendum: Sexual behaviour and uptake of modern contraceptives among adolescents in public secondary schools in Lagos State, Nigeria. Afr J Health Sci. 2023;35(6):783–97. Millanzi WC, Osaki KM, Kibusi SM. Attitude and prevalence of early sexual debut and associated risk sexual behaviour among adolescents in Tanzania; Evidence from baseline data in a Randomized Controlled Trial. BMC Public Health. 2023 Dec 1;23(1):1–13. Akumiah PO, Suglo JN, Sebire SY. Early Life Exposures and Risky Sexual Behaviors among Adolescents: A Cross-sectional Study in Ghana. Niger Med J J Niger Med Assoc. 2020;61(4):189. Pathmendra P, Raggatt M, Lim MSC, Marino JL, Skinner SR. Exposure to Pornography and Adolescent Sexual Behavior: Systematic Review. J Med Internet Res. 2023;25. Heidari MG, Kazemi Y, Ph D, Nikmanesh Z. Predictors of Adolescents’ Pornography: Level of Sexual Behavior and Family Environment. J Fam Reprod Health. 2012;6(4):165–9. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4507410","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":325227370,"identity":"26fae8be-3bc4-4af3-aafa-503aa64fa8b0","order_by":0,"name":"Elihuruma Eliufoo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyElEQVRIiWNgGAWjYDAC5gNAokCChx/ESSggRgtbApAwkJCRbABpMSBeC4ONAcg2BmK0GBxjPvjgg4EFj/H51YkfHhgwyPOLHSCkhS3ZcIaBBI/ZjbebJYAOM5w5O4GAlvs9ZtI8YC1nN4C0JBjcJqTlGI+Z9B+gFuMZZzf/IF4LMMR4DPh7txFniyTILz1ALRI3eLdZJBhIEPYLHyjEflTU2fP3n91880eFjTy/NAEtCCABVilBrHIQ4D9AiupRMApGwSgYSQAApSo968jTgS0AAAAASUVORK5CYII=","orcid":"","institution":"Central South University","correspondingAuthor":true,"prefix":"","firstName":"Elihuruma","middleName":"","lastName":"Eliufoo","suffix":""},{"id":325227373,"identity":"2f4d03a9-a1b5-49f3-a9c7-d36316620b43","order_by":1,"name":"Mussa Bago","email":"","orcid":"","institution":"The University of Dodoma","correspondingAuthor":false,"prefix":"","firstName":"Mussa","middleName":"","lastName":"Bago","suffix":""},{"id":325227377,"identity":"10995241-b14f-4122-bf85-f3420ad790eb","order_by":2,"name":"Yusheng Tian","email":"","orcid":"","institution":"Central South University","correspondingAuthor":false,"prefix":"","firstName":"Yusheng","middleName":"","lastName":"Tian","suffix":""},{"id":325227378,"identity":"c686bff0-3283-4936-a6a8-86d1a12ab924","order_by":3,"name":"Jacktan Josephat","email":"","orcid":"","institution":"The University of Dodoma","correspondingAuthor":false,"prefix":"","firstName":"Jacktan","middleName":"","lastName":"Josephat","suffix":""},{"id":325227381,"identity":"515889cb-5a61-4b7f-93b0-f9efd48f1cd8","order_by":4,"name":"Mtoro J. Mtoro","email":"","orcid":"","institution":"Global Program","correspondingAuthor":false,"prefix":"","firstName":"Mtoro","middleName":"J.","lastName":"Mtoro","suffix":""},{"id":325227383,"identity":"a39c2f1c-7c7d-41a6-b456-26999bd663cd","order_by":5,"name":"Azan Nyundo","email":"","orcid":"","institution":"The University of Dodoma","correspondingAuthor":false,"prefix":"","firstName":"Azan","middleName":"","lastName":"Nyundo","suffix":""},{"id":325227386,"identity":"35a90655-7d06-4702-ba9c-ce8b1d4cb6f1","order_by":6,"name":"Yamin Li","email":"","orcid":"","institution":"Central South University","correspondingAuthor":false,"prefix":"","firstName":"Yamin","middleName":"","lastName":"Li","suffix":""}],"badges":[],"createdAt":"2024-05-31 08:30:04","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4507410/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4507410/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":62930291,"identity":"88959bca-58c3-4127-8d1d-8f5b5b3c11f0","added_by":"auto","created_at":"2024-08-21 07:39:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":845185,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4507410/v1/56e52afd-b054-427f-9442-5da1944c6f13.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Factor Associated with Sexual Behaviours among Adolescents in a Rural Tanzania: Evidence from the African Research, Implementation Science, and Education (ARISE) Network","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDuring adolescence, a child undergoes several physiological, psychological, and social growth and development changes, with sexual and reproductive growth and development being among the remarkable changes (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). The report shows more than 1.2\u0026nbsp;billion adolescents worldwide, and 90% live in middle- and low-income countries, according to 2022 UNICEF Statistics (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Among all those adolescents, studies have revealed the influence of sociological and cultural environments in shaping sexual behaviour in both urban and rural settings. These environments lead adolescents to face several preventable health problems in their transition to adulthood (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Almost 13% of adolescent girls globally present with early childbearing, with the majority being not aware of contraceptive methods and safe sex practices (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). UNICEF report showed a low uptake of HIV testing among adolescents despite early sexual debut. One-quarter of adolescent girls and 17% of adolescent boys in East and Southern Africa were tested for HIV and received results. The trend shows an increase in new HIV infections among adolescents (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). The number of adolescents is increasing, which poses a need for updated information and status regarding their sexual behaviour.