ADDIS ABABA UNIVERSITY

COLLEGE OF HEALTH SCIENCES

SCHOOL OF ALLIED HEALTH SCIENCES

DEPARTMENT OF NURSING AND MIDWIFERY

ASSESSMENT OF THE PREVALENCE OF PREMARITAL SEX AND UNPROTECTED

SEXUAL PRACTICES AMONG SECONDARY SCHOOL ADOLESCENT STUDENTS IN

SEBETA TOWN, OROMIA REGIONAL STATE, ETHIOPIA, 2014.

BY: HELEN BERIHUN (BSc)

A THESIS TO BE SUBMITTED TO SCHOOL OF GRADUATE STUDIES OF ADDIS

ABABA UNIVERSITY IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE

DEGREE OF MASTERS IN CHILD HEALTH NURSING

SEPTEMBER, 2014

ADDIS ABABA, ETHIOPIA

ASSESSMENT OF THE PREVALENCE OF PREMARITAL SEX AND UNPROTECTED

SEXUAL PRACTICES AMONG SECONDARY SCHOOL ADOLESCENT STUDENTS IN

SEBETA TOWN, OROMIA REGIONAL STATE, ETHIOPIA, 2014.

BY:

HELEN BERIHUN (BSc)

ADVISOR: ATO BAZE MEKONNEN (BSc, MSc)

SEPTEMBER, 2014

ADDIS ABABA, ETHIOPIA

 APPROVED BY THE BOARD OF EXAMINERS

This thesis by Helen Berihun is accepted in its present form by the board of examiners as

satisfying thesis requirement for the degree of masters in child health nursing.

Internal examiner:

__________________________________ _________ ___________ ____/____/____

Full name Rank Signature Date

Research advisor:

_____________________________ _________ ___________ ____/____/____

Full name Rank Signature Date

Acknowledgement

First of all, I would like to express my heartfelt thanks and appreciation to my advisor Ato Baze

Mekonnen for his undue supportive and constructive comments and suggestions starting from the

development of the research proposal up to its end.

My gratitude and sincere thanks are extended to the following people and organizations.

 Addis Ababa University, college of Health Science, Department of Nursing and

Midwifery for their financial support and provision of the opportunity to prepare this

study project

 My parents and friends for their encouragement, invaluable support and interest on my
work.
 Sebeta Town Education Bureau, Sebeta high school director, teachers and students.

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Table of content

Contents

Acknowledgement .......................................................................................................................................... i

Table of content ............................................................................................................................................. ii

List of Tables and Figure ............................................................................................................................... v

Abbreviations ................................................................................................................................................ vi

Abstract ........................................................................................................................................................ vii

1. INTRODUCTION ................................................................................................................................. 1

1.1. Background................................................................................................................................... 1

1.2. Problem Statement ....................................................................................................................... 3

1.3. Significance of the study .............................................................................................................. 5

2. LITERATURE REVIEW....................................................................................................................... 6

3. OBJECTIVE ............................................................................................................................................13

3.1. General objective ..............................................................................................................................13

3.2. Specific objectives ............................................................................................................................13

4. METHODS AND MATERIALS .............................................................................................................14

4.1. Study Area.........................................................................................................................................14

4.2. Study design and period ....................................................................................................................14

4.3. Population .........................................................................................................................................14

4.3.1. Source population.......................................................................................................................14

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 4.3.2. Study population ........................................................................................................................14

4.4. Sample size determinations and sampling technique ........................................................................15

4.4.1. Sample size determination .........................................................................................................15

4.4.2 Sampling Procedure ....................................................................................................................15

4.5. Study Variables .................................................................................................................................17

4.5.1. Independent variables.................................................................................................................17

4.5.2. Dependent variables ...................................................................................................................17

4.6. Data collection tool ...........................................................................................................................17

4.7. Data collection and quality control ...................................................................................................17

4.8. Operational definitions ......................................................................................................................18

4.9. Data entry, analysis and processing ..................................................................................................19

4.10. Ethical consideration .......................................................................................................................20

4.11. Dissemination of results ..................................................................................................................21

5. Results ......................................................................................................................................................22

5.1 Socio demographic characteristics .....................................................................................................22

5.2 Alcohol and drug conception .............................................................................................................25

5.3. Premarital sex ....................................................................................................................................26

5.4 Unprotected sexual practice ...............................................................................................................28

5.5 Risk factors associated with premarital sex .......................................................................................30

6. Discussion ................................................................................................................................................31

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 Strength of the study ................................................................................................................................33

Limitation of the study .............................................................................................................................33

7. Conclusion and Recommendation............................................................................................................34

7.1 Conclusion .........................................................................................................................................34

7.2 Recommendations ..............................................................................................................................35

References ....................................................................................................................................................36

Annex I: Informed Consent Sheet ................................................................................................................42

Annex II: Questionnaires .............................................................................................................................44

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List of Tables and Figure

Figure 1 Schematic presentation of sampling procedure…………………………………………16

Table 1 Socio demographic characteristics of secondary school adolescent students in Sebeta

Town, 2014……………………………………………………………………………………….23

Figure 2 Alcohol and drug conception of secondary school adolescent students, Sebeta Town,

2014………………………………………………………………………………………………25

Table 2 Premarital sexual practices among secondary school adolescent students in Sebeta Town,

2014………………………………………………………………………………………………27

Table 3 Unprotected sexual practices among secondary school adolescent students in Sebeta

Town, 2014……………………………………………………………………………………….29

Table 4 Risk factors associated with premarital sex among secondary school adolescent students

in Sebeta Town, 2014…………………………………………………………………………….30

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Abbreviations

AIDS – Acquired Immune Deficiency Syndrome

BSS – Behavioral Surveillance Survey

ETB – Ethiopian Birr

HIV – Human Immunodeficiency Virus

SPSS – Statistical Package for Social Science

STIs – Sexually Transmitted Infections

USA – United State America

WHO – World Health Organization

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Abstract

Introduction: The World Health Organization (WHO) defines adolescent people as those

between the ages of 10 to 19 years. These age groups are often characterized as being at a life

stage of increased experimentation and exploration associated with a range of risky behaviors,

including risky sexual behaviors. Moreover, adolescents are less likely than adults to have the

information, skills and support to protect themselves against HIV/AI DS and other consequences

of premarital sex.

Objective: To assess the prevalence of premarital sex and unprotected sexual intercourse practice

and associated factors among secondary school adolescent students in Sebeta Town, 2014.

Methods and Materials: A questionnaire based cross sectional study design was used to conduct

this study on 284 secondary school adolescent students in Sebeta Town from April to May 2014.

The data was processed and analyzed by using Epi Info 3.4.3 and SPSS version 16.0. Frequency

distribution, charts, figures and tables were used to present the results. Odd ratio and logistic

regression were used to determine association between specified factors and to control

cofounders respectively.

Results: The prevalence of premarital sex among the study participants of this study was 28.3%

and 90.1% of them were utilized condom during their sexual intercourse. The premarital sex was

strongly associated with grade level and their family income. Grade ten students were 7.99 times

high risk to be practiced premarital sex than others (AOR=7.99, CI= (2.2-28.5)) and grade eleven

students were 7.81 times high risk to be involved in premarital sex than others grade level

students (AOR= 7.81, CI= (2.4-25.4)). Students belong to family earned 500-1000 ETB were

vii
2.47 times high risk to be experienced premarital sex than others students (AOR= 2.47, CI=

(1.01-6.07))

Conclusion: The prevalence of premarital sex among the study participants was higher than the

studies conducted in different parts of Ethiopia and almost all of the students who have had

history of sexual practices utilized condom during their sexual intercourse. Premarital sex among

the study participants of this study was strongly associated with students‘ grade level and family

monthly income status.

