EC Gynaecology

Background: Unprotected sexual activity exposes young people to sexually transmitted infections, including HIV/AIDS, and unwanted pregnancies. These consequences often lead to serious health, social and economic problems, such as school dropout and lack of education. Despite its importance, data on premarital sexual practices in the study area remain limited, with notable gaps in the literature.

Objective: This study aimed to evaluate premarital sexual practices and associated factors among female students at Harambe University College in Adama, East Shewa Area, Oromia, Ethiopia.

Methods: A cross-sectional study was conducted among 351 university students. Participants were selected by systematic random sampling combined with simple random sampling. Data were collected using a semi-structured self-administered questionnaire that was pre-assessed for validity. Data entry was performed using Epi-Info and exported to SPSS version 21 for analysis. Bivariate and multivariate logistic regression analyses were applied. Variables with a p-value ≤ 0.25 were introduced in the bivariate analysis in multivariate models. The associations were considered significant with a p-value < 0.05, with odds ratios (OR) and 95% confidence intervals (CI) being calculated as measures of effect.

Results: Of the 351 female university students who participated in the study, 203 (57.8%) reported having maintained premarital sexual activity. Of these, 74 (21.1%) began sexual practice between the ages of 20 and 22. Multivariate logistic regression analysis identified several significant factors associated with premarital sex. Female Students aged 21-23 years were substantially more likely to have premarital sex (AOR = 10,889, 95% CI: 1,649-71,917), and those who had viewed pornography were markedly more likely (AOR = 12,408, 95% CI: 4,048-38,026). Peer pressure also played a significant role, with affected female students more than twice as likely to report premarital sex (AOR = 2.225, 95% CI: 1.044-4.739). Interestingly, third-year female students were less likely to have premarital sex compared to their peers (AOR = 0.37, 95% CI 0.14-0.96), and female students living in urban areas had a lower prevalence of premarital sexual practice (AOR = 0.482, 95% CI: 0.303-0.768).

Conclusion: The study demonstrated a high prevalence of premarital sexual practice among female university students. Age, exposure to pornography, peer pressure, academic course, and residence were significant factors. To address this problem, open discussions on sexual health should be encouraged and up-to-date reproductive health information provided through school education. It is recommended that reproductive health clubs be established within universities to raise awareness and reduce risky behaviours.

Keywords: Adama; Harambe; Premarital Sexual Practice; Students

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