Sexual and reproductive health among primary and secondary school pupils in Mwanza, Tanzania: need for intervention
Matasha, E.; Ntembelea, T.; Mayaud, P.; Saidi, W.; Todd, J.; Mujaya, B.; Tendo-Wambua, L.
Aids Care 10(5): 571-582
1998
ISSN/ISBN: 0954-0121 PMID: 9828954 DOI: 10.1080/09540129848433Document Number: 274507
Sexual and reproductive health knowledge and behaviors were investigated in a baseline cross-sectional survey of 892 randomly selected students 12-19 years of age attending 18 primary and 5 secondary schools in Tanzania's Mwanza Region. Among primary school students, 80% of boys and 68% of girls were already sexually active; in the secondary school group, these rates were 89% and 48%, respectively. 9% of primary school students reported anal sex as their first sexual act. The main reasons cited for not having sex were, for boys, fear of HIV/AIDS and other sexually transmitted diseases (STDs) and, among girls, fear of pregnancy and parents. Forced sex was reported by 47% of sexually active primary school girls and 37% of experienced secondary school girls. 50% of primary school females had previously had sex with adults, including teachers and relatives. 14% of primary school girls had been pregnant, and over 50% of these pregnancies were terminated through illegal abortion. 33% of primary school boys and 25% of girls reported a history of at least one STD. The lifetime rate of condom use was 30%. The STD rate was lower among secondary school students who were well informed about STDs and HIV/AIDS and used condoms. Discussions about sex were restricted almost exclusively to peers. The Tanzanian Ministry of Education and Culture has designed a family life education program for primary schools that focuses on AIDS prevention. The African Medical and Research Foundation has developed a regional adolescent sexual and reproductive health program to support and complement this initiative; it will be implemented in rural Mwanza starting in 1996 and evaluated in 1999. The findings of the present survey underscore the urgent need for such programming to reduce the grave consequences of early sexual activity.