Recommendation: Ministry of Health, Ministry of Education and schools in collaboration

should provide psychosexual services for adolescent students at secondary school level.

Key words: premarital sex, unprotected sex, adolescent students, Ethiopia.

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 1. INTRODUCTION
1.1. Background

The World Health Organization (WHO) defines adolescent people as those between the ages of

10 to 19 years (1). Adolescence is the time of transition from childhood to adulthood during

which young people experience significant physiological, psychological and social changes

following puberty; but not immediately assume the roles, privileges and responsibilities of

adulthood (2).

Premarital sex is a penetrative vaginal or anal sexual intercourse performed between couples

before formal marriage. Some people who advocate virginity and abstinence argue that those

people engaged in such sexual practice may have sex with many sexual partners and may have

high number of life time sexual partners. As a result, they may be liable to acquire STIs including

HIV. Besides, females, particularly adolescent girls may end up with unwanted pregnancies,

abortions, teenage deliveries, and various complications of these including death. Moreover, the

girls may dropout from school to look after their children and in most cases they become

economically dependent up on their parents (3).

Unprotected/unsafe sex is a sexual intercourse where an exchange of body fluids take place with

no barrier such as condom: can transmit STI, including HIV, between partners (4).But, in

addition to this, females may end up with unwanted pregnancy and its negative sequel. Both male

and female adolescents are usually curious to discover sex and are highly liable to practice

premarital sex which is usually unprotected.

Family context has been shown to have consistent and strong effects on the timing of sexual

debut. Adolescent living in single-parent families or with stepparents initiates sexual activity

1
earlier than those in two-parent families (5). Adolescent feelings of closeness and connectedness

to parents, parental disapproval of sex, and positive peer influences have been shown to delay

sexual activity (6). Dating, and especially early steady dating, provides a context for many

adolescent sexual experience. Previous studies have shown that adolescents' attitudes about sex

affect adolescent sexual behavior, more permissive attitudes lead to earlier first sex (7).

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1.2. Problem Statement

One in every five people in the world is an adolescent, defined by World Health Organization as

a person between 10 to 19 years of age. Unsafe sex is a major threat to the health and survival of

millions of adolescents. Each year, one in 20 adolescents worldwide contracts STI including

HIV. Every day, over 7000 young people aged from 10 to 24 years become infected with HIV

(8). Globally more than half of all new HIV infections are among 15 to 24 years old (9).

Early sexual initiation may predispose young people to HIV as their chances of having several

partners before marriage increases (10). Therefore, delaying the age of sexual debut and

increased condom use is recommended in preventing HIV infection for this age group (11). In

Zambia, behavioral interventions have led to a decline in the prevalence of HIV (12).

In many societies, premarital sex is a taboo, especially among unmarried girls (13). This norm is

widespread in rural Ethiopia, as in many traditional societies (14). A study about the concepts of

HIV and AIDS in Ethiopia suggested that premarital sex may contribute to the expansion of HIV

and AIDS (15). Indeed, several studies from Ethiopia have shown that young people are engaged

in premarital sex, have multiple sexual partners, and do not use condoms at all or use them

irregularly (16).

Adolescents in Ethiopia are also exposed to various risks such as unprotected sex, early marriage,

early pregnancy, sexually transmitted infections (STIs) and HIV/AIDS, unemployment, drug

abuse and crime (17).Moreover, studies show that in Ethiopia, 60% of adolescents‘ pregnancy is

unwanted or unintended pregnancies resulted from unprotected sexual intercourse (18).

In order to tackle these problems, adolescents should learn to develop the life skill they need to

survive in their environment. Life skill based education enables them to develop an ability in

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critical thinking, problem solving, self-management and interpersonal Communication skills in

order to adopt a healthy behavior. Because, when sexuality is discussed openly and when young

people learn more about their bodies and their emotions, they are better able to cope with sexual

maturations (1).

Schools are the ideal places where adequate and accurate information be provided along with

their formal education. Moreover, peer groups in school play a great role in information

dissemination and help students internalize the facts that lead to behavioral change. Actually, this

needs the integrated effort of adolescents, school- teachers, the family and other relevant bodies.

In general, many literatures suggest that the individual, family and peer variables have

considerable influence on the sexual behavior of the youth. However, it is one of the least

researched topics in Ethiopia, Due to the sensitivity of the topic of premarital sexuality; youth

receive inadequate education, guidance and services on reproductive health. To fill the gap, it is

thus imperative to study the prevalence of premarital sex and the factors surrounding premarital

sex in the context of high school students in order to inform Ministry of Health, Ministry of

Education and planners to develop appropriate and timely intervention programs to prevent high

risk sexual behavior such as premarital sex and unsafe sexual practices in these populations.

4
1.3. Significance of the study

The study related to the prevalence of premarital sex and unprotected sexual practice among

secondary school adolescent students is the critical issue to be studied. Because the students of

this age group have great role conflict about their activities because of immaturity, acquired new

developmental stage and hotness. Hence, these students do not get adequate reproductive health

services and may be practicing unsafe sex and exposed to HIV infection. The result of this study

is important to provide baseline information related to school adolescents sexual behavior in the

area and the baseline data will be used by different stakeholders like Ministry of Health, Ministry

of Education and other Organizations to take appropriate measures to improve current sexual

behavior of the students in order to prevent burdens following premarital sex and unprotected

sexual activity such as sexually transmitted infections including HIV/AIDS, unintended

pregnancy, abortion, school dropout and early marriage.

5
 2. LITERATURE REVIEW

The period of adolescence encompasses the transition from childhood to adulthood during the

second decade of life. These age groups are often characterized as being at a life stage of

increased experimentation and exploration associated with a range of risky behaviors, including

risky sexual behaviors (19). Moreover, adolescents are less likely than adults to have the

information, skills and support to protect themselves against HIV/AI DS and other consequences

of premarital sex (20).

Adolescents all over the world are sexually active, but the age at which they start sexual

intercourse varies between regions and within a country, between urban and rural settings (21).

Age at first sexual activity in many areas tends to begin at a younger age than in the past. The

mean age of marriage has gradually been increasing while the age of puberty in both sexes

appears to be falling (22). Many studies showed that young men begin sexual activity earlier than

young women because premarital sex is accepted for males, whereas females are expected to

postpone the initiation of intercourse until they marry (21).

Adolescents‘ premarital sexual activities are increasing in the countries around the world, many

of which are risky, unplanned, and unprotected (23 - 26).

In the US, over 90% of young adults in 2001 reported sexual debut during adolescence and prior

to marriage. In the early 1990s, the majority of young adults (ages 20–25) surveyed in eleven

European nations reported experiencing sexual initiation during adolescence. For males, the

prevalence of sexual initiation before age 20 ranged from 73% in the Netherlands to 88% in

Iceland; for females, the low was in Portugal at 51% and the high in Denmark at 90% (27).

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In USA, adolescent sexual experience rates were 53% and 72.2% for females and males,

respectively (28). In Canada, studies showed that 31% of male and 21% of females of 9th grade

students were found to be sexually active while the figure increases to 49% of males and 46% in

grade 11. A survey conducted in 2001 in 32 nations found the prevalence of ever having sexual

intercourse among 15-year-olds varied from a low of 15% in Poland to a high of 75% in

Greenland (29).

The studies conducted in Brazil showed that 64% of 15 to 17 years old men reported engaging in

sex before marriage as opposed to only 13% of females. In a study of young women in Shanghai

who received medical examination prior to marriage, 76% reported having had sexual intercourse

and 27% had aborted a pregnancy. Another study in Bangladesh found that 88 % of unmarried

urban boys and 35 % of unmarried urban girls had engaged in sexual intercourse by the time they

were 18 years (22).

