Plain English summary
Background
Methods
Study design and search strategy
Study selection and eligibility criteria
Inclusion criteria:
-
Participants: this review included studies that were conducted on risky sexual practices and its determinants in Ethiopia. The participants were people of all ages regardless of their sex and occupation.
-
Setting: Studies conducted at community or institutional level in Ethiopia.
-
Outcome: The prevalence of risky sexual practices using the communicable disease control (CDC) definition [1].
-
Type of study: All study types were included in the review.
-
Publication types: journal articles, master’s thesis and dissertations
-
Only studies in English were included in the review.
Exclusion criteria:
-
Studies with the methodological problems and review articles were excluded from the review.
-
Retrieved articles were assessed for inclusion using their title, abstract and then a full-text review of articles for quality was done before inclusion in the final review.
Data extraction
Quality assessment and data collection
Publication bias and heterogeneity
Statistical methods and analysis
Results
Study selection
Characteristics of included studies
S.N | Author, Year | Study design | Year study conducted | Sample size | Study area | Age in years | Response rate | Prevalence (Outcome) | Weakness of the study |
---|---|---|---|---|---|---|---|---|---|
1. | (Abebe, Tsion, & Netsanet, 2013) | Institutional based cross sectional study | February 14–28/2012 | 273 | Jimma town | Mean ± SD = 18.6 ± 1.6 Range = 15–24 | 94.8% | 42.1% (Early sexual initiation) | Relatively small sample size |
2. | (Abosetugn, Zergaw, Tadesse, & Addisu, 2015) | Community based cross-sectional study design | January, 2012 | 236 | Dilla | Range = 15–24 | Not reported | 48.3% (Unprotected sex) | Relatively small sample size |
3. | (Alamrew, Bedimo, & Azage, 2013) | Institutional based cross sectional study | March 2012 | 790 | Bahir dar city | Mean ± SD = 21.5 ± 2.44 | 97.6% | 45.3%(Having multiple sexual partners) | Not clearly stated |
4. | (Bayissa, Mebrahtu, Bayisa, & Mekuanint, 2016) | Institutional based cross sectional study | April 15 to 24, 2015 | 328 | Ambo University | mean age = 22.18 years | 87.9% | 20.4% (Early sexual initiation) | Not clearly stated |
5. | (BELETE, 2016) | Institutional based cross-sectional study | March to April 2016 | 388 | Addis Ababa University | Median age = 21 years | 92% | 58.2% (having multiple sexual partners) | Might have under reported by Social desirability bias |
6. | (Bogale & Seme, 2014) | Institutional based cross sectional study | December; 2011 to January; 2012 | 826 | Shendi town, West GojjamZone | Mean ± SD = 17 ± 1.4 Range = 15–24 | 97.1% | 24.8%(having multiple sexual partners) | Social desirability bias responding cannot be ruled out |
7. | (Cherie & Berhane, 2012) | Institutional based cross-sectional study | 2011 | 3543 | Addis Ababa, | Majority were in the age group 15–16 year | 92.5% | 10.6% RSB | Not clearly stated |
8. | (Dadi & Teklu, 2014) | Institutional based cross-sectional study design | February to April 2014 | 422 | Humera town | Mean ± SD = 16.89 ± 1.16 | 100% | 13.7% RSB | Might have social desirability bias |
9. | (Dagne, 2013) | Institutional based cross-sectional study | December, 2013 toDecember, 2014 | 700 | Debre Markos town | Mean ± SD = 17.1 ± 1.6 years Range = 15–24 years | 100% | 78.8% (Early sexual initiation) | recall bias |
10. | (Debebe, 2015) | Institutional based cross-sectional study | February 1–30, 2014 | 604 | Madawalabu University, | Mean ± SD= 21 ± 1.60 years | 95.3% | 35.2% (having multiple sexual partners) | Personal and sensitive issues related to sexuality which might have caused underreporting of some behaviors |
11. | (Derbie, Assefa, Mekonnen, & Biadglegne, 2016) | Institutional based cross sectional study | February 1- march 30, 2014 | 343 | Debre Tabor University | mean age 21.1 years (SD ±2.3) | 87.1% | 39.6% (inconsistent condom used) | The study lacks data on the sexual experiences of students before they join the University |
12. | (Desale, Argaw, & Yalew, 2016) | Institutional based cross sectional study | June 2014 | 1332 | Lalibela town | Mean ± SD =17.39 ± 1.63 years Range = 15–24 years | 97.8% | 46.5% RSB | Might have underreporting as it is not free from social desirability bias and a recall bias, especially in estimating age at first sexual experiences. |
