Early Sexual Debut among Young Women of Reproductive Age in Bangladesh: An Exploration through Survival Analysis

Early sexual debut (ESD) is a significant public health concern globally, specifically in lower-middle-income countries where traditional gender norms dominate. Patriarchal beliefs regarding sexuality contribute significantly to health risks for adolescent females. ESD increases the risk of HIV/AIDS, sexually transmitted diseases, unwanted pregnancy, adverse birth outcomes, and psychosocial problems. This study utilized data from the Bangladesh Demographic and Health Survey (BDHS) 2022 to investigate the demographic and socioeconomic determinants of ESD among young women aged 15–24. Out of 4,750 weighted respondents across the age group (15–19 and 20–24), the combined prevalence of early sexual debut was 83.52%, with 51.4% of the respondents having their first sexual experience at ages 16–18, and only 16.5% had it after 18 years. Results of survival analysis showed that youth who began cohabiting after age 18 years had significantly lower risk (AHR: 0.01; 95%CI: 0.009–0.015) of experiencing ESD, while female youths with secondary or higher education had 69% less likelihood of experiencing ESD than those with no formal education (AHR:0.31; 95%CI: 0.24–0.40). Wealthier households presented a 22.0% lower risk (AHR: 0.78; 95% CI: 0.70–0.86); urban youth (AHR: 0.81; 95% CI: 0.74 − 0.89) also had a lower risk. Working youth (AHR: 1.16; 9595% CI: 1.05 − 1.28) and knowledge of contraceptives also had a higher risk of experiencing ESD. Study findings suggested that policymakers and respective stakeholders should give appropriate attention to empowering women, enhancing household wealth status, and increasing media exposure to reduce early sexual debut among young women of reproductive age.