Another study of the young factory workers in Kathmandu revealed that 20% of unmarried boys

and 12% of unmarried girls aged 14–19 years were sexually experienced (penetrative sex).

Interestingly, the mean age for first sexual debut was the same for both the boys and the girls (15

years) (30). Similarly a survey conducted among teenagers in seven districts of Nepal showed

risky sexual behavior especially among young boys. About 22% of the boys interviewed had

premarital sexual experience and only two thirds of them used condom. The number of boys who

had sex with multiple partners was also high (31).

With an increasing age at first marriage across sub-Saharan Africa, the context of sexual

initiation in many countries has shifted from marriage to premarital sex (32). This development

has been accompanied by an increase in the years that young women are at risk for premarital

7
birth (33). Premarital pregnancy and childbearing can influence the achievement and timing of

key transitions to adulthood, and alter young women's life trajectories in the longer-term. In

particular, research in sub-Saharan Africa has linked premarital pregnancy and birth to early

termination of education, lower long-term earning potential, decreased opportunities for union

formation, and experiences of discrimination and stigmatization for young women (34).

A cross sectional study conducted in Tanzania showed that 0.3% girls and 3.2% boys had their

first sexual debut by the age of 9 years and 10% of both sex by the age of 13 years. The largest

group, 55% of girls and 45% of boys, had their first sexual intercourse between the ages of 14 to

17 years (35). According to a study conducted in urban Kenya, by age 18, 64 % of respondents

had initiated premarital sex (36). Another study in rural Kenya revealed that among students aged

15 to 19 years, boys perceived sexual activity as part of their initiation into manhood. Many were

sexually active and many had multiple sexual partners (22).

However, some studies in Africa and Latin America showed that sexual initiation for girls can

occur before menarche. In Malawi, 56% of the 300 female adolescents surveyed reported being

sexually experienced, and of these, 58% had sex before menarche. The mean age at first

intercourse was 13.6 years while the mean age of menarche was 14.5years. In Guinea, the age at

first intercourse reported as early as 11 years. In Brazil school based study, among 36% of

adolescent females those reporting sexual intercourse, one fourth of them had their sexual

experience before age 13 (37).

The situation in Ethiopia is also the same. According to the study conducted in Ethiopia, 66.2%

of the adolescents expressed that they had sexual intercourse and of those who had ever had sex,

the age at first intercourse ranged from 8 to 31years with the mean age of 17.4 and females had

8
their first intercourse at significantly younger age. In addition, out of the total respondents, 53.8

% have regular partner while the remaining 46.2 % reported no regular partners (17).

The national HIVAIDS behavioral surveillance survey also showed that 16% (19% of males and

13% of females) of the in-school youth had ever had sex. Among these the proportion was

highest in Oromia region (31.3%) and lowest in Addis Ababa (6.5%). More than 25% of the in-

school youth had sex by the time they were 15 years old. The two most common reasons for

starting sex were personal desire (68%) and peer pressure (22%). The percentage of in school

youth reported more than one sexual partner. During their last sexual encounter with non

commercial partners, 52.4% of in school youth (64.2% of males and 40.2% of females) had used

a condom and 73.6% (79.2% of males and 64.4%of females) had used condoms consistently. The

commonest reasons for not using condom amongst the youth were partner trust (54.4%) and

partner objection (9.4%) (38).

A study conducted in Addis Ababa showed that 19.5% had a coital exposure at least once prior to

the study of which 83.8% were boys and 13.5% were girls. The minimum age of sexual onset for

boys was 12 years and that of girls was 14 years. The reasons given by these students for starting

sex were peer pressure (35.2%), forced sex (21.6%), alcohol use (11.5%) and drug (10.3%).This

study showed that 10% of the sexually active male students admitted having sex with commercial

sex workers. This study showed that 82% of the sexually active did not use condoms on their first

sexual encounter. Only 27.7% of the sexually actives claimed that they had continuously used

condoms. The two outstanding reasons for not using condoms were negligence (28.2%) and

embarrassment in buying from shop or pharmacy (39).

9
Another study conducted among high school students in North West Ethiopia also showed that

31.9% were sexually active. The mean age of sexual commencement was 16.7 for males and 15.5

for females. The study showed that females become sexually active earlier than boys. The survey

also showed that 45.9% had used condoms within the last 6 months prior the study and among

these 39.3% reported to be using condoms always. The reasons for non-condom use were non-

approval from the partner 21.4% and decreased sexual satisfaction 19.6% respondents (40).

A study conducted among the senior high school students in Harrar showed that 65% of males

and 20% of females were sexually active (41). In Jimma Town, 17.9% high school

adolescents (6.7% of females and 11.2% of males) were involved in unprotected sexual

activities (42).

According to a study conducted in Nekemte town among adolescents aged 10-19years, 21.4% of

the study population reported to have premarital sexual intercourse at the time of the survey, of

which 70.3% were males and 29.7% were females. The mean age at first sexual intercourse was

16.2 for male and 15.18 for females. From all sexually active adolescents, 5.8% of males and

14.6% of females had their first sexual intercourse before the age of 14 years, while the large

proportion, 94.2% of males and 85.4% of females had their first sexual intercourse after the age

of14 years. The majority of the adolescents 83 (57.2%), (69.5%of boys and 65.6% of the girls)

had their first sexual intercourse between the ages of 15 and 17years (43).

According to comparative study conducted in south west Ethiopia, 26% of the male and

21.6% of the female students had two or more sexual partners in the last six months. 32%

of the male and 43.5% of the female students was practiced unsafe sex in the last six months

prior to the study. 25.9% of male and 21.6% of female students had two or more sexual

10
partners in the last six months prior to the study. Only 9.4% of the male and 8.6% of the female

students used condom consistently (44).

A similar study done among Agaro high school students showed 25% of the sexually active

students had sexual history. The mean age of coitus was 16.45 and 16.8 for males and females

respectively .This study also showed that 55.6% of the sexually active students had one partner,

35.6% had 2 - 5 and the remaining had more than 5 sexual partners during the past 12 months.

Among these, 40% males and 7.1% females reported to have 2-5 and more than 5 partners

respectively. The study revealed that 54.4% of the sexually active used condoms at least once. Of

these, 46.9% of them used condoms always and 38.8% occasionally (45).

According to study conducted among youth in rural part of Ethiopia, Alcohol and Khat use were

strongly associated with premarital sexual initiation. Habitual users of khat report that it produces

increased levels of energy, alertness, and self-esteem, sensations of euphoria, enhanced

imagination, and the capacity to generate ideas (46). Then after Alcohol drinking follows khat

chewing and might be associated with unprotected sex (47).

Generally, early initiation of sexual activity is linked to higher numbers of non-marital sex

partners, minimal condom use, increased rates of STIs, increased rates of out-of-wedlock

pregnancy and birth, increased single parenthood, decreased marital stability, increased

maternal and child poverty, increased abortion, increased depression, and reduced happiness

(48).

The available literatures in the area strongly recommend that sexual behavior among in-

school youth and adolescents should be based on the ability to delay sexual initiation and to use

condom consistently when abstinence is not possible. Success in these two strategies can be

11
strongly affected by individual factors such as the value given to virginity and boy/

girlfriend, and stigma attached to condom (49).

12
 3. OBJECTIVE

3.1. General objective

To assess the prevalence of premarital sex and unprotected sexual intercourse practice and

associated factors among secondary school adolescent students in Sebeta Town, 2014.

3.2. Specific objectives

 To assess the magnitude of pre-marital sex among secondary school adolescent students

in Sebeta Town.

 To assess the magnitude of adolescents‘ utilization of condom for dual protection.

