Magnitude and Associated Factors of Transactional Sex among High School Students in Debre Markos Town, Northwest Ethiopia

Introduction: Sex driven by material benefits is a challenging public health concern, particularly in Sub-Saharan Africa. Assessing youth’s transactional relationships remains the integral part of HIV prevention programs. This study aimed to determine the magnitude and associated factors of self-reported transactional sex engagement among high school students in Debre Markos town, Northwest Ethiopia. Method: A cross-sectional study was conducted between 07 February and 13 May, 2015 on 726 girls identified from randomly selected secondary schools. Data were analyzed using bivariate and multivariate logistic regression to identify the predictors of transactional sex. Result: Two hundred sixty-two (37.3%) of the respondents reported having had ever sex at the time of the survey. Out of those sexually active students, 17.6% reported engaging in transactional sex in the previous one year prior to the survey. After controlling for other covariates, while chewing khat and lack of communication about sexual and reproductive health issues were predictors of increased risk for engagement in transactional sex, higher class level, delayed age at first sex, never watching pornographic material, having regular pocket money and parental supervision were found to be protective factors. Conclusion: This study has shown that considerable proportion of students engage in transactional sex and they are influenced by multiple socio-demographic/socio-economic and individual behavior characteristics. Programs and services designed to control HIV/AIDS transmission should aim to focus on addressing the context specific female students’ HIV risk, and sexual entitlement and promoting gender inequity.