Prevalence of Risky Sexual Behaviour and Associated Risk Factors Among Young Internally Displaced Persons in the Dschang Health District: A Mixed Method Study
DOI:
https://doi.org/10.17140/phoj.11.01.519Keywords:
Risky Sexual Behaviour, Young internally displaced persons, Sexual and Reproductive Health, Dschang health district, CameroonAbstract
Young internally displaced persons (YIDPs) face heightened vulnerability to risky sexual behaviours (RSB) due to displacement-related socioeconomic instability, disrupted education, limited access to sexual and reproductive health (SRH) services, and exposure to gender-based violence. Evidence on RSB among YIDPs in Cameroon remains scarce, particularly in humanitarian host communities. This study assessed the prevalence of risky sexual behaviours and identified associated factors among YIDPs aged 10–24 years in the Dschang Health District (DHD) in Cameroon.
Methods: A community-based cross-sectional mixed-methods study was conducted between January and July 2025. Quantitative data were collected from 276 YIDPs selected using stratified systematic sampling across seven health areas. Data were analysed using SPSS version 27, with bivariate and multivariate logistic regression to identify predictors of RSB. Qualitative data were collected through four focus group discussions and four key informant interviews involving YIDPs, parents/guardians, teachers, community health workers, and SRH service providers. Thematic content analysis was performed to present quantitative findings.
Results: The overall prevalence of RSB was 44.7% among all respondents and 90.4% among sexually active YIDPs. The most common RSBs were inconsistent or non-use of condoms (90.4%), unwanted pregnancy (47.3%), multiple sexual partnerships (35.6%), spontaneous sexual activity (33.3%), transactional sex, and substance use before sexual intercourse (26.7%). Multivariate analysis identified nightclub attendance more than once per month (aOR=5.01, p=0.001), psychoactive substance use (aOR=2.8, p=0.02), non-utlisation of SRH services (aOR=2.9, p=0.002), informal employment (aOR=2.2, p=0.03), and low economic status (aOR=2.5, p=0.038) as independent variables increasing the likelihood of RSB among YIPDs. Living with both parents reduced the likelihood of RSB (aOR=0.58, p=0.025). Qualitative findings highlighted peer pressure, economic difficulties, housing insecurity, misinformation about contraception, and coercion as key drivers of RSB.
Conclusion: Risky sexual behaviours are highly prevalent among YIDPs in Dschang, driven by structural, social, and behavioural factors. Integrated, youth-friendly SRH interventions addressing economic vulnerability, substance use, and access to services are urgently needed in displaced populations.
References
Ní Ghráinne, B. Internally Displaced Person in International Law. Int J Refugee Law. 2019 Dec 23;33(2):366–392. doi: 10.1093/ijrl/eey055.
Internal Displacement Monitoring Centre (IDMC). Global report on internal displacement 2024–2025. Available from: https://www.internal-dis placement.org/. 2025, Oct 28th.
United Nations Office for the Coordination of Hu-manitarian Affairs (OCHA). Number of internally displaced breaks new record with no let-up in conflicts, disasters. 2025 May 15. Available from: https://news.un.org/en/story/2025/05/1 163176. Accessed 2025, June 26th.
Igonya, E. K., Armah-Ansah, E. K., Muga, W., & Stojanovski, K. Forced internal displacement of sexual and gender minorities in Kenya: An ethno-graphic analysis of displacement trajectories and vulnerabilities. Front Sociol. 2025;10:1499312. doi:10.3389/fsoc.2025.1499312.
Tekletsadik, E. A., Abebe, H. B., & Dessie, Y. Deter-minants of risky sexual behaviour among under-graduate students in Ethiopia: a systematic re-view and meta-analysis. Published 2021. https: //www.ncbi.nlm.nih.gov/pmc/articles/PM C8753482/
Chawla, N., Rajender, G., & Arora, V. Defin-ing “High-risk Sexual Behavior” in the Context of Substance Use: A Review. J Addict Res Ther. 2019;10(1):1000369. doi:10.1177/2631831818822015.
