Background:  Adolescent sexual activity exists throughout the world, yet the extent to which it is nonconsensual is only recently being assessed. Sexual abuse, rape, sex trafficking, psychological abuse, sexual harassment, economic exchange for sex, and incest are a group of sexual violence for which young people are especially at risk, and which has devastating and long-lasting consequences on their reproductive health. The incidence of this sexual exploitation and its association with sexually transmitted infections (STI) among female adolescents was investigated.

Methods:  We recruited 1500 adolescents from 5 different colleges with different economic status. Data were derived from focused group discussions and individual interviews. We evaluated results of a structured questionnaire covering socio-demographic data, the frequency of different sexual activities, economic exchange for sex, rape, sexual harassment, psychological trauma, incest, knowledge of STI/HIV, knowledge of HIV status, acquisition of STI/HIV, knowledge and use of condoms, harmful traditional practices, such as forced early marriage and female genital cutting.

Results:  Of 1500 respondents, 20% were married, 80% single; and the age range was between 15 and 25 years:  30% had had anal sex, 20% has been involved with oral sex, 5% acknowledged being raped, 30% had been sexually harassed, 25% had exchanged sex for money, 1.8% had been involved in incest. To protect family names from the public only 1.5% of the sexual abuse episodes was officially reported. Of the total, 80% have knowledge of STI/HIV, 40% had acquired STI at one time or another, of whom 5% received treatment in a hospital, 10% in chemists, and others managed the ailment on their own. Most (98%) have knowledge of condoms, and 10% use condom consistently; 2% know their HIV status, 76% would want to know if given the opportunity. Only 5% had been forced into early marriage, while 10% had undergone genital cuttings.

Conclusions:  Women are more vulnerable than men to violence and abuse at all stages of life. The psychological trauma and the risk of acquiring STI/HIV, which the victims of sexual abuse face cannot be overemphasized. An association was found between sexual abuse and sexually transmitted infections (p = 0.05).