\u003c/p\u003e \u003cp\u003eIn Tanzania, half of the population is aged less than 19 years (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Currently, there is a dynamic shift in the growth of rural adolescents. They face several challenges to sexual health, including limited access to sexual education, contraceptives, and other healthcare services (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). These challenges are coupled with traditional norms and cultural beliefs, which are strongly upheld in the rural area. The high level of poverty increases the vulnerability of these adolescents to sexual health. As a result, most start to work early and live independent lives that are out of their parents\u0026rsquo; watch (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Some of these adolescents tend to have unprotected sexual intercourse and multiple sexual affairs, all of which expose them to unintended pregnancy and sexually transmitted infections (STIs), including HIV infection (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Despite the risks mentioned above, only 15% of young women aged 15\u0026ndash;19 in developing countries use contraceptives, whether married or not (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). In Tanzania, only 18.4% of sexually active women aged 15\u0026ndash;19 have been reported to use any contraception method (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Poor access to medical facilities, stigma towards sexual health discussion, and other taboos related to sexuality lead to an upsurge of unhealthy sexual lifestyles among adolescents in rural settings (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Understanding sexual behaviour is critical among adolescents, especially those in rural settings where access to healthcare and education is limited.\u003c/p\u003e \u003cp\u003eThe early debut of sexual intercourse has been seen among rural adolescents, which predisposes them to have a higher number of lifetime sexual partners (\u003cspan additionalcitationids=\"CR15 CR16 CR17\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Recently, the Dodoma region has been growing into a large cosmopolitan city with all the socio-economic stratification predisposing adolescents to a higher risk of early sexual exposure. As these young people\u0026rsquo;s population keeps growing, it is vital to comprehend their ever-changing reproductive health needs. Despite the need to address adolescent sexual health, little has been done to investigate the particular sexual practices and difficulties of young people in rural areas with limited resources. This knowledge gap hinders the creation of focused interventions and policies meant to encourage healthy sexual behaviours and lessen the incidence of STIs and unwanted pregnancies among adolescents. This secondary analysis aims to fill the gap by examining adolescent sexual behaviour in a rural setting with limited resources. We aimed to provide research-supported strategies customised to the specific requirements of rural adolescents by identifying patterns, drivers, and contextual factors impacting sexual behaviours.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and setting\u003c/h2\u003e \u003cp\u003eThis study employed a household-based cross-sectional design. We used data from The Adolescent Health Study of the ARISE Network, which was carried out across seven locations in sub-Saharan African countries. This collaborative effort was undertaken in partnership with various esteemed institutions, including the Africa Academy for Public Health in Tanzania, the Centre de Recherche en Sant\u0026eacute; de Nouna in Burkina Faso, Haramaya University in Ethiopia, Muhimbili University of Health and Allied Sciences in Tanzania, the University of Dodoma in Tanzania, the University of Ghana in Ghana, the University of Ibadan in Nigeria, and the University of Swaziland in Swaziland. Our analysis used a dataset from Dodoma, Tanzania. We included household members who lived in the study area for at least four months.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eSample size and sampling\u003c/h2\u003e \u003cp\u003eARISE Network included 7,662 adolescents from eight sites in six countries participating in the survey. This study included three urban locations, Dar es Salaam (Tanzania), Harar (Ethiopia) and Ibadan (Nigeria), as well as five areas: Dodoma (Tanzania), Iganga/Mayuge (Uganda), Kersa (Ethiopia), Ningo Prampram (Ghana) and Nouna (Burkina Faso). The principal aim was to collect household-based data on health-related activities and the associated risk factors among teenagers to identify disease loads and potential areas for medical solutions.\u003c/p\u003e \u003cp\u003eThe current study involved an analysis of 1,226 participants who had completed a survey in the Chamwino district, Dodoma, Tanzania. Communities were selected randomly, taking advantage of cohorts of the current population under the supervision of health and demographic surveillance systems (HDSSs). Teenagers aged 10\u0026ndash;19 years were randomly selected from each household, and each household was limited to one participant only.