Sifer, S. D., & Getachew, M. S. Risky sexual behav-ior and associated factors among out-of-school youths in Addis Ababa, Ethiopia; mixed methods study. Reprod Health. 2024 Jun 5;21(1):77. doi: 10.1186/s12978-024-01808-y. PMID: 38840149; PMCID: PMC11155156.
Ondimagegne, Y. A., & Anbese, A. T. Risky sex-ual behaviors and associated factors among adolescent in Gedeo Zone, South Ethiopia: a community based cross-sectional study. Sci Rep. 2024;14(1):19908. doi:10.1038/s41598-024- 67944-4.
United Nations Population Fund (UNFPA). Ado-lescent sexual and reproductive health in human-itarian settings: an overview. New York: UNFPA; 2015.
Dimbuene, Z. T., & Defo, B. K. Risky sexual behaviour among unmarried young people in Cameroon: another look at family environment. Journal of Biosocial Science. 2011 Mar;43(2):129– 53.
Teke Johnson Takwa. Determinants of Early First Sexual Intercourse (before 16) among Students Currently aged 14–19 in Secondary Schools in Cameroon’s Capital City, Yaoundé. Central Bu-reau for Censuses and Population Studies, BU-CREP, Yaoundé, Cameroon. Presented at the In-ternational Population Conference 2021. Avail-able at: https://ipc2021.popconf.org/up loads/210188.
Lydie, N., Robinson, N. J., Ferry, B., Akam, E., De Loenzien, M., Zekeng, L., & Abega, S. Adoles-cent sexuality and the HIV epidemic in Yaounde, Cameroon. J Biosoc Sci. 2004;36(5):597–616. [PubMed: 15446354]
Tarkang, E. E., Tatah, L., & Kang, M. S. Highly prevalent at-risk sexual behaviours among out-of-school youths in urban Cameroon. Pan Afr Med J. 2018 Aug 5;30:71. doi: 10.11604/pamj.2018.30.71.14594.
Donatus, L., Assah, F., Mbuagbaw, L., et al. Factors associated with adolescent schoolgirl pregnancy in Kumbo East Health District, Cameroon: a cross-sectional study. Pan Afr Med J. 2018 Oct 24;31:138. doi:10.11604/pamj.2018.31.138.16292.
Ministry of Public Health, Cameroon. RMNCAH Bulletin No. 001 – Q1 2025. Yaoundé: Ministry of Public Health; 2025.
Mann, C., Knight, R., Bopp, M., et al. Sexual and reproductive health and rights in humanitarian settings: an overview. Confl Health. 2024;18:1– 12. doi:10.1186/s13031-024-00567-w.
Casey, S. E., Chynoweth, S. K., Cornier, N., et al. Progress and gaps in reproductive health services in humanitarian settings: a system-atic review. Confl Health. 2015 Dec 21;9:29. doi:10.1186/s13031-015-0054-0.
Fonkwo, J., Besong, M., Ngong, J., Glazier, A., Talawa, D., & Alio, A. The effect of the anglophone crisis on youth sexual and reproductive health in the Northwest region of Cameroon: A qualitative study. Journal of Global Health Reports. 2023 Aug 16;7:e2023040.
OCHA. Multi-Sector Needs Assessment in the West and Littoral regions, Cameroon, August 2020 [In-ternet]. 2020 Aug [cited 2025 Jun 22]. Available from: https://www.humanitarianresponse .info/en/operations/cameroon/north-w est.
OCHA Cameroon. Gender-based violence exac-erbated in crises-affected regions in Cameroon situation report. 2023. https://reports.unoc ha.org/en/country/cameroon/card/1G32bq 1M1B/. Accessed 10/08/2024.
