The understanding of the patterns of association between positive sexual behaviours and protective factors that have greater impact helps to design appropriate strategies not only on positive sexual behaviour but also for reproductive health outcomes. The purpose of the study was to explore the protective factors and develop strategies to support positive sexual behaviours among high school adolescents. A concurrent mixed method research design was employed to explore the protective factors for positive sexual behaviours. A total of 990 adolescent students attending regular classes were selected using systematic sampling technique for the quantitative study and 33 focus group participants for qualitative study. Pre-tested, self-administered questionnaire was used for the quantitative whereas focus group discussions were employed for the qualitative phase. Protective factors were assessed at family, community/ neighbourhood, school, peer and individual levels. Quantitative data was analyzed using SPSS version 23. Descriptive statistics and binary logistic regression analysis were employed to identify protective factors. Variables with significant association in bivariate analysis were entered into logistic regression to control confounding effects. The qualitative data management, analysis and interpretation followed thematic analysis principles. Illuminating verbatim quotations used to illustrate findings. RESULTS: adolescents follow parents' rules about sexual activities [AOR=0.462, 95%CI: 0.285-0.748], authoritative [AOR=0.075, 95%CI: 0.021-0.265] and authoritarian [AOR=0.091, 95%CI:0.025-0.331] parenting styles were protective factors. Adolescents’ communication with parents was more likely to have positive association [AOR=0.56, 95%CI:0.31-0.94] than counterparts. Parental greater monitoring [AOR=0.604, 95%CI:0.38-0.959], clear rules and consequences [AOR=0.378, 95%CI: 0.233-0.613] and need for permission to go anywhere [AOR=0.387; 95%CI: 0.235-0.637] were significantly associated. School performance [AOR=0.141, 95%CI:0.055-0.362], perception that teachers are supportive [AOR=0.447, 95%CI:0.266-0.752], sex education [AOR=0.424, 95%CI: 0.243- 0.742], people approved contraceptive use [AOR=0.319, 95%CI: 0.165-0.619] and discussion with health workers on sexuality AOR=0.545, 95%CI:0.318-0.932] were strongly associated with positive sexual behaviour. Positive sexual behaviour associated with peer influence resulted in preferred later sexual debut [AOR=0.444, 95%CI: 0.248- 0.797] and bonding with peers AOR=0.531, 95%CI: 0.327-0.862]. / Health Studies / D. Lit. et Phil. (Health Studies)

BACKGROUND: Studies done in both developed and developing countries have reported the tendencies of adolescents to engage in risky behaviours. Such behaviours include indulging in early and unsafe sexual activities, having multiple sexual partners, alcohol and drug use and dropping out of school among others. PURPOSE: The main aim of the study was to develop intervention strategies for reducing sexual risk practices among adolescents in Ethiopia. METHODS: A mixed method approach using quantitative and qualitative approaches was employed in order to investigate the risks of sexual practices among urban and rural adolescents in the selected area. A cross-sectional survey was used to gather data quantitatively and focus group discussions were used for the qualitative part of data collection. A total of 449 students and 72 FGD participants were selected for quantitative and qualitative study respectively using systematic random sampling technique. Logistic regression was done to identify possible factors associated with knowledge on emergency contraceptive, condom utilisation, pre-marital sex practices and perception of risky sexual practices. RESULTS: One hundred and seventy (37.9%) respondents had experienced sexual intercourse at the time of the study. The higher proportion (42.6%) of those who had engaged in sexual relationships was from the rural school compared to 33.1% in the urban schools. The proportion of sexually active respondents was higher among males (44.8%) compared to (29%) females. Multiple partners were higher in rural adolescents (44.7%) compared to 31.8% among urban adolescents. Sexually Transmitted Diseases were reported by 28.6% of the sexually active adolescents and the prevalence was higher among males (73.5%) compared to 27% females. 87% of the sexually active adolescents rarely used a condom. CONCLUSION: The study identified a knowledge gap on ASRH which limited adolescents to access reproductive services. Social, cultural and economic factors contributed to adolescent engagement in risky sexual behaviours. Based on the major findings of this study, intervention strategies targeting behavioural, biomedical and structural interventions were proposed. / Health Studies / D. Litt. et Phil. (Health Studies)

BACKGROUND: Studies done in both developed and developing countries have reported the tendencies of adolescents to engage in risky behaviours. Such behaviours include indulging in early and unsafe sexual activities, having multiple sexual partners, alcohol and drug use and dropping out of school among others. PURPOSE: The main aim of the study was to develop intervention strategies for reducing sexual risk practices among adolescents in Ethiopia. METHODS: A mixed method approach using quantitative and qualitative approaches was employed in order to investigate the risks of sexual practices among urban and rural adolescents in the selected area. A cross-sectional survey was used to gather data quantitatively and focus group discussions were used for the qualitative part of data collection. A total of 449 students and 72 FGD participants were selected for quantitative and qualitative study respectively using systematic random sampling technique. Logistic regression was done to identify possible factors associated with knowledge on emergency contraceptive, condom utilisation, pre-marital sex practices and perception of risky sexual practices. RESULTS: One hundred and seventy (37.9%) respondents had experienced sexual intercourse at the time of the study. The higher proportion (42.6%) of those who had engaged in sexual relationships was from the rural school compared to 33.1% in the urban schools. The proportion of sexually active respondents was higher among males (44.8%) compared to (29%) females. Multiple partners were higher in rural adolescents (44.7%) compared to 31.8% among urban adolescents. Sexually Transmitted Diseases were reported by 28.6% of the sexually active adolescents and the prevalence was higher among males (73.5%) compared to 27% females. 87% of the sexually active adolescents rarely used a condom. CONCLUSION: The study identified a knowledge gap on ASRH which limited adolescents to access reproductive services. Social, cultural and economic factors contributed to adolescent engagement in risky sexual behaviours. Based on the major findings of this study, intervention strategies targeting behavioural, biomedical and structural interventions were proposed. / Health Studies / D. Litt. et Phil. (Health Studies)