Determinants of early sexual initiation among female youth in Ethiopia: A multilevel analysis of 2016 Ethiopian Demographic and Health Survey

Abstract Background: Evidences on determinants of early sexual initiation among female youth is still limited especially; community-level factors are not investigated in Ethiopia. Therefore, the aim of this study was to assess individual and community-level factors associated with early sexual initiation among female youth in Ethiopia.Methods: The 2016 Ethiopian Demographic and Health Survey (EDHS) dataset were used and a total of 6,143 participants (female youth) were included. Multi-level mixed-effect logistic regression was done to identify individual and community-level factors. Adjusted odds ratio along with 95% confidence interval was used to show the strength and direction of the association. Finally, the level of statistical significance was declared at P value less than 0.05.Results: Individual-level factors significantly associated with early sexual initiation among female youth were; age group from 19-24 years [AOR=5.8, 95% CI= (4.6, 7.3)], not attending school [AOR=14.1, 95% CI= (8.1, 24.7)], ever chewing Chat [AOR= 2.0, 95% CI= (1.3, 3.0)]. From community-level factors: living in Addis Ababa [AOR= 0.3, 95% CI= (0.2, 0.5)], living in Gambella [AOR=2.7, 95% CI= (1.7, 4.3)] and live in a low proportion of poor communities [AOR= 0.7, 95% CI= (0.5, 0.9)] were significantly associated with early sexual initiation among female youth in Ethiopia.Conclusions: Age, low educational status, ever chewing Chat, region and live in a high proportion of poor community had a statistical association with early sexual initiation among female youth in Ethiopia. Improving educational coverage and community-level of wealth status are important intervention areas to delay the age of early sexual initiation.