Objectives: Adolescent sexuality is a growing public health concern. This study aimed to identify the determinants of the sexuality of adolescents attending school. Materials and Methods: Between April and September 2024, a cross-sectional and analytical study was conducted among adolescents aged 15 to 19 years enrolled in the third to final year of secondary school in six secondary schools in the West Cameroon region. A three-stage sampling method was used. Statistical analysis was performed using SPSS 23.0 software. Binary stepwise logistic regression was used to search for independent determinants associated with the sexuality of these adolescents. The significance level was 5%. Results: Out of 1776 pupils included, the prevalence of adolescent sexuality was 20.3%. The independent risk factors for this sexuality were age greater than or equal to 17 years (aOR: 1.84 [1.26 - 2.70]; p = 0.002) and male sex (aOR: 1.44 [1.01 - 2.04]; p = 0.042) in biological terms. At the behavioural level, it was frequenting bars/snack bars (aOR: 4.60 [3.05 - 6.93]; p < 0.001), nightclubs (aOR: 3.32 [2.20 - 5.02]; p < 0.001) and watching erotic television programmes (aOR: 2.90 [1.99 - 4.22]; p < 0.001). Socially speaking, this sexuality was favoured by living alone (aOR: 7.31 [2.61 - 20.48]; p < 0.001) and having a boyfriend (aOR: 10.10 [6.82 - 14.94]; p < 0.001). Among the economic determinants, adolescents who received family advice on sexuality (aOR: 0.63 [0.43 - 0.92]; p = 0.019) as well as those with parental control of their relationships with the opposite sex (aOR: 0.68 [0.47 - 0.96]; p = 0.033), were less likely to initiate sexual activity, while adolescents who discussed sexuality with their opposite-sex peers were at greater risk (aOR: 2.16 [1.49 - 3.12]; p < 0.001). Conclusion: Adolescents attending school in the West Cameroon region are frequently sexually active. This sexuality is influenced by biological, behavioural, social and economic factors.
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