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eData collection tool and procedure\u003c/h2\u003e \u003cp\u003eData was collected from April to December 2017 in the rural Chamwino district. Participants voluntarily agreed to participate, and the trained research assistant collected information through interviewer-administered questionnaires. We used the Global School-based Health Survey (GSHS) and the Health Behaviour School-aged Children Survey (HBSC), which covered different aspects of health and socio-demographic and economic background information. This study focused on sexual behaviours and practices questions originating from the health-related quality of life (HRQOL), the HBSC symptom checklist, and questions on sexual assault adapted from the Life Events Checklist (LEC) for Diagnostic Statistical Manual (DSM-5). More information about the methodology is found in the published methodology paper (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eVariable measurement\u003c/h2\u003e \u003cp\u003eThe outcome variable for this study was the experience of sexual intercourse. The independent variables included demographics (age, sex, education level/status, living arrangement, life status of a biological parent, and if the participant has ever worked before) and other sexual characteristics (condom use at last sexual encounter, used another family planning method, pregnancy history, wanted the previous pregnancy, the outcome of last pregnancy, self-reported of ever had sexually transmitted infection, and places to get condoms).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eWe analysed data using STATA version 17 (Stata Corp, College Station, TX). Descriptive statistics were summarised and presented in frequency and percentages for categorical variables, mean (standard deviation) for continuous variables, and Confidence Intervals (CI) estimated precision. The crude and adjusted prevalence ratios were calculated using the Poisson regression model with robust standard errors. Prevalence ratios were used because of the high prevalence of the dependent variable \u0026lsquo;ever had sex\u0026rsquo;. Crude and adjusted prevalence ratios with corresponding 95% confidence intervals (CIs) were reported. A p-value of less than 0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eAdolescent characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn total, 1,226 adolescents were included in the study conducted in the rural part of the Dodoma region (Chamwino district). Among the sample, 66.7% of adolescents were between the ages of 10 and 14, and 33.3% were between the ages of 15 and 19, with a mean age of 13.7 (SD\u0026plusmn;2.3). Over half of the adolescents were girls (55.3%), and almost one-third (69.5%) had completed primary education. (Table 1)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1: Socio-economic and demographic characteristics among adolescents in Dodoma, 2017 (N=1,226)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge group (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003e10-14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e818\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e66.7 (64.0-69.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003e15-19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e408\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e33.3 (30.7-35.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003eMean (Standard deviation)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e13.7 (\u0026plusmn;2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e(13.6-13.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e548\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e44.7 (41.9-47.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e678\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e55.3 (52.5-58.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation status*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003eNo formal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e0.8 (0.4-1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003ePrimary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e624\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e69.5 (66.4-72.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003eSecondary/Higher education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e267\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e29.7 (26.8-32.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiving arrangements\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003eBoth parents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e753\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e61.4 (58.7-64.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003eSingle parents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e245\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e20.0 (17.8-22.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003eGuardians\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e16.5 (14.5-18.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003eCohabiting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e0.9 (0.5-1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003eBy self/with colleagues\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e1.2 (0.7-2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLife status of biological parents\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003eBoth alive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e1,089\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e88.8 (86.9-90.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003eSingle parent alive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e10.0 (8.4-11.