 To identify factors associated with premarital sex among secondary school adolescent

students in Sebeta Town.

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 4. METHODS AND MATERIALS

4.1. Study Area

The study was conducted among secondary school adolescent students in Sebeta Town which is

one of the special Oromia Zones around Finnfine, Oromia regional state. It is located along Addis

Ababa to Jimma Road on 24 km away from Addis Ababa, the capital city of Oromia Regional

state, as well as Ethiopia and Headquarter of Africa Union. There are one secondary school and

12 primary schools in the study area.

4.2. Study design and period

A cross-sectional study design, quantitative method, was used to assess the prevalence of

premarital sex and unprotected sexual activity among secondary school adolescent students in

Sebeta Tow, from April to May, 2014

4.3. Population
4.3.1. Source population

The source population for this study was all students those attending their regular education at the

time of data collection.

4.3.2. Study population

All students attending their regular education at the time of data collection and fulfilling the

inclusion criteria was included.

Inclusion criteria

All regular, unmarried students aged 10 to 19 years, and attending their regular education at the

time of data collection was included.

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Exclusion criteria

Non-regular and not attending the school at the time of data collection and age greater than 19

years as well as married students were excluded from the study.

4.4. Sample size determinations and sampling technique

4.4.1. Sample size determination

All students who met the inclusion criteria were included until the required sample saturated.

The required sample size was calculated by the following formula and p-value obtained from

study conducted in Nekemte, prevalence of premarital sex among high school adolescents 21.4%

in the literature.

A single population proportion formula, [n = (Z α /2) 2p (1-p)/ d2], was used to estimate the

sample size. (p = 0.214), 95% confidence interval, margin of error 5% (d = 0.05). Computing

with the above formula and 10% of contingency for non respondent rate gives a total sample size

of 284.

4.4.2 Sampling Procedure

The secondary school, in the respective area, was included in the study. Consultation with the

school administration was made to obtain details of classes and respective numbers of students in

the school. Sampling frame of classes in the high school was prepared and 16 classes were

selected out of 53 classes by using probability sampling proportional to size and simple random

sampling (lottery) method was applied to select equal number of study subjects from each class.

The number of required sample was calculated from each class and divided into grades, (9th to

12th).

15
16
4.5. Study Variables
4.5.1. Independent variables

 Socio-demographic variables (age, sex, grade level, parental education, family monthly

income)

 Substance abuse (alcohol, Khat, drugs)

 Living arrangement and Pocket money

4.5.2. Dependent variables

 Premarital sex

 Unprotected sexual practice

 Condom use

4.6. Data collection tool

The questionnaire consists of the following data:

 Socio demographic data of the family and the student

 Sexual history

4.7. Data collection and quality control

The structured questionnaire adapted from the BSS Ethiopia 2001. It was prepared by English

language. It was translated to local language Afan Oromo and discussions was made if there are

culturally unacceptable questions, ambiguous words etc with small group of respective ethnic

groups, then it was translated back to English for analysis. Then the questionnaire was pretested

17
on 14 Teji high school adolescent students nearby to the study area. Training was given for one

supervisor degree holder and four diploma holder data collectors for two days.

The data was collected by data collectors through self administered questionnaire, and then

checked by supervisor. The principal investigator was coordinating the overall activity of the

study.

The data collection format of each data collectors was checked daily for completeness, missed or

other relevant information on meeting and supportive supervision during data collection. Data

editing was done by the data collectors, supervisors and the principal investigator in the field and

further cleaning of data, coding and entry to computer.

4.8. Operational definitions

Age of sexual debut: The age at which the first sexual initiation occurred.

Casual sex: A sexual intercourse happening by chance without care or thought.

Commercial sex partner: A partner who involved in sexual relationship/intercourse to get

money in exchange for sex.

Early sexual intercourse: A penetrative vaginal sexual intercourse performed before the age of

sexual maturity and socially acceptable age (18 years of age).

Non-commercial sex partner: Any partner who do not need sexual relationship/intercourse to be

paid for or for seek of money.

Premarital sex: A penetrative vaginal sexual intercourse performed before formal marriage.

18
Sexually active: A study subject who have had a penetrative vaginal sexual intercourse at least

once prior to the study.

Sexual history: An individual who had history of sexual intercourse.

4.9. Data entry, analysis and processing

Data was entered to Epi-Info 3.4.3 for windows and analyzed using SPSS version 16.0 for

windows. The data was double entered to check the consistency and was cleaned and edited

before analysis. During the process of analyzing, Frequency distributions, pie chart, figures and

tables were used to provide an overall and coherent presentation and description of the data and

odd ratio was performed on some selected variables to determine the association of these selected

variables and Logistic regression was used to control any confounders.

19
4.10. Ethical consideration

The thesis proposal was submitted to Addis Ababa University, college of health science, School

of Allied Health Science, Department of Nursing and Midwifery, Nursing Research Review

Committee for approval. Following the approval by Institutional Review Board, official letter of

co-operation was written to the concerned bodies by School of Allied Health science, Department

of Nursing and Midwifery. As the study was conducted through consenting the study participants

to answer the self administered questionnaire privately and the individual students was not

subjected to any harm as far as the confidentiality was kept. No personal identifiers were used on

data collection form. The recorded data was not accessed by a third person except the principal

investigator, and was kept confidentially.

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4.11. Dissemination of results

Findings of the study will be communicated to the schools where the study was conducted, to

Ethiopian Ministry of Education to inform the importance of reproductive health for school

adolescent, School of Allied health Science through soft and hard copy after presentation.

The findings will also be disseminated to different organizations those have a contribution to

promote health and prevent diseases related to adolescent reproductive health in the region and

zone. The findings will also be presented in various seminars and workshops. The findings will

finally be published to access to other users as well.

21
 5. Results

The total sample size was 284 secondary school adolescent students. From these, 272 study

participants were provided their complete and relevant responses which making response rates

95.8%. The rest did not provide either complete data or refused to complete the questionnaire.

5.1 Socio demographic characteristics

The mean age of the study participants were 17.15 with standard deviation of 1.32. The

maximum age was 19 years and the minimum age was 14 years. One hundred seventy four (64%)

of the study subjects were male and the remaining 98(36%) were female. Most of the students,

205(75.4%) were grade 9th - 10th and 67(24.6%) were grade 11th -12th (Table 1).

The majority of the study participants, 198(72.8%), were Oromo, followed by 40 (14.7%)

Amhara, 27(9.9%) were Gurage and 7(2.6%) were others. By religion, 193(71%) were Orthodox,

48(17.6%) were Protestant and the rest 31(11.4%) were Muslim (Table 1).

Regarding educational level of the study subjects‘ family, majority of them, 97(35.7%) have no

formal education, 83(30.5%) attained secondary school, 60(22%) attained primary school and the

remaining 32(11.8%) complete College/University (Table 1).

Monthly income of most of the study subjects‘ family ranges from 500-1000 Birr which accounts

71(26.1%), 1600- 2000 Birr accounts 53(19.5%), >2000 Birr accounts 53(19.5%), 1100-1500

Birr accounts 50(18.4%) and < 500 Birr accounts 45 (16.5%), (Table 1).

22
Table 1 Socio demographic characteristics of secondary school adolescent students in

Sebeta Town, 2014.

