Age at sexual initiation and factors associated with it among youths in North East Ethiopia

Background: For behavioral as well as physiological reasons, early sexual debut increases young peoples' risk for infection with HIV and other STIs. Youths who begin sexual activity early are more likely to have high-risk sex or multiple sexual partners and are less likely to use condoms. It is crucial to understand the factors associated with early sexual initiation in a broader context for designing and implementing effective interventions targeting youth. Objective: The objective of the study was to determine the median age at first sexual intercourse and the associated factors of sexual initiation among rural and urban youths (age 15- 24 years). Methods: A comparative cross sectional study was conducted between, March 1 -15, 2008, in Dessie town and Dessie Zuria Woreda. To draw a total sample of size 1294 (647 urban and 647 rural), a multistage cluster sampling was used. Bivariate and multivariate analyses were employed. Moreover, Kaplan Meier survival analysis was used to estimate the probability of sexual initiation at various age stratified by residence and sex. Result: About half, 51.3% of the youths have ever had sex. Rural youths initiate sexual intercourse at lower age than their urban counterparts with mean (±SD) (16.49+2.11) for rural and (17.18+2.32) for urban youths. The median age at sexual debut was 16 years for rural and 17 years for urban. The hazard ratio for sexual imitation was significant (AHR [95% CI] =1.45 [1.19, 2.55]. Multivariate analysis showed that being female by gender (AOR [95% CI]=1.56 [1.11, 2.19]), chewing Khat (AOR [95% CI] = 2.05 [1.05, 3.96]), drinking alcohol (AOR [95% CI] = 2.16 [1.12, 4.18]), watching pornographic materials at age < 18 years (AOR [95% CI] = 24.13 [3.28, 177.80]) and being less connected with parents (AOR [95% CI] =2.30 [1.35, 3.91]) were associated with early sexual initiation. Conclusion and Recommendation: Early sexual initiation prevails more in rural than urban youths. Delaying sexual debut can be achieved through well designed sexual education programs at earlier life. Strengthening the norm of virginity should be advocated. Equally, ways to access condoms and other contraceptives especially to rural youths should be sought for those who already initiate sexual intercourse.

Association of Supply Type with Fecal Contamination of Source Water and Household Stored Drinking Water in Developing Countries: A Bivariate Meta-analysis

BACKGROUND: Access to safe drinking water is essential for health. Monitoring access to drinking water focuses on water supply type at the source, but there is limited evidence on whether quality differences at the source persist in water stored in the household. OBJECTIVES: We assessed the extent of fecal contamination at the source and in household stored water (HSW) and explored the relationship between contamination at each sampling point and water supply type. METHODS: We performed a bivariate random-effects meta-analysis of 45 studies, identified through a systematic review, that reported either the proportion of samples free of fecal indicator bacteria and/or individual sample bacteria counts for source and HSW, disaggregated by supply type. RESULTS: Water quality deteriorated substantially between source and stored water. The mean percentage of contaminated samples (noncompliance) at the source was 46% (95% CI: 33, 60%), whereas mean noncompliance in HSW was 75% (95% CI: 64, 84%). Water supply type was significantly associated with noncompliance at the source (p < 0.001) and in HSW (p = 0.03). Source water (OR = 0.2; 95% CI: 0.1, 0.5) and HSW (OR = 0.3; 95% CI: 0.2, 0.8) from piped supplies had significantly lower odds of contamination compared with non-piped water, potentially due to residual chlorine. CONCLUSIONS: Piped water is less likely to be contaminated compared with other water supply types at both the source and in HSW. A focus on upgrading water services to piped supplies may help improve safety, including for those drinking stored water. CITATION: Shields KF, Bain RE, Cronk R, Wright JA, Bartram J. 2015. Association of supply type with fecal contamination of source water and household stored drinking water in developing countries: a bivariate meta-analysis. Environ Health Perspect 123:1222–1231; http://dx.doi.org/10.1289/ehp.140900