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003eBoth not alive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e1.2 (0.7-2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver worked in the last 12 months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e797\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e65.0 (62.3-67.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.42307692307692%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.243589743589745%\" valign=\"top\"\u003e\n \u003cp\u003e429\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.333333333333336%\" valign=\"top\"\u003e\n \u003cp\u003e35.0 (32.4-37.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e* Frequency does not tally due to missing values\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSexual practices among sexually active adolescents\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOverall, the proportion of adolescents who \u0026lsquo;ever had sex\u0026rsquo; was 21.1% ((95% CI: 18.9-23.5). The mean age of the individuals who were having intercourse was found to be 15.3 (\u0026plusmn;2.4) years. Of the adolescents, 45.6% said they had more than one sexual partner. More than a quarter (27.4%) reported condom usage during their most recent sexual experience. The majority (86.5%) reported not utilising any other form of family planning. Three in five adolescents (61.2%) have never been pregnant. It\u0026rsquo;s interesting to note that most (87.1%) of pregnant adolescents wanted to have it. Of those who were pregnant, 77.4% had a live birth, while 22.6% are now pregnant. Furthermore, 99.4% of adolescents did not self-report having ever experienced a sexually transmitted infection. (Table 2)\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2: Sexual practices among sexually among adolescents in Dodoma, 2017 (N=1,226)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eMean age (Standard deviation)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e15.3 (2.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e(15.02-15.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of sexual partners\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eOne partner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e54.4 (48.3-60.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eMore than one partner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e118\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e45.6 (39.6-51.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCondom use at the last sexual encounter\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e188\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e72.6 (66.7-77.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e27.4 (22.3-33.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUsed another FP method\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e224\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e86.5 (81.7-90.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e13.5 (9.8-18.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePregnancy history\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e61.2 (50.0-71.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eYes, one time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e35.0 (25.2-46.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eYes, more than once\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e3.8 (1.2-11.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWanted the last pregnancy?\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eI wanted it\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e87.1 (68.9-95.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eI did not want it\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e12.9 (4.6-31.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eThe outcome of the last pregnancy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eCurrently pregnant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e22.6 (10.7-41.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eLive birth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e77.4 (58.4-89.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSelf-reported of ever had STI\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e651\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e99.4 (98.4-99.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e0.6 (0.2-1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlaces to get condoms\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eShop\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e40.0 (24.7-57.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003ePharmacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e42.9 (27.1-60.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eGovernment Clinic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.884615384615383%\" valign=\"top\"\u003e\n \u003cp\u003e17.1 (7.6-34.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e* Frequency does not tally due to missing values\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFactors associated with having ever had sexual intercourse among adolescents\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFemales were inversely associated with ever having sexual intercourse (APR: 0.37; 95% CI: 0.29-0.47). Age was positively related to the likelihood of ever having sexual intercourse (APR: 1.17; 95% CI: 1.12-1.23). There is a notable positive association between an adolescent who is living with a spouse and ever having sexual intercourse (APR: 4.77; 95% CI: 3.08-7.38) and also among those living with a colleague (APR: 2.92; 95% CI: \u0026nbsp;1.96-436). Being employed within the past year increased the likelihood of engaging in sexual activity by 1.34 times (APR: 1.34, 95% CI: 1.09-1.65). Our finding indicated a strong association between being exposed to pornography and ever having sexual intercourse (APR: 2.07; 95% CI: 1.64-2.60).