Characteristics Frequency Percent

<15 3 1.1
Age (years) 15 -19 269 98.9
Total 272 100.0

Sex Male 174 64.0

Female 98 36.0
Total 272 100.0

School grade 9th – 10th 205 75.4

11th – 12th 67 24.6
Total 272 100.0

Ethnic Oromo 198 72.8

Group Amhara 40 14.7
Gurage 27 9.9
Others 7 2.6
Total 272 100.0

Orthodox 193 71.0

Religion Protestant 48 17.6
Muslim 31 11.4
Total 272 100.0

Have no formal 97 35.7

Parental education
educational Primary School 60 22.0
status Secondary School 83 30.5
College/University 32 11.8
Total 272 100.0

<500 Birr 45 16.5

500-1000 Birr 71 26.1
Monthly 1100 - 1500 Birr 50 18.4
income 1600 - 2000 Birr 53 19.5
>2000 Birr 53 19.5

23
 Total 272 100.0

School fee Father 40 14.7

covered by Mother 73 26.8
Both parents 137 50.4
Self 22 8.1
Total 272 100.0

Employment Yes 144 52.9

of the student No 128 47.1
Total 272 100.0

Type of jobs Labor work 58 40.3

of the student Shoe shining 13 9.0
Shop keeper 32 22.2
Café servant 33 22.9
Others 8 5.6
Total 144 100.0

Current Both parents 138 50.7

Residence Mother 66 24.3
Father 31 11.4
Alone 27 9.9
Others 10 3.7
Total 272 100.0

Regarding their school expenses which including transportation fee, lunch and some school

payment were covered by both parents 137(50.4%), mother only 73(26.8%), father only

40(14.7%) and 22(8.1%) were paid by themselves. One hundred forty four (52.9%) study

subjects work different jobs to get money. These include 58(40.3%) labor worker, 33(22.9%)

were café servant, 32(22.2%) were shop keeper, 13(9%) were shoe shining and 8(5.6%) work

other jobs.

24
When concerning current residence of the study participants, majority of them 138(50.7%) were

living with their both parents, 66(24.3%) were living mother only, 31(11.4%) were living with

father only, 27(9.9%) were living alone and the rest 10(3.7%) were living with other relatives.

5.2 Alcohol and drug consumption

Among 272 study participants, 107 of them reported that they used different type of drugs. These

include 61(57%) of them were consumed Alcohol, 19(17.8%) were used Khat, 12(11.2%) were

smoke cigarette, 10(9.3%) were used hashish and 5(4.7%) were used others different drugs

(Figure 1).

Figure 2 Alcohol and drug consumption of secondary school adolescent students, Sebeta Town,
2014

25
5.3. Premarital sex

Out of two hundred seventy two study participants, majority of them, 191(70.2%) had no sexual

partner and the remaining 81(29.8%) had sexual partner. Regarding the premarital sexual practice

195(71.7%) of them did not ever involved in any sexual practice but 77(28.3%) were experienced

sexual intercourse with different people. Forty seven (61%) of them had sexual intercourse with

their boy/girl friend, 29(37.7%) with acquaintance and 1(1.3%) with other people.

The maximum age at which the study subjects had sexual intercourse was 19 year and the

minimum age was 13 year with the mean age of 16.51. The maximum age of their first sexual

partner for female students was 26 year and the minimum age was 12 year for male students with

the mean age of 16.9.

Regarding the purpose of having the first sexual intercourse, 36(46.8%) of them were reported

because of falling in love with their sexual partner, 30(38.9%) had desire to have sexual

intercourse, 8(10.4%) due to peer pressure and the remaining 3(3.9%) had sexual intercourse due

to other reasons like rape and financial purpose.

When concerning the total number of sexual partner they have had sexual intercourse yet,

majority of them, 54(74%) of them have had sex with one partner, 19(24.7%) have had sex with

two partner and the rest 1(1.3%) has had sex with more than two partner.

26
Table 2 Premarital sexual practices among secondary school adolescent students in Sebeta Town,

2014.

Characteristics Frequency Percent

Had sexual partner
Yes 81 29.8
No 191 70.2
Total 272 100.0
Ever had sexual intercourse
Yes 77 28.3
No 195 71.7
Total 272 100.0
Age at first sexual
intercourse 8 10.4
10 – 14 69 89.6
15 – 19 77 100.0
Total
Age of first sexual partner
10-14 26 33.8
15-19 35 45.4
>=20 16 20.8
Total 77 100.0
Reason to start sex
Fall in love 36 46.8
Had desire 30 38.9
Peer pressure 8 10.4
Others 3 3.9
Total 77 100.0
Relationship of the first
sexual partner
An acquaintance 29 37.7
Boy/girl friend 47 61.0
Others 1 1.3
Total 77 100.0
Total number of sexual
partner 57 74.0
1 19 24.7
2 1 1.3
>2 77 100.0
Total

27
5.4 Unprotected sexual practice

Among the study participants who have experienced sexual intercourse (77 students), larger

proportion 71(92.2%) of them had sexual intercourse in the last 12 months prior this study. The

remaining 6(7.8%) did not practice sexual intercourse in the past 12 months.

Concerning the total number of partner they have had sex in the past 12 months, 56(78.9%) of

them had sex with only one partner, 14(19.7%) had sex with two partner and the rest 1(1.4%) had

had sex with more than two people. Among the students who had sexual intercourse in last 12

months, 54(76 %) of them had sex with non commercial sex partner, 11(15.5%) with commercial

sex partner and 6(8.5%) with both commercial and non commercial sex partner.

Regarding safe sexual practice, majority of them 64(90.1%) of the students were used condom in

their most recent sexual intercourse and the rest 7(9.9%) did not use condom during their most

recent sexual practice. Concerning the initiation of condom using among those study participants

who were used condom in their most recent sexual practice, larger proportion, 38(59.4%) of the

decision to use condom was made by self, 17(26.6%) were decided jointly and 9(14%) were

influenced to use condom by their partner.

The reason of majority of the study participants to use condom during sexual intercourse was fear

of HIV/AIDS which accounts 40(62.5%), 18(28.1%) of them used to prevent pregnancy, 5(7.8%)

to prevent STI and the rest 1(1.6%) used condom for other purposes. The reasons of non users

were 3(42.8%) of them ashamed to buy, 2(28.6%) of them trust their partner and the remaining

2(28.6%) did not use condom due to other different reasons.

28
Table 3 Unprotected sexual practices among secondary school adolescent students in Sebeta

Town, 2014.

Characteristics Frequency Percent

Had sexual intercourse in
the last 12 months
Yes 71 92.2
No 6 7.8
Total 77 100.0
Number of sexual partner in
the last 12 months
One 56 78.9
Two 14 19.7
More than two 1 1.4
Total 71 100.0
Type sexual partner
Commercial 11 15.5
Non commercial 54 76.0
Both 6 8.5
Total 71 100.0
Condom use in the most
recent sexual intercourse
Yes 64 90.1
No 7 9.9
Total 71 100.0
Initiator to condom use
Self 38 59.4
Partner 9 14.0
By joint decision 17 26.6
Total 64 100.0
Reason for condom use
To prevent pregnancy 18 28.1
Fear of HIV/AIDS 40 62.5
To prevent STI 5 7.8
Others 1 1.6
Total 64 100.0
Reason of non condom users
Ashamed to buy condom 3 42.8
I trust my partner 2 28.6
Others 2 28.6
Total 7 100.0

29
 5.5 Factors associated with premarital sex

The risk factors associated with premarital sex among the study subjects are grade level, and

family monthly income. Grade ten students are 7.99 times risk to be involved in premarital sex

than others (AOR=7.99, CI= (2.2 – 28.5)) and grade eleven students are 7.81 times high risk to be

involved in premarital sex than other grade level students (AOR= 7.81, CI=(2.4 – 25.4)).

Regarding family monthly income, the students belongs to those families monthly earned 500-

1000 ETB are 2.47 times high risk to be involved in premarital sex than other students

(AOR=2.47,CI=(1.01 – 6.07)).

Table 4 Risk factors associated with premarital sex among secondary school adolescent students

in Sebeta Town, 2014.

