Sexual Risk Behaviour and associated factors: a cross-sectional study among undergraduates in a lower resource setting

Abstract

Introduction: Sexual Risk Behaviour (SRB) among undergraduates has emerged as an important public health issue worldwide. Therefore, the study objective is to assess the prevalence of SRB and its associated factors among second-year undergraduates in a lower resource setting. Methods: A descriptive-cross-sectional study was carried out among 1290, second-year undergraduates in Sri Lanka using multi-stage stratified cluster sampling. Four universities were randomly selected out of 10 eligible universities. The cluster size was 30 and 43 clusters were allocated proportionate to the total second-year undergraduate population and three faculties selected. University Health Risk Behaviour (UniHRB) Inventory is a self-administered questionnaire (SAQ) developed, translated and validated in a local setting. SRB was assessed using 18 items, and the minimum score obtained was 0 and the maximum possible score was 78. The minimum threshold score for the presence of SRB was 27 based on expert opinion. A SAQ was developed to assess its associated factors. The factors significantly associated with SRB were identified using appropriate significant tests. All the variables significant p £0.05 in the bivariate analysis were checked for possible effect modification with each other for SRB. In logistic regression analysis forward stepwise logistic regression method was used to identify Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI). Results: Overall response-rate for the study was 88.1% (n=1136). Prevalence of SRB was 3.5% (95%CI:2.6%-4.7%) and it was more among females (3.9%, 95%CI: 2.5-5.8%) and undergraduates of the Engineering Faculty (5.3%,95%CI:1.8-12.2%). SRB was significantly associated with risky-substance-use (AOR=5.7; 95%CI:1.7-18.4), undue-risk-behavior (AOR=9.0;95%CI:2.6-30.4), being emotionally abused during childhood (AOR=5.9; 95%CI:1.6-20.9), perpetrating physical bullying (AOR=2.2;95%CI 1.5-3.1), discrimination due to religion (AOR=4.1;95%CI:1.2-14.2) and negatively associated with EI (AOR=0.96;95%CI 0.92-0.99). Conclusions: Co-existence and clustering of HRBs were observed, Higher emotional intelligence was significantly negatively associated with SRB.