Correlates of early sexual initiation behaviour linked to youth in Tanzania: survival approach on the national study

Effective policies to combat early sexual intercourse require scientific evidence to inform targeted interventions. This study was guided by Bronfenbrenner’s ecological systems theory, which provides a basis for identifying multidimensional predictors of youth participation in sexual intercourse. A sample size of 8,268 youth aged 15–24 years was determined from secondary data originally collected for the Tanzania Demographic and Health Survey-2022. Results from the Cox proportional hazard model indicated that the risk of early sexual debut in urban areas was lower than that in rural areas. Youth originated from households experiencing poverty, alcohol consumption and social media exposure, and individuals from households headed by females indicated increased hazard. Female youth face a high risk, determined by gender imbalances and social expectations. HIV knowledge is a protective factor that promotes delayed and safer sexual behaviours. These findings are essential inputs to support evidence-based policy reviews for reducing early sexual initiation.PRACTICE IMPACT STATEMENT This study highlights the need to strengthen gender empowerment policies that protect girls from cultural norms and community pressures. Comprehensive policies that focus on imposing direct and indirect taxes on alcoholic beverages while implementing the provision of a conditional business licence may reduce these risks. Promoting media literacy programmes and enhancing parental communication with emphasis on monitoring digital use could help address social and structural factors as mechanisms for fighting early sexual intercourse.