Abstract
BACKGROUND: Premarital sexual practices are increasing among adolescents worldwide, particularly in developing countries like Ethiopia. This study aimed to estimate the pooled prevalence and identify factors associated with such practices among Ethiopian adolescents. METHODS: A meta-analysis was conducted using the Cochrane Q and I (2) statistics to assess study heterogeneity. A random-effects model was applied to estimate the pooled prevalence. RESULTS: The pooled prevalence of premarital sexual practices among adolescents in Ethiopia was 35.04% (95% CI: 22.80-47.29). Significant associated factors included being male (POR = 2.57), having pocket money (POR = 2.87), alcohol consumption (POR = 3.73), and peer pressure (POR = 13.62). CONCLUSION: Over one-third of Ethiopian adolescents engage in premarital sex. Key contributing factors are male gender, access to money, alcohol use, and peer pressure. These findings highlight the need for targeted interventions to address risky sexual behaviors among adolescents.