Abstract
BACKGROUND: Adolescence is a transition period of advancement from a state of immature sexual characteristics to sexual and reproductive maturity; an improvement in the mental form progressing to the mental maturity of a grown-up adult; and a period of transition from total socioeconomic dependence to relative independence. An adolescent is defined as a person aged between 10 and 19 years. This study assessed the level and determinant factors of knowledge, attitude, and practice of risky sexual behavior among secondary school adolescents in Harar, Eastern Ethiopia, 2022. METHODS: A school-based cross-sectional study design was employed. From the total population of adolescents, 387 respondents were sampled. A simple random sampling method was used to select study participants. The data was collected by using a self-administered questionnaire and analyzed using SPSS version 26. RESULT: Among the participants, 47.3% had good knowledge of risky sexual behavior. 41.9% had a positive attitude toward risky sexual behavior. 36.1% of students had started sexual activity before they reached 18 years old. Out of 9.3% of respondents who have had sexual intercourse, almost 50% of them had multiple partners. Students who live in urban areas were three times (adjusted odds ratio: 3.3, 95% CI: 1.6, 6.6) more likely to have good knowledge about risky sex than their counterparts in rural settings. CONCLUSION: There is a significant number of risky sexual behaviors, such as having a different sexual partner and having unprotected sex with a non-regular partner. Being female, in urban residence, not having pocket money, and attending parties have significant associations with having good knowledge about risky sex. Harari Regional Educational and Health Bureau should provide repeated tailored information that can specifically address the attitude of the adolescents toward risky sexual behavior using different media, teachers, and school clubs in respect of sexual and reproductive health. The existing adolescent reproductive health program should be strengthened and evaluated to improve the sexual behavior of adolescents.