Gynaecogy and Obstetrics, University of Yaounde I
June, 2017


The magnitude of unmet Adolescent Sexual and Reproductive Health (ASRH) needs has become of increasing interest in our country in the recent years. This is probably because of the high rate of adolescent sexuality, STI/HIV and child bearing which constitute an economic burden on the parents and the society. Good knowledge of adolescents is indispensable in rational decision making as concerns sexuality and reproductive health.
The objective of this study was to evaluate the knowledge of sexuality and their sexual-linked behaviours while identifying factors associated to high/good knowledge in secondary school students in Yaoundé and Bamougoum.
This was a school-based cross sectional study targeting secondary school students of both genders from form three to uppersixth schooling in Yaoundé and Bamougoum. The study was carried out from the 2nd of January to the 31th of March 2017 and a Cluster randomised sampling technique was used. Data was collected using an anonymous self-administered questionnaire supervised by trained surveyors and analyzed using the statistical software Epi Info version 3. 5. 4. Means were calculated for continuous variables and proportions for categorical variables. With a threshold of statistical significance set at p-value≤0.05, the odds ratio was used as a measure of association between selected factors and our outcome of interest.
Out of the 1599 participants, 887 (55.5%) were from the urban setting while the other 712 (44.50%) were from the rural setting. The females represented about 50.7% with a sex ratio of about 1:1. The mean age of our study population was 16.27±2.01 years. From our study, the mean age at coitarche was 15.28±2.42years and 23.8% (21.8 – 26.0%) of our participants were sexually active with a significantly higher rate in the rural (30.50%) compared to the urban(18.50%) setting (OR 1.93 [1.53-2.44] p-value<0.001). The mean age at coitarche in the urban setting was (14.66±2.39years) significantly lower compared to that in the rural(15.75±2.35years) setting (p-value<0.001). Students who had good knowledge were less likely to be sexually active than those who did not have a good knowledge (OR 0.61[0.43-0.87] p-value=0.006). The rate of condom use in the sexually active population was 71.61% (73.80% and 70.00% in the urban and rural setting). Only 9% of the sexually active population used any other method of contraception. The proportion of participants with good knowledge in urban and rural setting was about the same (83.80% and 85.40% in urban and rural settings respectively). Following simple logistic regression, we identified the following as factors associated to higher or better knowledge; occupation of skilled job by at least one parent (OR= 0.76[0.58- 1.00], p-value=0.05), students whose parents had attained at least secondary school, (OR= 0.69[0.51- 0.93], p-value 0.016), students who were in senior secondary school (OR=0.14[0.10- 0.19], p-value< 0.001), students whose main source of information was school (OR= 0.70[0.52-0.96], p-value 0.027) and students who had a lesson on sexuality in school at least once a month (OR=0.66[0.48- 0.90], p-value 0.009).
Conclusion: The proportion of sexually active students was very high(23.8%). This proportion was significantly higher among rural than urban students (30.50% as against 18.50%). The mean age at coitarche among the students was 15.28±2.42years and was significantly higher in rural than in the urban participants. Consistent condom use among the students is still very low (35.30%). The knowledge of the urban and rural students was relatively high but unsatisfactory with no significant difference in the level of knowledge between urban and rural students. The determinants of a good level of knowledge on sexuality are; skilled job by parents, senior secondary school students, parents who had attained at least secondary school, sexuality education lessons at least once a month and school as main source of information.
Keywords: sexuality education, secondary school students, coitarche