Abstract:
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].
