This study found that a high proportion of secondary school students engage in risky sexual behaviors in Dar es Salaam, Tanzania. About 40% of students who reported being sexually active in the past one year had multiple sexual partnerships. Our study also found that 10.5% of secondary school students had experienced concurrent sexual partnerships. Despite such high proportions of multiple and concurrent sexual partnerships, 41.1% of young people who had sexual intercourse in the past one year did not use a condom at last sexual intercourse. A higher level of parental monitoring among male students in this study was significantly associated with the condom use at last sexual intercourse.
A high proportion of young people in this study engaged in multiple sexual partnerships. The proportion of secondary school students engaging in such risky behavior reported in our study was higher than that recorded among young people of the general population in Tanzania
. For example, 13.9% of men and 3.3% of women aged 15–24 years were reported to have multiple sexual partnerships in a population survey conducted in 2010. Having multiple sexual partnerships increases the risk of being infected with STIs and HIV
. This study also found a high proportion of concurrent sexual partnerships among secondary school students in Dar es Salaam. Though the importance of concurrency as a main driver of the HIV epidemic in Africa may still be debatable
, it nevertheless remains a high-risk behavior that needs to be addressed. Concurrency is said to fuel HIV transmission more than serially monogamous relationships
. This is because, when one person in the network is infected with HIV, this person places the whole sexual network at a risk of such infection.
Although condom use reduces the risk of transmission of HIV and other STIs
, a high proportion of students in our study did not use such protection at last sexual intercourse. Clearly, this is an important concern, as the prevalence of HIV/AIDS in the general population is high in Dar es Salaam, Tanzania. The goal to reach zero new HIV infections
 may be far from reach with such trends of involvement in risky sexual behaviors. However, our results regarding the association between parental monitoring and condom use present an important area for intervention that may be useful to reduce risky sexual behaviors, particularly among male students.
A high level of parental monitoring among male students of this study was associated with condom use at last sexual intercourse. Young male students who are closely monitored may feel especially loved and cared for by their parents. For that reason, they may refrain from risky sexual behaviors to avoid disappointing their parents, particularly when it may result in STIs and pregnancy. Other male students may refrain from risky sexual behaviors to avoid being punished by their parents when undesired outcomes such as pregnancy occur
. In addition, parental monitoring may reduce engagement in risky behaviors directly or indirectly by improving social skills and reducing the influence of deviant peers
. In the USA, one study also found an association between parental monitoring and condom use among adolescents
, though another study among young adults in the USA did not find such an association
. In Tanzania, young people typically live with their parents until they get married. Therefore, parents in Tanzania may exert influence in their lives for a longer duration than in other countries such as the USA.
In this study, the association of parental monitoring with condom use at last sexual intercourse among female students was not statistically significant. This may be due to issues of gender inequality. In Tanzania, female students receive a higher level of monitoring from parents and from community members compared to male students
. Also, despite high levels of parental monitoring, its effect among female students may not be significant when they lack autonomy in sexual relationships. For example, previous studies have reported the limited influence women have on sexual relationships, which may compromise their powers to negotiate condom use
The lack of association between parental communication and condom use at last sexual intercourse among both male and female students may be due to the context of Tanzanian and African culture. In this context, talking about SRH matters is considered taboo
. Furthermore, some parents who talk to their children on such matters may lack adequate knowledge and proper communication skills
. Therefore, even where such communication does occur, it may be of poor quality and lack significant effects to promote safer sexual behaviors such as condom use among young people.
Male students who live with caregivers other than their own biological parents were less likely to use condoms. Such caregivers may not care greatly nor have firm control on sexual behavior of male students in their care. Our results on this theme are consistent with a previous study done in Cameroon
Male students who used alcohol and had high level of delinquency were less likely to use a condom at last sexual intercourse. Young people who consume alcohol may lose their control to a certain extend and thus be more likely to engage into other risky behaviors such as unprotected sexual intercourse. A previous review study undertaken in a developing country context reported a similar association between condom use and alcohol consumption
Our results should be interpreted in the light of two key limitations. First, self-reporting of sexual behaviors might have introduced the risk of a social desirability bias. To minimize such risk, we ensured privacy and made the data collection as comfortable as possible through the absence of their teachers in the classes or halls in which the questionnaires were administered. Second, our results may not be generalized to all young people in the country particularly in the rural areas. However, these findings may be useful to populations of the urban areas and areas with people of similar background in the Tanzanian context and within other countries in the region.