\u0026nbsp;(Table 3)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3: Factors associated with having ever had sexual intercourse among adolescents in Dodoma, 20 (N=1,226)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"643\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver had sex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnadjusted\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjusted\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e179 (32.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e80 (11.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e0.36 (0.28-0.46)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e0.37 (0.29-0.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.34 (1.28-1.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.17 (1.12-1.23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiving arrangements\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eBoth parents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e144 (19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eSingle parents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e54 (22.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.15 (0.78-1.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e0.316\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e0.97 (0.74-1.28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e0.842\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eGuardians\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e35 (17.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e0.91 (0.65-1.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e0.564\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e0.90 (0.65-1.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e0.517\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eWith spouse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e15 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e5.23 (4.51-6.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e4.77 (3.08-7.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eBy self/with colleagues\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e11 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e5.23 (4.51-6.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e2.92 (1.96-4.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eBiological parents\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eBoth alive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e223 (20.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eSingle parent alive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e34 (27.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.36 (0.99-1.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e0.050\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.06 (0.77-1.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e0.699\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eBoth not alive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e2 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e0.65 (0.18-2.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e0.516\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e0.65 (0.23-1.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e0.416\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver worked in the last year\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e118 (14.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e141 (32.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e2.22 (1.79-2.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.34 (1.09-1.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver been bullied\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e185 (19.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e74 (27.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.40 (1.11-1.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.04 (0.84-1.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e0.704\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver sent or received a sext\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e238 (19.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e21 (87.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e4.42 (3.66-5.34)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.52 (1.12-2.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver watch porn\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e104 (11.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e155 (47.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e4.15 (3.35-5.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e2.07 (1.64-2.60)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver received a sex joke\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e154 (15.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e105 (40.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e2.53 (2.06-3.12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.84 (1.51-2.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhysical attack\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e214 (21.