Peer Pressure Is the Prime Driver of Risky Sexual Behaviors among School Adolescents in Addis Ababa, Ethiopia

Background: Understanding ecological factors that influence risky sexual behavior of adolescents is vital in designing and implementing sexual risk reduction interventions in specific contexts. Interventions undertaken without understanding the critical factors may not produce the desired results. Objective: The objective of this study was to identify the factors associated with adolescent risky sexual behavior among school adolescents in Addis Ababa, Ethiopia. Methods: This cross-sectional study was done among randomly selected school adolescents in Addis Ababa, Ethiopia. Data were collected by an anonymous self administered questionnaire. Risky sexual behavior was assessed by asking question about sexual activity, consistent condom use and faithfulness to a single partner. Logistic regression analysis was done to identify factors related to sexual behavior using the ecological framework. Result: Overall 377(10.6%) of the 723 sexually active students were involved in risky sexual practices. Risky sexual behavior was significantly and very strongly associated with perception of peers' involvement in sexual intercourse [AOR = 11.68 (95% CI: 8.76 - 15.58)]. Conclusion: This study demonstrated that peer pressure is the most important factor associated with risky sexual behavior among school adolescents in Addis Ababa. Interventions aimed at reducing sexual behavior among school adolescents should target adolescents as a group rather than individually.