Ejoh, A. R., Nwachan, B. M., & Noumo, N. T. An assessment of the nutritional status of internally displaced school children in the West and Littoral Regions of Cameroon. Food Science & Nutrition. 2024 Jun;12(6):4086–99. https://doi.org/10 .1002/fsn3.4068.
Tassang, A. E., Guoqing, S., Akintunde, T. Y., Sayibu, M., Isangha, S. O., Adedeji, A., & Musa, T. Social integration, solidarity, and psycholog-ical health of internally displaced persons in Cameroon: Exploring the role of community sat-isfaction. Heliyon. 2023 Oct 1;9(10).
Djatche, J. M., Herrington, O. D., Nzebou, D., Galusha, D., Boum, Y., & Hassan, S. A cross-sectional analysis of mental health disorders in a mental health services-seeking population of children, adolescents, and young adults in the context of ongoing violence and displacement in northern Cameroon. Comprehensive Psychiatry. 2022 Feb 1;113:152293.
Office of the Senior Divisional Officer, Service in Charge of Culture and Social Affairs, Senior Di-visional Office, Menoua Division. 2025. Unpub-lished data. Accessed 10th November.
Pourhoseingholi, M. A., Vahedi, M., & Rahimzadeh, M. Sample size calculation in medical studies. Gastroenterol Hepatol Bed Bench. 2013 Winter;6(1):14–7. PMID: 24834239; PMCID: PMC4017493.
Dimbuene, Z. T., & Defo, B. K. Risky sexual behaviour among unmarried young people in Cameroon: another look at family environment. J Biosoc Sci. 2011;43(2):129–53.
Ateudjieu, J., Yakum, M., Goura, A. P., et al. EPI immunization coverage, timeliness and dropout rate among children in a West Cameroon health district: a cross sectional study. BMC Public Health 20, 228 (2020). https://doi.org/10 .1186/s12889-020-8340-6.
Diaby, O., Mbanga, C., Biwole Fouda, J., et al. Factors associated with household willing-ness to pay for Universal Health Coverage in Cameroon: a nationwide cross-sectional anal-ysis. BMC Health Serv Res 24, 1313 (2024). https: //doi.org/10.1186/s12913-024-11767-6.
Cleland, J., Ingham, R., & Stone, N. WHO’s Il-lustrative Questionnaire for Surveys with Young People. UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Re-search Training in Human Reproduction. Geneva; 2001. 105 p.
World Bank. Cameroon Poverty & Equity Brief. April 2020. https://databankfiles.worldb ank.org/public/ddpext_download/pover ty/33EF03BB-9722-4AE2-ABC7-AA2972D68 AFE/Global_POVEQ_CMR.pdf. Accessed 18th November 2024.
Institut National de la Statistique (INS). Fifth Cameroon Household Survey (ECAM5): Situation of Household Living Conditions in 2021–2022. Yaoundé: INS; 2024.
Kaestle, C. E., Halpern, C. T., Miller, W. C., & Ford, C. A. (2005). Young age at first sexual intercourse and sexually transmitted infections in adoles-cents. Journal of Adolescent Health, 36(4), 271– 278. https://doi.org/10.1016/j.jadoheal th.2004.12.011.
Tarkang, E. E., Pencille, L. B., Dadah, E., Nzegge, M. M., & Komesuor, J. Highly prevalent at-risk sexual behaviours among out-of-school youths in urban Cameroon. Pan African Medical Journal. 2018;30(1).
Mirzaei, M., Ahmadi, K., Saadat, S. H., & Ramezani, M. A. Instruments of high risk sex-ual behavior assessment: a systematic re-view. Mater Sociomed. 2016 Feb;28(1):46– 50. doi:10.5455/msm.2016.28.46-50. PMID: 27047267; PMCID: PMC4789722.
Arora, S. K., Shah, D., Chaturvedi, S., & Gupta, P. Defining and Measuring Vulnera-bility in Young People. Indian J Commu-nity Med. 2015 Jul-Sep;40(3):193–7. doi: 10.4103/0970-0218.158868. PMID: 26170545; PM-CID: PMC4478662.
