Risk factors of sexual and reproductive health problems, service utilization, and its challenges among street youths in East Gojjam zone, North West Ethiopia: exploratory qualitative study

埃塞俄比亚西北部东戈贾姆地区街头青少年性与生殖健康问题风险因素、服务利用及其挑战:探索性定性研究

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Abstract

BACKGROUND: Children on the streets are still vulnerable to early and unsafe sexual experiences. Having multiple sexual partners and the limited use of condoms were major risk factors for the spread of sexually transmitted diseases among youths in Ethiopia. OBJECTIVE: This study aimed to explore the risk factors of sexual and reproductive health problems, service utilization, and challenges among street youths in the East Gojjam Zone. METHOD: A phenomenological study design was employed on street youths residing in the East Gojjam Zone. Study participants were purposively recruited from four town administrations in the East Gojjam Zone. The primary study unit was street youths who live in the zone. Eight in-depth interviews and eight focus group discussions were conducted. The data were audio recorded and analyzed using inductive thematic analysis. RESULTS: In this study, the risk factors that exposed street youths to sexual and reproductive health problems included low perceived susceptibility, lack of awareness of sexual and reproductive health, having multiple sexual partners, exposure to pornographic films, and utilization of alcoholic drinks and substances. Mainly, those street youths who were engaged in transactional sexual relationships were utilizing condoms consistently and had regular HIV screening tests. In addition, few street youths ever utilized maternal and child health services. The unsupportive behavior of health professionals, the absence of exact data, the health system, and lack of specific responsible organization on the sexual and reproductive health of street youths were considered major challenges. CONCLUSION AND RECOMMENDATION: Most of the street youths were not utilizing reproductive health services. Limitation on the accessibility of sexual and reproductive health services to this segment of the population was the main contributing factor. So, the health system and policy should take front-line responsibility for the sexual and reproductive health of street youths and consider convenient reproductive health service programs for them.

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