Variables Premarital Sex

Yes % No % p- COR(95% CI) p- AOR(95% CI)
value value
Sex
Male 58(33.3) 116(66.7) 0.015 0.48(0.27-0.87)*
Female 19(19.4) 79(80.6)
Students grade level
Grade 9th 27(31.4) 59(68.6) 0.121 2.19(0.81-5.87)
Grade 10th 32(26.9) 87(73.1) 0.042 2.72(1.04-7.14)* 0.001 7.99(2.2-28.5)**
Grade 11th 8(17.0) 39(83.0) 0.007 4.88(1.5-15.56)* 0.001 7.81(2.4-25.4)**
Grade 12th 10(50.0) 10(50.0)
Monthly income
<500 birr 12(26.7) 33(73.3) 0.436 1.41(0.59-3.39)
500-1000 birr 12(16.9) 59(83.1) 0.031 2.53(1.09-5.87)* 0.048 2.47(1.01-6.07)**
1100-1500 birr 19(38.0) 31(62.0) 0.67 0.84(0.38-1.88)
1600-2000 birr 16(30.2) 37(69.8) 0.677 1.19(0.53-2.69)
>2000 birr 18(34.0) 35(66.0)

30
 6. Discussion

Being adolescence age group is characterized by different risk behaviors, including risky sexual

behaviors (20). Adolescents all over the world are sexually active, but the age at which they start

sexual intercourse varies between regions and within a country, between urban and rural settings

(21).

Adolescents‘ premarital sexual activities are increasing in the countries around the world, many

of which are risky, unplanned, and unprotected (23 - 26).

The prevalence of premarital sex among the study participants was 28.3% with the mean age of

16.51 and the maximum age 19 year and the minimum age 13 year. When compared to the study

conducted in Nekemte Town the prevalence of premarital sex was 21.4% (43) and Agaro high

school 25% (45). The premarital sexual practice among this study subjects is higher when

compared to these studies because the participants of the current study are more susceptible to the

effect of globalization because they are closer to the capital city of Ethiopia, Addis Ababa, in

which globalization is highly expanded including experimentation of different sexual practices.

The main reason of having sexual intercourse of this study subjects was fall in love (46.8%)

followed by had desire to have sexual practice (38.9%). But the reason of having premarital sex

among Addis Ababa high school adolescent students was peer pressure (35.2%), rape and use of

drugs, which is different from the current study participants (39).

In this study majority (74%) of the students who have experienced premarital sex, had one sexual

partner. Similarly the study conducted among Agaro high school adolescent students showed that

larger proportion of the study participants 55.6% had one sexual partner (45).

31
Using condom during sexual intercourse is one of the preventive methods of STI including

HIV/AIDS and unwanted pregnancy. Ninety percent (90.1%) of these study participants were

used condom during their most recent sexual intercourse. When compared to the studies

conducted in different parts of Ethiopia, among secondary school adolescent students in North

West Ethiopia 45.9% were used condom (40) and among Agaro high school adolescent students

54.4% were used condom during their sexual practices (45), the study subjects of this study were

highly utilized condom during their sexual practices. The reason behind may be due to the

proximity of the study area to the capital city in which more information about condom use is

daily heard/announced.

The reasons of non condom users of this study participant were ashamed to buy 42.8% and trust

of their friends 28.6%. Similarly, the study conducted among high school adolescent in Addis

Ababa revealed that the reason of non condom users was embarrassment in buying from shop or

pharmacy (39). But the study conducted in North West Ethiopia revealed that the reasons of non

condom users‘ high school adolescent students were partner opponent 21.4% and decreased

sexual satisfaction 19.6% (40).

In this study, the mean age of first sexual intercourse is 16.9 years which is higher than the result

found in the study done in Addis Ababa (39) which was 12 years for boys and 14 years for girls.

This could be due to the fact that Sebeta town is closer to rural setting thus adolescents may

abstain from early sexual intercourse more than the adolescents in Addis Ababa.

The risk factors associated with premarital sexual practices among this study subjects were

different in grade level and family monthly income. Grade ten students were 7.99 times high risk

to be experienced than other grade students and grade eleven students were 7.81 times high risk

32
be involved in premarital sex than others grade level students. The students from families earned

500-1000ETB were 2.47 times high risk to be practiced premarital sex than others students.

Strength of the study

 The study utilized simple random sampling technique to obtain the required sample

size which maximizes the representativeness of the sample to the source population.

 Since the study is quantitative, it minimizes subjectivity.

 Multiple logestic regression was used to control the effect of confounders.

Limitation of the study

 Although their confidentiality was reassured, since sexuality is a sensitive issue and

the respondents may feel that their privacy is violated. As a result, tendency to hold back

or give false information could be a limitation to this study.

 Since sexual issue is sensitive issue which requires special techniques of information

elicit through interview, relying only on self administered questionnaire which

compromises the quality of raw data in such sensitive issue is another drawback to this

study.

33
 7. Conclusion and Recommendation

7.1 Conclusion

This study revealed that the prevalence of premarital sex among the study participants is higher

than the studies conducted in different parts of Ethiopia. The utilization of condom among the

study participants was so appreciated practice because almost all of the students who have had

history of sexual practices utilized condom during their sexual intercourse.

Premarital sexual practice among the study participants of this study was strongly associated with

being grade tenth and grade eleventh as well as family monthly income status.

34
7.2 Recommendations

 Ministry of Health in collaboration with Ministry of Education should encourage

reproductive health education which plays a vital role in adolescent healthy sexual

behavior.

 Ministry of Health should establish adolescent clinic at school which provide

psychosexual counseling for the students.

 The schools should provide psychosexual services for adolescent students.

35
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Annex I: Informed Consent Sheet

Consent to participate on a project assessing prevalence of premarital sex and unprotected sexual
activity among high school adolescents in Sebeta Town, Ethiopia

Greetings! My name is ________________________________ I am a data collector temporarily

working on behave of principal investigator on the Thesis with the objective assessment of
prevalence of premarital sex and unprotected sexual activity among high school adolescents in
Sebeta Town.

Purpose of the Study

Two hundred and eighty four (284) high school adolescent students will be involved to assess
prevalence of premarital sex and unprotected sexual activity among high school adolescents in
Sebeta Town.

Confidentiality

All information collected on forms will be entered into computers with only the study
identification number. All information that will be collected from you will be protected. The
study will not include details that directly identify you, such as your name. Only a participant
identification number will be used in the survey. Only a small number of researchers/ Research
Assistants will have direct access to the survey. If the results of the current study will be
published or presented in a scientific meeting, names and other information that might
identify you will not be used.

Risks

As the study will be conducted through self administered questionnaire, the individual student
will not be subjected to any harm.

Rights to Withdraw and Alternatives

Taking part in this study is completely your choice. You are free to skip any question if you feel
uncomfortable to disclose information. You can stop participating in this study at any time,
even if you have already given your consent. Refusal to participate, or withdrawal from the
study, will not involve penalty or loss of any benefits to which you are otherwise entitled.

Benefits

There are no direct benefits to you; But, I hope that the results of the study will provide
valuable information on the prevalence of premarital sex and its consequences.

42
Who to Contact

If you ever have questions about this study, you should contact the principal investigator Helen
Berihun (+2519-11-68-07-29) Addis Ababa University, Collage of Health Science, Allied
School of Health Sciences, Department of Nursing and Midwifery.

Signature: _____________________

Do you agree to participate?

Participant agrees ……………………… Participant does NOT agree ………………..

Name and Signature of the data collector ________________________ Date_________

43
 ADDIS ABABA UNIVERSITY

COLLEGE OF HEALTH SCIENCES

SCHOOL OF ALLIED HEALTH SCIENCES DEPARTMENT OF NURSING AND

MIDWIFERY

Annex II Questionnaires

Informed Consent Form

Dear students!