13. | (Dessie, Berhane, & Worku, 2014) | Community based cross-sectional study | March to July 2012 | 633 | Harar town | Range = 13–18 years | 98.75 | 47.55% RSB | Might have social desirability bias |
14. | (Dingeta, Oljira, & Assefa, 2012) | Institutional based cross sectional study | March to April, 2010. | 1286 | Haramaya University | Mean ± SD = 21.4 ± 1.3 | 98.9% | 28% (Early sexual initiation) | Not clearly stated |
15. | (Fite & Cherie, 2016) | Community based cross sectional study | March to June 2014 | 407 | AddisAbaba | Mean ± SD = 16 ± 1.22 years | 96.4% | 23.6% (Early sexual initiation) | Social desirability bias |
16. | (Fury, 2006) | Institutional based cross-sectional study | Jan. 2006 to Feb. 2006 | 813 | Ambo town | Mean ± SD= 17.26 ± 2.1 SD years Range = 10–30 years | 96.4% | 56.4% (having multiple sexual partners) | recall bias |
17. | (G. M. Kassa et al., 2016) | Institutional based cross-sectional study design | April to May 2014 | 300 | Jigaworeda, West Gojjam | Mean ± SD = 17.75 ± 1.37 years | 96.8% | 56.3% % (Early sexual initiation) | Might have recall bias |
18. | (Girma, Hailu, Ayana, & Ketema, 2015) | Institution based cross sectional study | February to March,2014 | 636 | Addis Ababa | Mean ± SD = 17.86 ± 0.97 Range = 15–24 | 97.85% | 25.3% (Early sexual initiation) | Not clearly stated |
19. | (Gizaw, Jara, & Ketema, 2014) | Institutional based cross sectional study | Apri1.7–25, 2014 | 836 | Addis Ababa | Mean = 17.3 Range = 15–24 | 99.3%. | 26.7% RSB | Response may affected by social desirability bias |
20. | (Guta & Yeshambel, 2016) | Institutional based cross sectional study | April 15 to 24, 2015 | 328 | Ambo University | Mean age = 22.18 years | 87.9% | 20.4%(Early sexual initiation) | Not clearly stated |
21. | (Henok, Kassa, Lenda, Nibret, & Lamaro, 2015) | Institutional based cross-sectional study design | June to July 2014. | 284 | Mizan-Tepi University | 18–23 years (80.3%) | 100% | 44.5% (having multiple sexual partners) | Relatively small sample size |
22. | (Kebede et al., 2005) | DHS based survey | December 2001 and May 2002 | 20,434 | Ethiopia | Range = 15–24 years | 91.2% | 20% (unprotected sex) | Not clearly stated |
23. | (Mulu, Yimer, & Abera, 2014) | Institutional based cross sectional study | December to February2013. | 817 | Bahir Dar University | mean age = 21 years Range = 18–30 years | 97.1% | 62% (Unprotected sex) | Social desirability bias |
24. | (Regassa, Chala, & Adeba, 2016) | Institutional based cross-sectional study | February to March 2014 | 704 | Wollega University | median age of respondents was 21 years | 99.86% | 62.1% (Early sexual initiation) | Not clearly stated |
25. | (Seme & Wirtu, 2016) | Institution based cross sectional study | February andMarch 2006 | 676 | Nekemte | Mean = 16 years | 93.6% | 57.2% (Early sexual initiation) | Not clearly stated |
26. | (T. A. Kassa, Luck, Birru, & Riedel-Heller, 2014) | Cross-sectional survey | June toSeptember 2012 | 426 | Addis Ababa | Mean ± SD = 20.8 ± 2.6 years | 100% | 75. 1% (Early sexual initiation) | Social desirability bias |
27. | (Tadesse & Yakob, 2015) | Community based cross-sectional study | September2011 | 711 | Tiss Abay | Mean ± SD = 21.54 ± 3.84 years Range = 15–29 years | 95.9% | 70.3% RSB | Not clearly stated |
28. | (Teferra, Erena, & Kebede, 2015) | Institutional based cross sectional study | March 1 -may30 2013 | 302 | MadawalabuUniversity | Range = 15–34 | 93.2% | 33.6%(having multiple sexual partners) | Not clearly stated |
29. | (Teshome & Gedif, 2013) | Institutional based cross-sectional study design | November to December 2010 | 2551 | Addis Ababa | Mean ± SD = 16.93 ± 1.35 yearsRange = 14–25 years | 92.4%) | 52.5% RSB | Not clearly stated |
30. | (Tiruneh, Wasie, & Gonzalez, 2015) | Community-based cross-sectional study | July 8–18, 2013 | 756 | Metema District | Median age 22 years and IQR = 20–25 | 100% | 74% RSB | Social desirability responding cannot be ruled out |
31. | (Tura, Alemseged, & Dejene, 2012) | Institutional based cross-sectional study | November 2009 | 1010 | Jimma University | Mean ± SD = 17.7 ± 2.7 years | 80% | 28.3%(having multiple sexual partners) | Social desirability bias might result under reported |