title: Assessment of exposure to sexually explicit materials and factors associated with exposure among preparatory school youths in Hawassa City, Southern Ethiopia: a cross-sectional institution based survey.
abstract: BACKGROUND
  According to the 2007 Ethiopian census, youths aged 15-24 years were more than 15.2 million which contributes to 20.6% of the whole population. These very large and productive groups of the population are exposed to various sexual and reproductive health risks. The aim of this study was to assess exposure to Sexually Explicit Materials (SEM) and factors associated with exposure among preparatory school students in Hawassa city, Southern Ethiopia.
  
  
  METHODS
  A cross-sectional institution based study involving 770 randomly selected youth students of preparatory schools at Hawassa city. Multi stage sampling technique was used to select study subjects. Data was collected using pre-tested and self-administered questionnaire. Data was entered by EPI INFO version 3.5.1 and analyzed using SPSS version 20.0 statistical software packages. The result was displayed using descriptive, bivariate and multivariate analysis. Statistical association was done for independent predictors (at p < 0.05).
  
  
  CONCLUSIONS
  About 750 students were participated in this study with a response rate of 97.4%. Among this, about 77.3% of students knew about the presence of SEM and most of the respondents 566(75.5%) were watched SEM films/movies and 554(73.9%) were exposed to SE texts. The overall exposure to SEM in school youths was 579(77.2%). Among the total respondents, about 522(70.4%) claimed as having no open discussion on sexual issues with in their family. Furthermore, About 450 (60.0%) respondents complained for having no sexual and reproductive health education at their school. Male students had faced almost two times higher exposure to SEM than female students (95 % CI: AOR 1.84(C.I = 1.22, 2.78). Students who attended private school were more than two times more likely exposed to SEM than public schools (95 % CI: AOR 2.07(C.I = 1.29, 3.30). Students who drink alcohol and labelled as 'sometimes' were two times more likely exposed to SEM than those who never drink alcohol (95 % CI = AOR 2.33(C.I = 1.26, 4.30). Khat chewers who labelled "rarely", "sometimes" and "often" had shown higher exposure (95 % CI: AOR 3.02(CI = 1.65, 5.52), (95 % CI: AOR 3.40(CI = 1.93, 6.00) and (95 % CI: AOR 2.67(CI = 1.46, 4.86) than those who never chew khat, respectively. Regarding SEM access, school youths with label 'easy access were exposed in odds of six folds than youths of no access (95 % CI: AOR 5.64(C.I = 3.56, 8.9).
  
  
  CONCLUSIONS
  High number of students was exposed to sexually explicit materials. Sex, school type, substance use and access to SEM were observed independent predictors of exposure to SEM.
  
  
  BACKGROUND
  The current generation of young people is the healthiest, most educated, and most urbanized in history. However, there still remain some serious concerns. Most people become sexually active during adolescence. Premarital sexual activity is common and is on the rise worldwide. Rates are highest in sub Saharan Africa, where more than half of girls aged 15-19 are sexually experienced. Millions of adolescents are bearing children, in sub-Saharan Africa. More than half of women give birth before age 20. The need for improved health and social services aimed at adolescents, including reproductive health services, is being increasingly recognized throughout the world. Approximately 85 % of world adolescents live in developing countries. Each year, up to 100 million becomes infected with a curable sexually transmitted disease (STI). About 40 % of all new global human immunodeficiency virus (HIV) infections occur among 15-24 year olds; with recent estimates of 7000 infected each day. These health risks are influenced by many interrelated factors, such as expectations concerning early marriage and sexual relationships, access to education and employment, gender inequities, sexual violence, and the influence of mass media and popular culture. Furthermore, many adolescents lack strong stable relationships with parents or other adults whom they can talk to about their reproductive health concerns. Despite these challenges, programs that meet the information and service needs of adolescents can make a real difference. Successful programs help young people develop life-planning skill, respect the needs and concerns of young people, involve communities in their efforts, and provide respectful and confidential clinical services. Accordingly, the government of Ethiopia now works on improving adolescent's health as one part of MDG (Goal VI-halting transmission of HIV/AIDS, STI, and other communicable diseases) with a focus on adolescents, since they are most affected population. This finding, therefore, will benefit the government to partly evaluate the goal achieving through adolescents exposure status to sexually explicit materials and improvement of sexual issues free talk with in school with class mates and their family at home. For that matter, we authors decided to publish this finding in BMC Reproductive Health Journal so that on line access will be easy to all governing bodies that they use to re-plan their strategies for better product of plan. Moreover, Researchers, Practitioners, policy makers, Students, school leaders and professionals will also benefit from this finding for their future researches references, knowledge gain and practice.
authors.affiliation: Welayta Zone Health Department, SNNPR Health Bureau, Ministry of Health, Addis Ababa, Ethiopia. Tonychin78@gmail.com.
authors.forename: Tony
authors.initials: T
authors.lastname: Habesha
authors.affiliation: Department of Nursing and Midwifery, Arba Minch College of Health Sciences, Arba Minch, Southern Ethiopia, Ethiopia. Zewdie1984@gmail.com.
authors.forename: Zewdie
authors.initials: Z
authors.lastname: Aderaw
authors.affiliation: Department of Public Health, Debre Markos University, Debre Marqos, Northern Ethiopia, Ethiopia. lserawit@yahoo.com.
authors.forename: Serawit
authors.initials: S
authors.lastname: Lakew
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D004882:Erotica; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008297:Male; D009040:Motion Pictures; D012574:Schools / Q000706:statistics & numerical data; D012736:Sex Education / Q000592:standards; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology; D055815:Young Adult