To ensure the health of adolescents, understanding of the existing health problems and related
behaviors of these populations is essential. Owing this, this study is designed to assess the
sexuality, determinant factors of these behaviors and utilization of condoms among high school
adolescents.

You are chosen to participate in this study .The choice of the grade and an individual was done
randomly using a type of lottery and systematic approach.

The purpose of this study is to generate important information about high school adolescents‘
sexual behaviors, determinant factors and condom utilization and to propose future school health
program interventions.

These study questions will involve various personal and sexual issues of individuals. So, it is
your full right to refuse or participate in this study. If you do not want to participate, you can
leave the question papers on the table upside down, & you are kindly requested to remain on your
seat until others finish filling the questions. Moreover, I assure you that your responses are
completely confidential & non-of your responses will be reported to anybody. Therefore, there is
no need to write your names on these survey papers.

However, in order to attain its goal, we kindly request your kind and good will to participate in
the survey. So, please take a few minutes to answer the questions.

Would you like to participate? Yes [___] No [___]. Mark" X" in the appropriate
space

If yes, go to the next page. If no, remain on your seat.

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Date (DD/MM/YY) _________________

Name of the school: ___________________ Grade_____________

Questionnaire Code ________________________

Name of data collector __________________Signature_________

Name of supervisor _____________________Signature_________

Principal investigator: Helen Berihun

Part I: socio- demographic characteristics

SN Question Response Skip to Code

101 Your sex Male 1
Female 2
102 Your age [___________] in year
103 Your Grade level Grade 9th 1
Grade 10th 2
th
Grade 11 3
Grade 12th 4
104 Ethnic group Oromo 1
Amhara 2
Gurage 3
Tigre 4
Others(specify) _________
105 Religion Orthodox 1
Protestant 2
Muslim 3
Others (specify) _________
106 Educational status of parents Illiterate 1
Can read and write 2
Grade 1- 8 3
Grade 9 – 12 4
University/ college 5
107 Family monthly income < 500 Birr 1
(For those who have family) 500 – 1000 Birr 2
1000 – 1500 Birr 3
1500 – 2000 Birr 4
>2000 Birr 5
108 Who pays your school fee? Father 1
Mother 2
Both parents 3
Myself 4

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 Others (specify) _________
109 Do you work to get money? Yes 1
No 2 111
110 If your response to Q109 is ‗Yes‘, Labor work 1
What do you do to earn money? Shoe shining 2
Shop keeper 3
Café servant 4
Others (specify)__________
111 With whom are you living currently? Both parents 1
Mother 2
Father 3
Sister 4
Brother 5
Alone 6
Others (specify)__________
112 Have you ever had drinks containing Yes 1
alcohol? No 2 114
113 If your response to Q112 is ‗Yes‘, Every day 1
How often have you had drinks Once per week 2
containing alcohol in the last 4 Less than one per week 3
weeks? More than one per week 4
114 Which one of these drugs you have Khat 1
tried? Cigarette 2
(Multiple answers are possible) Hashish 3
Alcohol 4
Other (specify) __________
115 If you have used any one the above Every day 1
drug, how often per week? Once 2
Less than one 3
More than one 4

Part II: Sexual history

SN Question Response Skip to Code

201 Have you ever had sexual partner? Yes 1
No 2
202 Have you ever had sexual intercourse? Yes 1
No 2 207
203 If ‗yes‘, at what age did you first had
sexual intercourse? [_____________] in years
204 How old was your partner at that
time? [_____________] in years
205 What was the relation of you to your An acquaintance 1
first partner? A friend 2
Finance 3

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 Boy/girl friend 4
Others(specify)_______
206 Why did you decide to have sexual Fall in love 1
intercourse the first time you had sex? Had desire 2
Raped 3
To get money/gifts 4
peer pressure 5
drug use [khat, alcohol] 6
Others. (specify)________
207 How many sexual partners have you One 1
had so far? Two 2
Three 3
Four or more 4
208 Have you had sexual intercourse in the Yes 1
past 12months? No 2 213
209 If yes, how many people in the total One person 1
have you ever had sexual intercourse Two persons 2
with during thelast12months? Three persons 3
Four persons 4
Five and above 5
210 If your response to question 208 is commercial Sex Partner 1
"Yes" with whom you had sexual Non Commercial 2
intercourse in the last12 months? Both 1 and 2 3
211 The last time you had sex with your Yes 1
partner; did you and your partner use a No 2 216
condom?
212 If your response to Q211 is "Yes" who Myself 1
suggested using condom that time? My partner 2
By Joint decision 3
213 Why did you and your partner decided To prevent pregnancy 1
to use condom? Fear of HIV/AIDS 2
To prevent STI 3
Influence each other 4
Others (specify) ________
214 If you have not used condom at all or Condoms not available 1
haven‘t used constantly, what was the Condoms are expensive 2
reason? Ashamed to ask my Partners 3
(multiple responses are possible) I wanted to get pregnant 4
I ashamed to buy condom 5
I trust my partner 6
I don't know how to use 7
Fear of Its bursts 8
It decreases satisfaction 9
My religion prohibit 10
I was drunk 11
Others(specify) ------------

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 ADDIS ABABA UNIVERSITY

COLLEGE OF HEALTH SCIENCES

SCHOOL OF ALLIED HEALTH SCIENCES DEPARTMENT OF NURSING AND

MIDWIFERY

Universitii Finfinnee Fakaaltii Fayyaatti, Muumme Narsingitii fi Midiwayiferitti gaaffilee

barattoota mana barumsaa sadarkaa lammaffaa Godina Adda Oromiyaa bulchiinsa Magaalaa
Sabbatatiin kan guutamu.

Jaallatamtoota barattootaa!

Tajaajila fayyaa qaama hormaataa dargaggootaa fooyyessuuf rakkoolee fayyaa dhimma

walqunnamtii naf-saalaa fi amaloota dargaggotaa dhimma kana waliin wal-qabatan gad-
fageenyaan qoratanii hubachuun barbaachisaa dha.

Sababa kanaaf qorannoon amala qunnamtii naf-saalaa ,amaloota kanaaf dhimmoota murteessoo
ta'anii fi itti fayyadama kondomii dargaggootaa qorachuuf qorannoon kun qophaa'eera. Isinis
qorannoo kanaaf carraadhaan filatamtaniijirtu.

Gaaffileen qorannoo kanaa dhimmoolee dhuunfaa kan ilaallatan waan ta'aniif qorannoo kana
keessatti hirmaachuun fedhii irratti kan hundaa'e ta'a. Kanaafis hirmaachuu fi dhiisuu irratti mirgi
keessan kabajamaa dha .Kanaaf hirmaachuun fedhii keessan miti yoo ta'e,waraqaa gaaffichaa
gad-galagalchuudhaan minjaala fuuladura keessan jiru irra kaa'aatii hanga warri kaan xumuranitti
bakkuma jirtan turaa.

Haata'u malee galmaan ga'umsa kaayyoo qorannoo kanaa fi fooyya'insa tajaajila fayyaa
dargaggootaaf jecha hirmaannaa keessan kabajaan isin gaafatna. Deebiin keessan hundi iccitiitti
kan qabamu ta'uu isaa ni mirkaneessina.Kanaafis maqaa keessan waraqaa gaaffii kana irraati
barreessuun isin hin barbaachisu.

Kanaaf qorannnoo kana keessatti himaachuun fedhii keessanii?

Eeyyee (____________) Miti (_______________) mallattoo―X

‖ galchuudhaan mirkaneessa.
Erga kana dubbistanii booda gaaffilee qophaa'an deebisuuf gara fuula itti aanutti darbaa.