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"29.082426127527217%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.063763608087092%\" valign=\"top\"\u003e\n \u003cp\u003e45 (19.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e0.88 (0.66-1.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e0.394\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.662519440124417%\" valign=\"top\"\u003e\n \u003cp\u003e0.89 (0.69-1.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.26438569206843%\" valign=\"top\"\u003e\n \u003cp\u003e0.388\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*PR=Prevalence ratio CI: Confidence interval\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eWe aimed to study the sexual behaviour among adolescents and the factors associated with ever having sexual intercourse. This study found the majority of participants start early sexual intercourse as the majority cannot give proper consent. A population-based study showed the same mean age as in our study (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). The majority of adolescents had multiple partners with poor condom use, which can be attributed to their young age and not being aware of the risky behaviour. The same finding was also noted in the study conducted in the National Longitudinal Study of Adolescent to Adult Health (Add Health) (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). The majority of participants reported not using family planning methods while they have initiated sexual activities, which results in teen pregnancy. The same findings were noted in the study conducted in Sierra Leone and Liberia (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). This misuse can be due to a lack of understanding and awareness (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). These findings call for an immediate targeted health education intervention among adolescents to increase awareness of risky sexual behaviours. Pedagogical health education can be shared with school-going and non-school-going adolescents to raise awareness and prevent teen pregnancies.\u003c/p\u003e \u003cp\u003eSeveral factors were assessed to see how they influence the sexual behaviour of an adolescent. Female adolescents were seen not to engage early in sexual activities as compared to males. This finding showed the critical aspect of gender disparities in sexual behaviour. Our findings were supported by another study, which showed that boys were more likely to engage in sexual intercourse early compared to girls (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Another study also revealed more boys participated in early initiation of sexual intercourse than girls (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Further qualitative studies need to be performed to explore more individual factors which can provide more insight into targeted interventions like sexual health education, which will improve adolescents\u0026rsquo; sexual well-being.\u003c/p\u003e \u003cp\u003eAnother factor was the age of the respondent, where the increase in age was associated with the likelihood of engaging in sexual activities. This finding was supported by a population-based study which was conducted for 14 years and found the probability of an increase in age to increase engagement in sexual activities (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Another piece of evidence from baseline data of a randomised control trial in Tanzania among adolescents showed most of them were okay to initiate sexual intercourse early, before 18 years, and the practice increased with age (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). This association show how age is an essential factor when exploring sexual behaviours among adolescents. Additionally, our findings can be used to guide age-directed intervention to promote sexual health decision-making among adolescents.\u003c/p\u003e \u003cp\u003eAdditionally, those who were working in the past year were also associated with having sexual intercourse more than those who had never worked before. Working adolescents are exposed to older peers in the workplace and less parental control. Our finding was supported by another finding, which showed that the working environment gave adolescents a sense of overconfidence and responsibility, providing them with increased independence (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). These findings highlight the need to establish targeted health promotion interventions that will reduce risky sexual behaviour among adolescents.\u003c/p\u003e \u003cp\u003eAdolescents who watched pornographic content were more likely to engage in sexual intercourse. This finding showed the influence of pornography on adolescents\u0026rsquo; sexual lives and other related behaviours. The same findings were also seen in the systematic review conducted by Pathmendra et al. (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). Another study also showed pornography to be a predictor of the early debut of sexual intercourse and increased other sexual behaviour (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). Comprehensive sexual education should be directed towards adolescents on the impact of pornography, sex jokes, psychological and other social influences surrounding sexual health and related behaviour.