Adolescent girls’ participation in peer-group improved condom use at sexual debut in rural Eastern Ethiopia: a community based cross-sectional study

Background: Adolescent girls engaged in sexual activity are unlikely to use condoms during their sexual debut. Younger adolescents are also not often targeted for sexual-related interventions because of the taboos associated with sexuality in traditional societies. This study examined the association between peer-group participation and condom use at sexual debut among young adolescent girls in rural Eastern Ethiopia. Design: The study analyzed data from a large quasi-experimental study involving 3290 young adolescent girls aged 13-17. The intervention targeted adolescent girls aged 10 – 14 years. Unmarried sexually active adolescent girls, and married girls who had their sexual debut before marriage were the study population. Multi-level mixed-effect logistic regression analysis was employed to examine associations using STATA/SE version 16 statistical software. Results Among 3290 adolescent girls surveyed, 258 (7.84%) reported engaging in sexual intercourse. The Mean(+SD) age at sexual debut was 14.36 (+1.32), with no observed statistical difference between the intervention and control groups (p=0.1164). The magnitude of condom use at sexual debut was 22.46%, 95 % CI (14.11, 33.81%). The odds of using condoms during sexual debut among girls who participated in peer-group was 11.51 times higher (Adjusted OR: 11.51, 95% CI: 1.95, 67.84) than those in the control group. Conclusions Peer group participation improved condom use at sexual debut. Peer groups can be critical for engaging adolescent girls in HIV and other sexually transmitted infection prevention and avoiding unwanted/unplanned pregnancies. Further studies with larger sample size and specifically design research is necessary to generate evidence for scale up of this potentially lifesaving intervention.