Galatoomaa!

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 Guyyaa _________________
Maqaa mana barumsich: ___________________ Kutaa_____________
koodii Gaafichaa ________________________
Maqaa Nama data Funaanuu __________________Mallattoo_________
Maqaa To‘ataa _____________________Mallattoo_________
Maqaa Qorannoo Gaggeessaa: Helen Berihun

Kutaa I: Gaaffilee haala dhuunfaa ilaallatan

Lak. Gaaffilee Deebii Utaali Koodii

101 Saala kee Dhiira 1

Dhalaa 2

102 Umrii kee [___________] waggaadhan

103 Sadarkaa barumsaa kee kutaa 9ffaa 1

kutaa 10ffaa 2
kutaa 11ffaa 3
kutaa 12ffaa 4

104 Saba kee Oromoo 1

Amaaraa 2
Guragee 3
Tigree 4
Kan biraa (ibsi) ________

105 Amantii kee Orthodoksii 1

Pirootestaanti 2
Musliima 3
Kan biraa (ibsi) _______

106 Sadarkaa barnoota maatii (Abbaa Kan hin baranne 1

yookan Haadhaa)
Dubbisuu fi barreessu ni
danda‘u 2

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 Kutaa 1- 8 3
Kutaa 9 – 12 4
Kutaa 12 oli 5

107 Galii maatii ji‘aan tilmaaman < 500 Birrii 1

500 – 1000 Birrii 2
1000 – 1500 Birrii 3
1500 – 2000 Birrii 4
>2000 Birrii 5

108 Kafaltii mana barnootaa kee eenyutu Abbaa 1

siif kafala?
Haadha 2
Lamaan isaanii 3
Ofii kootiif 4
Kan biraa (ibsi) _________

109 Qarshii archuuf hojii ni hojjataa? Eeyyee 1

Lakki 2 111

110 Deebiin kee gaaffii 108 ‗eeyyee‘ yoo Hojii humnaa 1

ta‘e, hojii gosa akkamii hojjata?
Kophee xaraguu 2
Suukii daldaaluu 3
Mana bunaa keessa 4
Kan biraa (ibsi)__________

111 Yeroo ammaa kana eenyu faana Maatii waliin 1

jiraata jirta?
Haadha waliin 2
Abbaa waliin 3
Obboleettii waliin 4
Obboleessa waliin 5
Kophaa 6
Kan biraa (ibsi)__________

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112 Dhugaatii alkoolii of keessa qabu Eeyyee 1
dhugdee beektaa?
Lakki 2 114

113 Deebiin kee gaaffii 112 ‗eeyyee‘ yoo Guyyaa hunda 1

ta‘e, torba arfan darban keessatti
dhugaatii alkoolii of keessa qabu Torbanitti yeroo tokko 2
yeroo meeka dhugde? Torbanitti yeroo tokko gadi 3
Torbanitti yeroo tokko oli 4

114 Kanneen tarrefaman keessaa maal Chaatii 1

fayyadamtee beekta?
Sijaaraa 2
(baay‘ee deebisuun ni danda‘ama)
Hashishaa 3
Alkoolii 4
Kan biraa (ibsi) __________

115 Kanniin armaaan olii keessa tokkoo Guyyaa hunda 1

isaa illee yoo fayadamte, torbaanitti
yeroo meeqa fayyadamta? Torbanitti yeroo tokko 2
Torbanitti yeroo tokko gadi 3
Torbanitti yeroo tokko oli 4

Kutaa II: seenaa qunnamtii naf-saala

Lak. Gaaffilee Deebii Utaali koodii

201 Hiriyaa jaalalaa qabbdaa? Eeyyee 1
Lakki 2

202 Qunnamtii naf-saalaa raawwattee Eeyyee 1

beektaa? Lakki 2 207

203 Eeyyee,yoo jette,yeroo jalqabaaf

qunnamtii naf-salaa yeroo raawwattee [__________] waggaadhaan
umuriin kee meeqa ture?

204 Hiriyyaan kee ati qunnamti naf-saalaa

waliin raawwatte yommas umuriin

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 isaa/ishee meeqa ture? [___________] waggadhan

205 Walitti dhiyeenyi ati jaalallee kan Hiriyaa mana barumsaa 1

Jalqabaa waliin qabdu maal ture? Hiriyaa jaalalaa 2
kaadhimaa 3
Okan biraa (ibsi)_______

206 Yeroo jalqabaaf qunnamtii naf-saalaa Jaalalatu na qabe 1

Raawwachuuf kan si kakaase maal Fedhii qabaadhee 2
ture?
Gudeedamee 3
Qarshii/kennaa fudhachuuf 4
Dhiibbaahiriyyaa 5
Dhugaatii dhugee 6
Kan biraa. (ibsi)________

207 Hanga ammaatti hiriyyaa jaalalaa Tokko 1

qunnamtii naf-saalaa waliin raawwatte Lama 2
meeqa qabda? Sadii 3
Afurii fi isaa oli 4

208 Ji'oota12 darban keessa qunnamtii Eeyyee 1

naf-saalaa raawwatteertaa? Lakki 2 213

209 Eeyyee yoo jette, ji'oota darban 12 Nama tokko 1

keessatti namoota meeqa wajjiin Nama lama 2
qunnamtii naf-saalaa raawwattee jirta? Nama sadii 3
Nama afurii fi isaa oli 4

210 Deebiin kee gaaffii 208 ‗eeyyee‘ yoo Dubartoota mana bunaa
ta‘e, Ji'oota12 darban keessa eenyu waliin 1
faana qunnamtii naf-saalaa raawwattee
? Jaalallee koo waliin 2
Lamaanu waliin 1 and 2 3

211 Yeroo qunnamtii naf-salaa raawwatte Eeyyee 1

kondomii fayyamtee beektaa?
Lakki 2 216

52
212 Deebiin kee gaaffii 211 ‗eeyyee‘ yoo Ana/ ofii koo 1
ta‘e, eenyutu akka fayyadamtaniif
yaada dhiyeesse? Hiriyaa koo 2
Murtii lamaan kenyaatiin 3

213 Maaliif kondomii fayyadamtan? Ulfa ittisuuf 1

HIV/AIDS ittisuuf 2
Dhukkuboota quunnamtii
saalaatiin daddarban ittisuuf
3
Wal dirqamsiisuun 4
Kan biraa (ibsi) ________

214 Yoo kondomiitti hin fayyadamne ta'e Kondomin waan hin jirreef 1
maaliif hin fayyadamne?
Kondomiin mi'aa waan ta'ef 2
(multiple responses are possible)
Jaalallee koo gaafachuu
waaniin saalfadheef 3
Ulfaa'uu waaniin barbaadeef 4

Kondomi bitachuu waanin

saalfadheef 5
Jaalallee koo waaniin
amaniuuf 6
Itti fayyadama isaa waaniin
hin beekneef 7
Waan tarsa'uuf 8
Fedhii ofii waan hir'isuuf 9
Amantiin koo waan na
dhorkuuf 10
Dhugaatii dhugee waaniin
tureef 11
kan biraa (ibsi) ------------

53
Declaration

I the undersigned declare that this is my original work and has not been presented in this or any

other University and all sources of materials used for this proposal have been fully

acknowledged.

Name principal investigator: Helen Berihun

Signature: __________

Date: _____________

Place: Addis Ababa University College of Health Sciences School of Allied Health Sciences

Department of Nursing and Midwifery

This thesis proposal has been submitted for approval to:

Advisor: Baze Mekonnen (BSc, MSc)

Signature: __________

Date: _____________

Place: Addis Ababa University College of Health Sciences School of Allied Health Sciences

Department of Nursing and Midwifery.

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