Sexual debut in adolescence presents new challenges and risks of pregnancy and STIs and is associated with the highest HIV risk burden among all age groups globally. While adolescent pregnancy and motherhood have been heavily explored, there remains a critical gap in understanding the circumstances and risk factors for adolescent fatherhood, especially in the context of African countries where the burden of adolescent HIV infection is highest.

Methods

This study utilized an observational cross-sectional analysis using deidentified data from the 2022 Kenya Demographic Surveys (KDHS) to identify the predictors of early fatherhood among Kenyan males. Participants were included in this analysis if they self-identified as male, had a biological child by the time they were 24 years old, and were 25 years old or younger at the time of the survey. The study employed descriptive, bivariate, and multivariate analyses to explore the trends and patterns of adolescent fatherhood, with specific responsiveness to demographic, knowledge, behavior, and household structure domains.

Results

The prevalence of adolescent fatherhood in the KDHS sample was 3%, of which 7.5% reported living with HIV. Adolescent fathers (n=439) mostly commonly lived in rural settings (63%), had primary (36%) or secondary (45%) education and held manual labor jobs (45%). Bivariate analysis show a statistically significant relationship between adolescent fatherhood and experiences of emotional (p=0.03) and physical violence (p<0.00) and living with or being married to your sexual partner (p<0.00). Multinomial logistic regression revealed that adolescent fathers were more likely to have good contraception knowledge (OR=1.89, p=0.058), to have three or more lifetime sexual partners (OR=2.52, p=0.008), and to have previously tested for HIV (OR=3.4, p<0.00); they were less likely to have a female head of household (OR=0.46, p=0.034) or to have used a condom during their last sexual encounter (OR=0.32, p<0.00).

Conclusion

These findings emphasize the importance of providing comprehensive services that are tailored to the needs of young people, especially in terms of integrating HIV and other sexual and reproductive health care for this vulnerable population.