\u003c/p\u003e \u003cp\u003eThis study presents some strengths and limitations. The study involved village adolescents, including non- and school-going adolescents, strengthening the coverage. Also, this study included younger ages of 10 to 14, whereas most surveys in Sub-Saharan countries included 15 to 18 years. However, shortcomings were noted as some information was not discovered from adolescents, producing missing values. Most of the findings were self-reported by participants, which may result in recall bias. These findings can be interpreted cautiously due to the nature of the observational study, and the sensitive topic might influence the participant\u0026rsquo;s responses.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study aimed to understand adolescent sexual behaviour and its associated factors, which underscore the need for targeted health education intervention to increase awareness and promote sound and healthy sexual behaviour among adolescents living in rural areas. Global initiatives have to be directed also to remote places in the limited resource setting to increase sexual health among adolescents. In the future, comprehensive programs for sexual education that are specifically designed to address the needs and challenges faced by adolescents must be put into place. In addition to teaching about family planning and contraception, these programs should emphasise the value of consent, wholesome relationships, and the risks of making their sexual debut too young. It is also essential to work with community organisations, schools, and parents to help adolescents make educated decisions about their sexual health. A further qualitative study needs to be conducted to explore in detail the reasons for unhealthy sexual behaviour to have information that will help in designing proper interventions.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eARISE \u0026ndash; African Research, Implementation Science, and Education\u003c/p\u003e\n\u003cp\u003eAPR \u0026ndash; Adjusted Prevalence Rate\u003c/p\u003e\n\u003cp\u003eCI \u0026ndash; Confidence Interval\u003c/p\u003e\n\u003cp\u003eDSM-5 \u0026ndash; Diagnostic Statistical Manual 5\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGSHS \u0026ndash; Global School-based Health Survey\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHDSS \u0026ndash; Health and demographic surveillance systems\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHRQOL \u0026ndash; Health-related quality of life\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHBSC \u0026ndash; Health Behaviour in School-aged Children\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLEC \u0026ndash; Life Events Checklist\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTDHS \u0026ndash; Tanzania Demographic Health Survey\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSTI \u0026ndash; Sexually transmitted infections\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSTATA \u0026ndash; Statistics and Data\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe existing public domain survey ARISE Network datasets that are openly accessible online and stripped of all identifying information served as the study\u0026rsquo;s foundation. Therefore, we obtained permission to use ARISE Network data. All methods were carried out following the relevant guidelines and regulations.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data presented in this study are available on request from the corresponding author due to their ownership by the ARISE Network.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere were no funds for this secondary analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEE, MB, JH, YT, MM, AZ and YL participated in the analysis plan, framework, data analysis, and final manuscript. All authors read and approved the final manuscript. \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis effort\u0026rsquo;s success is mainly due to our respondents, whom we thank. Knowledge produced after careful analysis may not always represent the opinions of the researcher or respondents\u0026rsquo; views.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHegde A, Chandran S, Pattnaik JI. Understanding Adolescent Sexuality: A Developmental Perspective. https://doi.org/101177/26318318221107598. 2022 Jul 1;4(4):237\u0026ndash;42. \u003c/li\u003e\n\u003cli\u003eUNICEF. UNICEF Statistics. 2022 [cited 2024 Mar 27]. Adolescents Statistics - UNICEF DATA. Available from: https://data.unicef.org/topic/adolescents/overview/\u003c/li\u003e\n\u003cli\u003eMunea AM, Alene GD, Debelew GT, Sibhat KA. 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Barriers and enablers to young people accessing sexual and reproductive health services in Pacific Island Countries and Territories: A scoping review. PLOS ONE. 2023 Jan 1;18(1):1DUMNMY. \u003c/li\u003e\n\u003cli\u003eTaiwo MO, Oyekenu O, Hussaini R. Understanding how social norms influence access to and utilisation of adolescent sexual and reproductive health services in Northern Nigeria. Front Sociol. 2023 Oct 11;8:865499. \u003c/li\u003e\n\u003cli\u003eBukenya JN, Nakafeero M, Ssekamatte T, Isabirye N, Guwatudde D, Fawzi WW. Sexual behaviours among adolescents in a rural setting in eastern Uganda: a cross-sectional study. Trop Med Int Health. 