Sexual risk behaviour among school-going adolescents in Sierra Leone and Liberia. A secondary analysis of the 2017 Global school health survey

Abstract Background: There is very little information on sexual risk behaviour among Sierra Leone and Liberia school-going adolescents. The present study assessed the prevalence and determinants of sexual risk behaviours among school-aged adolescents in Sierra Leone and Liberia. Method: We used publicly available nationally representative cross-sectional datasets of the 2017 Sierra Leone and Liberia Global school health survey. The sample consisted of 2798 and 2744 school-going adolescents from Sierra Leone and Liberia, respectively. Results: The majority of adolescents in the two countries were involved in multiple sexual risk behaviour (80.2%), with higher prevalence observed in Sierra Leone (85.2%) than in Liberia (75.3%), Liberian adolescents showed lesser odds of indulging in multiple sexual risk behaviours than their Sierra Leonean counterparts (AOR=0.572; 95%CI: 0.345-0.946). Male compared to females were more likely to engage in multiple sexual risk behaviour (AOR=2.310;95%CI:1.543-3.458), with a similar pattern observed in both countries. Alcohol use was associated with multiple sexual risk behaviour (AOR=3.064; 95%CI: 2.137-4.392). Also, in Sierra Leone and Liberia, adolescents with one and two or more forms of psychological distress were more likely to have ever had sex than those who do show any form of psychological distress. Missing class/school was associated with multiple sexual risk behaviour (AOR=1.655; 95%CI:1.133-2.418). Peer support was only found to be a protective factor against no condom use among Liberian adolescents (AOR=0.608; 95%CI: 0.435-0.850). Less parental support was only associated with ever had sex more likely to have ever had sex as seen among adolescents in Sierra Leone (AOR=2.027; 95%CI: 1.322-3.107) but not Liberia (1.034(0.650-1.644). Conclusion: Our study found a high sexual risk behaviour among school-going adolescents in Sierra Leone and Liberia. Our finding highlights the need to strengthen sexual and reproductive health education in schools and communities that incorporate mental health promotion activities tailored to this group.