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Purpose: To determine the incidence and predictors of adolescent's early sexual debut after three decades of HIV interventions in Tanzania. Methods: In a cross-section study of adolescents aged 16-19 residing in Morogoro Municipality, information on sociodemographic, parental-and-peer communication, and sexual behaviors were collected. Cox-regression analysis was used to examine predictors of time to sexual debut. Results: A total of 316 adolescents with mean age of 17.5±0.9 were recruited. Half (48.7%) of adolescent were sexually active with mean age at sexual debut of 14.6±2.3. Of these, 57.8% had sex before their 15th birthday with incidence of early sexual debut of 17.4/1000 person-years at risk. Adolescent family characteristics, peer pressure, alcohol use, parental and peer communication were key predictors of early sexual debut. Conclusion: Parental and peer communication strategies works calling for efforts to increase its scope to reach all adolescents alongside promoting family stability and reducing adolescent alcohol consumption. [ABSTRACT FROM AUTHOR]