Risky Sexual Behavior and Associated Factors Among Secondary School Students in Mirab Abaya District, Southern Ethiopia, 2024

Introduction : Ethiopia prioritized adolescent and youth health programmes in recent years; particularly in sexual and reproductive health and youth development. Despite these efforts, significant challenges remain, risky sexual behavior among adolescents poses significant public health challenges, including high rates of unintended pregnancies and sexually transmitted infections. Objective : To assess the magnitude of risky sexual behavior and factors associated with it among secondary school students in Mirab Abaya district, Southern Ethiopia, 2024. Method : A school-based cross-sectional study was carried out on 389 students selected by simple random sampling method from September 30 to October 14, 2024. The data were collected using a self-administered structured pretested questionnaire and analyzed using the statistical package for social science version 27. Binary logistic regression analysis was employed to identify the associated variables with the outcome variable. Variables found to have a p-value of <0.25 in the bivariable analysis were passed to multivariable analysis. Result : From 408 students, 389 participated, with a response rate of 95%. The prevalence of risky sexual behavior was 30.10% (95% CI: 25.65%–34.55%). Substance use (AOR = 3.85, 95% CI: 1.44–10.22), watching pornographic movies (AOR = 2.10, 95% CI: 1.64–5.61), neglectful parental monitoring (AOR = 3.71, 95% CI: 1.39–9.86), peer pressure (AOR = 3.46, 95% CI: 1.30–9.88), authoritative parental monitoring (AOR = 0.18, 95% CI: 0.07–0.49). Students’ knowledge (AOR = 2.33, 95% CI: 1.53–6.17) and attitudes (AOR = 2.58, 95% CI: 1.89–6.90) were significantly associated with risky sexual behavior. Conclusion and recommendation : The magnitude reported here is significant which demand crucial attention. Educational campaigns should be implemented to address the risks associated with substance use. Efforts should be made to improve the availability of condom, parental engagement in discussions regarding sexuality, and establishment of peer-led health clubs within schools to fostering supportive environments and promoting healthier choices among students.