Relationship between Early Sexual Initiation and Reproductive Health among Undergraduates in Universities within Nairobi County
Several studies in Sub-Saharan Africa have documented high and increasing premarital sexual activities among undergraduate students in universities. This exposes them to risks of unintended pregnancies, abortions, HIV and other sexually transmitted diseases. One of the SDGs is to reduce HIV/AIDs pandemic by the year 2030. In this context it is important to understand whether university students understand the consequences of engaging in premarital sex and the effects it has on their reproductive health. The main objective of this study was to determine the effects of premarital sexual behavior on the reproductive health of undergraduates in Nairobi County. Targeted universities were; Kenyatta, Moi, Mount Kenya, and Africa Nazarene University. Sample size was 324 students and included both male and female aged 18-24 years. The study adopted descriptive cross-sectional research design. Quantitatively, both open and closed ended questionnaires were used. FGDs and KIs were used for qualitative data. Stratified random technique was used to select the sample from the Universities’ Information management Unit. Statistical Package for Social Sciences (SPSS) version 20.0 was used to analyse data. Chi-Square tests was used to test for significance (P<0.05) and OR used to measure the exposure. Study found out that 63.6% of respondents had, and /or their partners contracted an STI following an unprotected sexual activity whereby only 63.5% were diagnosed by a healthcare provider. 66.7%) had several sexual partners ranging from 2-6 sexual partners. Mean SD age at sexual debut was at 15.9±2.67 years with a minimum and maximum age being 11 and 22 respectively. 115 of 169 female students had ever used a hormonal contraception with 62.6% having had exposure to emergency pills. Early sexual debut was a predictor to contracting STI at: OR=3.581, 95%CI (1.916-6.693), P<0.001. Respondents with one sexual exposure and with planned first sexual encounter were at lower risk OR=0.431, 95%CI (0.204-0.909), P=0.026 and OR 0.617(1.414-1.850), P=0.014 respectively. In conclusion, majority of respondents developed RH related complications following early sexual debt. Female youth are at a higher risk of developing STIs compared to their male counterparts. It is therefore recommended that institutional administrators, parents/guardians, the MOH, MOE and other key stakeholders provide access to condoms for students, provide reproductive health education and access to information, incorporate age appropriate sexuality education at primary school level and provide access to proper contraceptives in university infirmaries. The MOE and MOH must scale up the implementation of age-appropriate sexuality education framework as well as the ASRHR policy. Finally, it is imperative that the government increases the budgetary allocation for adolescent and youth programs to allow for efficient and effective implementation of youth programs.
Keywords: Sexual initiation, reproductive health, undergraduates, universities, Nairobi County
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