Abstract:
Adolescent period for females is a transition phase to adulthood. It is often a concern 
for families and national health authorities because of the possibility of unprotected sexual debut, 
unintended pregnancies and the acquisition of sexually transmitted infections (STIs), including 
human immunodeficiency virus (HIV). Adolescents may not have adequately developed life skills 
to protect themselves due to lack of knowledge or unavailability of protective means; especially 
in rural communities. However, community-based studies among early and unmarried adolescents 
regarding HIV knowledge and protective practices as well as interventions that promote greater 
self-protection in rural Ethiopia are also lacking.
Objective: The objective of the study was to assess adolescent girls’ participation in peer-group 
and improvements in comprehensive knowledge of HIV, knowledge about condoms and condom 
use at sexual debut in rural West Hararghe, Eastern Ethiopia
Methods: This study drew data from a large quasi-experimental implementation study conducted 
in West Hararghe, Oromia, Ethiopia. The study population was adolescent girls 13–17 years of 
age, who participated in a peer-group intervention and a comparison group. Provision of sexual 
and reproductive health (SRH) related education/information was one of the interventions. The 
study extracted de-identified data from baseline and endline surveys. Multi-level binary logistic 
regression was used to address the comprehensive knowledge and condom use at sexual debut 
outcomes, while multivariable logistic regression data analysis techniques was used to assess the 
correlation between peer-group participation and knowledge about condoms. 
Results: The odds of comprehensive HIV knowledge were higher among those who received SRH 
education in peer-group (AOR = 1.36, 95% CI: 1.01, 1.84) than those in the comparison group.
The odds of having good Knowledge about condoms was higher among peer-group participants
(AOR = 2.15, 95% CI: 1.42,3.26) than those in the comparison group. The odds of using condom 
during sexual debut was higher among girls who participated in peer-group (AOR: 11.51, 95% CI: 
1.95, 67.84) than those in the comparison group.
Conclusion: Comprehensive knowledge and condom use at sexual debut was low. Peer-group 
participation was significantly associated with better comprehensive knowledge of HIV,
knowledge about condoms, and condom use at sexual debut among young adolescent girls in rural 
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Ethiopia. Further studies are essential to evaluate the effectiveness of the intervention in diverse 
social contexts.