Forced sexual initiation among adolescent girls aged 15-19 years: evidence from four African countries using the performance monitoring for action survey.

OBJECTIVES: To assess the prevalence of forced sexual initiation and its associated factors among adolescent girls in four sub-Saharan African countries. DESIGN: Cross-sectional study design. SETTING: Four sub-Saharan African countries: Burkina Faso, Côte d'Ivoire, Kenya and Uganda included in this study. DATA SOURCE: Performance monitoring for action survey data collected in 2020. PARTICIPANTS: A total of 2307 weighted samples of adolescent girls aged 15-19 years were included in this study. OUTCOME MEASURE: Forced sexual initiation among adolescent girls. RESULTS: The pooled prevalence of forced sexual initiation was 24% (95% CI 17% to 31%) among adolescent girls aged 15-19 years in four sub-Saharan African countries. Age at sexual debut, relationship with the household head, educational status, wealth status, marital status and country of residence were statistically significant factors associated with forced sexual initiation among adolescent girls. CONCLUSIONS: Compared with that of the global target, the burden of forced sexual initiation among adolescent girls in the four sub-Saharan Africa was greater. This indicates that action is needed in this area to reach the global Sustainable Development Goals by 2030. Individual-level and community-level factors were associated with forced sexual initiation.