Displacement Monitoring Centre (IDMC). Becom-ing an Adult in Internal Displacement. 2020. Avail-able: https://api.internal-displacement. org/sites/default/files/publications/d ocuments/internally_displaced_youth_fi nal.pdf. Accessed on 12th December 2024.
Nkwele, I., Elong, J., Ngoúé, J., Bolo, Y., Chelo, D., & Kamgno, J. Distribution and determinants of sexuality among school adolescents in the West Region of Cameroon. Open J Pediatr. 2025;15(3):285–99. doi:10.4236/ojped.2025.153027.
Zulkifli, S. N., & Low, W. (2000). Sexual Practices in Malaysia: Determinants of Sexual Intercourse among Unmarried Youths. Journal of Adolescent Health, 27, 276–280.
Meyer, S., et al. School attendance and sexual and reproductive health outcomes among ado-lescents: a systematic review. SpringerMedizin. 2023 [cited 2025 Jun 16]. Available from: https: //www.springermedizin.de/school-atten dance-and-sexual-and-reproductive-hea lth-outcomes-am/23997576.
Agbor, V. N., Mbanga, C. M., & Njim, T. Ado-lescent deliveries in rural Cameroon: an 8- year trend, prevalence and adverse mater-nofoetal outcomes. Reprod Health. 2017 Sep 29;14(1):122. doi: 10.1186/s12978-017-0382-6. PMID: 28962649; PMCID: PMC5622552.
Njim, T., Tanyitiku, B. S., & Babila, C. S. Preva-lence of adolescent deliveries and its compli-cations in Cameroon: a systematic review and meta-analysis. Arch Public Health. 2020 May 5;78:24. doi: 10.1186/s13690-020-00406-1. PMID: 32391147; PMCID: PMC7199297.
Tebeu, P. M., Kemfang, J. D., Sandjong, D. I., Kongnyuy, E., Halle, G., & Doh, A. S. Geographic distribution of childbirth among young people in Cameroon from 2003 to 2005. Obstet Gynecol Int. 2010;2010.
Wallis, N. D., Cadena Camargo, Y., & Krume-ich, A. Adolescent pregnancy amongst displaced women in Bogota: playing between the barbs of structural violence — a qualitative study. Reprod Health 21, 118 (2024). https://doi.org/10.1 186/s12978-023-01731-8.
Family Planning 2030. A Need We Can No Longer Ignore: Family Planning in Humanitarian Emer-gencies. United Nations Foundation; 2025. Avail-able from: https://www.fp2030.org/globa l_search_item/a-need-we-can-no-longe r-ignore-family-planning-in-humanit arian-emergencies/. Accessed 20th of June 2025.
Zulkifli, S. N., & Low, W. (2000). Sexual Practices in Malaysia: Determinants of Sexual Intercourse among Unmarried Youths. Journal of Adolescent Health, 27, 276–280.
Meyer, S., et al. School attendance and sexual and reproductive health outcomes among ado-lescents: a systematic review. SpringerMedizin. 2023 [cited 2025 Jun 16]. Available from: https: //www.springermedizin.de/school-atten dance-and-sexual-and-reproductive-hea lth-outcomes-am/23997576.
Blum, R. W., Mmari, K., & Moreau, C. Risk and pro-tective factors affecting adolescent reproductive health in developing countries. WHO Technical Report Series 924. Geneva: World Health Organi-zation; 2003. Available from: https://apps.w ho.int/iris/bitstream/handle/10665/433 41/9241593652_eng.pdf.
Ajibade, B. O., Oguguo, C., Jonathan, L., & Ju-dith, E. (2022). Recommendations for remov-ing access barriers to effective Sexual/Reproduc-tive Health Services (SRHS) for young people in South East Nigeria: A systematic review. Int J Sex Reprod Health Care 5(1): 047–060. DOI: https: //dx.doi.org/10.17352/ijsrhc.000037.
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