Magnitude of risky sexual behavior and associated factors among secondary school students in southern Ethiopia, 2023.

Background: Risky sexual behavior (RSB) among youth can lead to serious socio-economic and health problems, such as unwanted pregnancy and acquired immune deficiency syndrome (AIDS). Little is known about RSB among secondary school students in the South Omo zone, South Ethiopia. Therefore, this study aimed to assess the magnitude of RSB and its determinants among secondary school students in the study area. Design and methods: An institution-based cross-sectional study was conducted in January 2023. A multistage sampling method was used to select 538 students. A structured self-administered questionnaire was used to collect data. Binary logistic regression analysis was used to determine associated factors. The level of statistical significance was declared to have a p-value less than 0.05 in multivariate analysis. Results: The prevalence of RSB among study participants was 25.9% (95% CI = 22.3, 29.9%). It was significantly associated with having close sexually active close friends (adjusted odds ratio (AOR) = 3.09; 95% CI: 1.90-5.02), attending night clubs (AOR = 2.56; 95% CI: 1.35-4.86), drinking alcohol (AOR = 1.90; 95% CI: 1.10-3.29), experiencing parental neglect (AOR = 2.10; 95% CI: 1.35-3.29) and poor HIV/AIDS knowledge (AOR = 1.76; 95% CI: 1.12-2.77). Conclusions: RSB among secondary school students in the South Omo zone was high. It was associated with the presence of sexually active friends, attendance at night clubs, alcohol consumption, parental neglect experience, and poor HIV/AIDS knowledge. Subsequently, it is necessary to strengthen HIV/AIDS education in schools, promote parental engagement in adolescent health, and raising community awareness on the risks of alcohol use and nightclub attendance.