Early sexual debut among unmarried adolescent girls and young women in Tanzania: analysis of the 2022 Demographic Health Survey on the role of coercion at first sex.

OBJECTIVE: In Tanzania, the problem of early sexual initiation among adolescent girls and adolescent girls and young women has remained a persistent public health and human rights challenge that continues to draw the attention of policymakers. Evidence suggests that in some parts of the country, as much as 70% of women had their sexual debut as minors, underscoring the urgency to understand all drivers of early sexual debut among this population. While scholars have pointed to addressing a range of factors that work to expose adolescent girls and young women to early sexual initiation, the role of coercion at first sex has been less explored. DESIGN AND SETTING: We used cross-sectional data from the 2022 Tanzania Demographic and Health Survey. PARTICIPANTS: A total sample of 1242 sexually active unmarried adolescent girls and young women aged 15-24. MEASURES: Our study relied on logistic regression models to examine the role of coerced sex on early sexual initiation among sexually active unmarried adolescent girls and young women aged 15-24 years in Tanzania. RESULTS: We found that 31% and 14% of sexually active unmarried adolescent girls and young women experienced early sexual initiation and coerced first sex, respectively. At the bivariate level, we discovered that those who indicated that they willingly wanted to have their first sex were less likely to initiate sex early (OR=0.44, 95% CI 0.27 to 0.72). At the multivariate level, the significance of these relationships largely holds, even after sequentially accounting for sociodemographic (OR=0.50, 95% CI 0.30 to 0.82) and HIV-related characteristics (OR=0.50, 95% CI to 0.30 to 0.83). CONCLUSIONS: We recommend re-examination of policy addressing early sexual initiation in Tanzania by incorporating coerced sex as one of the major determinants needing urgent attention. Intensifying awareness creation on the risk of early sexual initiation through coerced sex, especially among adolescent girls and boys, will go a long way to help reduce the incidence of early sexual initiation.