Experiences and Predictors of First Sex Initiation among Early Adolescents in Koforidua Municipality, Ghana: A Convergent Parallel Mixed-Method Study

Background: Early sexual initiation among adolescents increases the risk of STDs, unwanted pregnancies, unsafe abortions, and despair. Aims: This study explored first sexual initiation experiences among early adolescents (11–15years) in Koforidua Municipality, Ghana. Methods: The study adopted a convergent parallel mixed method anchored on a cross-sectional and phenomenological design. A custom-designed questionnaire and interview guide, developed through a comprehensive review of literature were used for the data collection. The questionnaire constituted 20 items: 14 measured sexual debut experience and 6 assessed delayed sexual debuts at the categorical level. A total of 373 early adolescents responded to the questionnaire while 10 participants were interviewed. The quantitative data was analyzed using binary logistic regression with p-value <0.05 considered statistically significant and fitted into the model. The qualitative data was analyzed using thematic approach. Results: The prevalence of sexual debut among early adolescents was 23.9%, with the mean age of sexual debut being 11.7 years. Almost 34 (38.2%) of the sexual debutants felt good, while 47(52.9%) had no regret after initiating first sex. Nearly 30 (30.7%) of the sexual debutants have had sex with multiple partners. In a multilevel analysis, the adjusted odds ratio (AOR) revealed that early adolescents who were dating [(AOR = 5.564 (95.0% CI: 2.512–12.324), P = .000] are five times more likely to initiate first sex compared to those who were not dating. Early adolescents who are residing in Srodae [(AOR = 5.144 (95.0% CI: 1.052–5.098), p = .037] are significantly more likely to initiate first sex compared to those residing in Betom and Zongo community. Conclusion: Providing culturally relevant age-appropriate and comprehensive sexuality education programs in schools and out-of-school early adolescents remains an effective strategy for addressing the sexual needs of early adolescents.