Introduction: Initiation of early sexual activity in adolescence is associated with numerous adverse consequences. To avoid the unwanted consequences of early sexual initiation we need to understand the factors that influence adolescent early sexual decision-making. Therefore, this study aimed to assess the determinants of early sexual initiation among teenage students in Yaoundé. Methodology: We carried out a cross-sectional study in nine secondary schools in Yaoundé from November 2023 to May 2024 (7 months). Ethical and administrative authorization was obtained. We included adolescents aged 10 - 19 years who were willing to participate in this study. Data was collected using a structured self-reported questionnaire and analyzed using Statistical Package for Social Sciences. Binary and multivariate logistic regression models were used to determine factors associated with early sexual activity (p < 0.05). Results: We consecutively enrolled 908 students, 777 consented and completed the questionnaire. Among the study participants, 61.9% were females giving a sex ratio of 1:1.6. The median age at sexual initiation was 15.46 ± 1.47 years. The prevalence of early sexual intercourse was 28.12%. Most participants had their first sexual experience during the holiday period (51.1%). The most frequent name for a sexual partner was described as boy/girlfriend (75.9%). The act was consensual in 99.6%, preceded by drug use (10.5%), and unprotected in 20.5%. On multivariate analysis, the main factors associated with early sexual initiation were the male gender (OR = 2.15; p < 0.001), being trans (OR = 2.96, p = 0.002), sexually active group of friends (OR = 3.97; p < 0.001), night club attendance (OR = 4.18; p < 0.001), and public school (0R = 2.37; p < 0.001). Conclusion: There exist factors associated with early sexual initiation among adolescents in secondary schools in Yaoundé. Interventions must be carried out at an individual, family, and community level to address this problem.
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