Prevalence and determinants of risky sexual practice in Ethiopia: Systematic review and Meta-analysis

Abstract

BackgroundRisky sexual practice is a major public health problem in Ethiopia. There are various studies on the prevalence and determinants of risky sexual practice in different regions of the country but there is no study which shows the national estimate of risky sexual practices in Ethiopia. Therefore, this review was conducted to estimate the national pooled prevalence of risky sexual practice and its risk factors in Ethiopia.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed to review published and unpublished studies in Ethiopia. The databases used were; PubMed, Google Scholar, CINAHL and African Journals Online. Search terms were; risky sexual behavior, risky sexual practice, unprotected sex, multiple sexual partner, early sexual initiation, and/or Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used for critical appraisal. The meta-analysis was conducted using Review Manager software. Descriptive information of studies was presented in narrative form and quantitative results were presented in forest plots. The Cochran Q test and I 2 test statistics were used to test heterogeneity across studies. The pooled estimate prevalence and the odd ratios with 95% confidence intervals were computed by a random effect model.ResultsA total of 31 studies with 43,695 participants were included in the meta-analysis. The pooled prevalence of risky sexual practice was 42.80% (95% CI: 35.64%, 49.96%). Being male (OR: 1.69; 95% CI: 1.21, 2.37), substance use (OR: 3.42; 95% CI: 1.41, 8.31), peer pressure (OR: 3.41; 95% CI: 1.69, 6.87) and watching pornography (OR: 3.6; 95% CI: 2.21, 5.86) were factors associated with an increase in risky sexual practices.ConclusionsThe prevalence of risky sexual practices is high in Ethiopia. Being male, substance use, peer pressure and viewing pornographic materials were found to be associated with risky sexual practices. Therefore, life skills training is recommended to reduce peer pressure among individuals. Interventions should be designed to reduce substance use and viewing pornography.

Quality of youth friendly sexual and reproductive health Services in West Gojjam Zone, north West Ethiopia: with special reference to the application of the Donabedian model

“…Young people in Ethiopia are at risk of a broad range of Sexual and Reproductive Health (SRH) problems such as unwanted pregnancies, unsafe abortion, pregnancyrelated complications, and sexually transmitted infections [4][5][6][7]. Besides, they have high unmet need for family planning utilization and limited awareness of STI prevention [7,8].…”

<p>Risky Sexual Practice, Sexually Transmitted Infection and Associated Factors Among Newly Diagnosed HIV-positive People in Northwest Ethiopia</p>

“…The prevalence of risky sexual practice among newly diagnosed HIV-positive people in the study area was lower (15.8%) compared to findings from different studies in other parts of Ethiopia. Risky sexual practices among preparatory school students was 19.6% in Aksum northern Ethiopia, 17 41.62% among university and college students across Ethiopia, 30 42.8% in the general population of Ethiopia 28 and 22.4% among preparatory school students in Arba Minch town, southern Ethiopia. 16 The differences of the findings may be due to the different characteristics of the study participants.…”

“…Factors associated with risky sexual practice in various studies include being educated, being wealthy and young, 27 substance abuse, peer pressure, and watching pornography. 16 , 17 , 28 – 30 Other factors are living in urban areas, 27 being single and married compared to widowed, 19 having HIV-positive sexual partner, nondisclosure of HIV-positive status, having experienced HIV-related stigma, 31 history of suicide attempt and sexual assault. 29…”

<p>Does Youth-Friendly Service Intervention Reduce Risky Sexual Behavior in Unmarried Adolescents? A Comparative Study in West Gojjam Zone, Northwest Ethiopia</p>

“…Young people in Ethiopia are at risk of a broad range of sexual and reproductive health (SRH) problems, such as unwanted pregnancy, unsafe abortion, pregnancy-related complications, and STIs. 14 – 17 They also have high unmet needs for family-planning utilization and limited awareness of STI prevention. 17 , 18 Although Ethiopia ihas been registered as one of the lowest HIV-prevalence countries in East Africa, 19 recent reports have indicated that the incidence is rising again.…”