2020;25(1):81\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eDessie Y, Berhane Y, Worku A. Parent-adolescent sexual and reproductive health communication is very limited and associated with adolescent poor behavioural beliefs and subjective norms: Evidence from a community-based cross-sectional study in Eastern Ethiopia. PLoS ONE. 2015;10(7):1\u0026ndash;14. \u003c/li\u003e\n\u003cli\u003eSekine K, Khadka N, Carandang RR, Ong KIC, Tamang A, Jimba M. Original research: Multilevel factors influencing contraceptive use and childbearing among adolescent girls in Bara district of Nepal: a qualitative study using the socioecological model. BMJ Open. 2021 Oct 19;11(10):46156. \u003c/li\u003e\n\u003cli\u003eMinistry of Health (MoH) [Tanzania Mainland], Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS) and ICF 2023. Tanzania Demographic and Health Survey and Malaria Indicator Survey: Key Indicators Report. 2023; \u003c/li\u003e\n\u003cli\u003eZango AB, Stutterheim SE, de Vries N, Crutzen R. Determinants of preventive sexual behaviours among first-year university students in Beira city, central Mozambique: a cross-sectional study. Reprod Health. 2024 Dec 1;21(1):1\u0026ndash;13. \u003c/li\u003e\n\u003cli\u003eRamteke RU, Makade JG, Bandre GR. Adolescent Sexual Behavior in Rural Central India: Challenges and Interventions. Cureus. 2023 Dec 1;15(11). \u003c/li\u003e\n\u003cli\u003eMmbaga EJ, Leonard F, Leyna GH. Incidence and predictors of adolescent\u0026rsquo;s early sexual debut after three decades of HIV interventions in Tanzania: A time to debut analysis. PLoS ONE. 2012;7(7):1\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eO. Asante K, Nketiah-Amponsah E, Andoh-Arthur J, Boafo IM, Ampaw S. Correlates of Early Sexual Debut Among Sexually Active Youth in Ghana. Int Q Community Health Educ. 2018;39(1):9\u0026ndash;17. \u003c/li\u003e\n\u003cli\u003eSacolo HN, Chung MH, Chu H, Liao YM, Chen CH, Ou KL, et al. High-Risk Sexual Behaviors for HIV among the In-School Youth in Swaziland: A Structural Equation Modeling Approach. 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Attitude and prevalence of early sexual debut and associated risk sexual behaviour among adolescents in Tanzania; Evidence from baseline data in a Randomized Controlled Trial. BMC Public Health. 2023 Dec 1;23(1):1\u0026ndash;13. \u003c/li\u003e\n\u003cli\u003eAkumiah PO, Suglo JN, Sebire SY. Early Life Exposures and Risky Sexual Behaviors among Adolescents: A Cross-sectional Study in Ghana. Niger Med J J Niger Med Assoc. 2020;61(4):189. \u003c/li\u003e\n\u003cli\u003ePathmendra P, Raggatt M, Lim MSC, Marino JL, Skinner SR. Exposure to Pornography and Adolescent Sexual Behavior: Systematic Review. J Med Internet Res. 2023;25. \u003c/li\u003e\n\u003cli\u003eHeidari MG, Kazemi Y, Ph D, Nikmanesh Z. Predictors of Adolescents\u0026rsquo; Pornography: Level of Sexual Behavior and Family Environment. J Fam Reprod Health. 2012;6(4):165\u0026ndash;9. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-4507410/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4507410/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eRural adolescents are transitioning to adulthood at an earlier age than previous generations. Consequently, there has been an increase in unsafe sexual practice behaviour. We assessed sexual behaviours and their associated factors among adolescents using African Research, Implementation Science, and Education (ARISE) Network data.\u003c/p\u003e\u003ch2\u003eSubject and Methods:\u003c/h2\u003e \u003cp\u003eWe utilise data from the ARISE Network\u0026rsquo;s Adolescent Health Study, a cross-sectional study in six countries in sub-Saharan Africa involving rural adolescents aged 10\u0026ndash;19 years. Participant information, health and sexual behaviours were collected through an interview-administered questionnaire. Both univariate and multivariate Poisson regression analyses were used to assess the factors associated with ever having sex.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe proportion of adolescents who had sexual intercourse was 21.1% (95% CI: 18.9\u0026ndash;23.5). Of those, 45.6% reported having more than one sexual partner. Being female was inversely associated with ever having sexual intercourse (APR: 0.37; 95% CI: 0.29\u0026ndash;0.47). Age was significantly associated with ever having sexual intercourse (APR: 1.17; 95% CI:1.12\u0026ndash;1.23). Living with a colleague (APR: 2.92; 95% CI: 1.96\u0026ndash;436), adolescents who have been employed within the past year (APR: 1.34; 95% CI: 1.09\u0026ndash;1.65), being exposed to pornography (APR: 2.07; 95% CI: 1.64\u0026ndash;2.60) and receiving a sex joke, (APR: 1.84; 95% CI: 1.51\u0026ndash;2.24) were significantly associated with ever having sexual intercourse among adolescents.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe findings highlight factors impacting sexual behaviour among adolescents. Promoting adolescents\u0026rsquo; sexual health and well-being requires community-based interventions, family involvement, and comprehensive sexual education programs. Efforts must be made to raise public understanding of good sexual practice behaviour.\u003c/p\u003e","manuscriptTitle":"Factor Associated with Sexual Behaviours among Adolescents in a Rural Tanzania: Evidence from the African Research, Implementation Science, and Education (ARISE) Network","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-12 07:53:54","doi":"10.21203/rs.3.rs-4507410/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5a28bd43-8c40-4505-956b-2995019c9b5d","owner":[],"postedDate":"July 12th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-12-19T13:23:41+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-12 07:53:54","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4507410","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4507410","identity":"rs-4507410","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}