Digital social network information accessed by youths and its effects on sexual and reproductive health among students at public Universities,in Addis Ababa, Ethiopia,2023:A cross- sectional study

Digital social network information accessed by youths and its effects on sexual and reproductive health among students at public Universities,in Addis Ababa, Ethiopia,2023:A cross- sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF comment Digital social network information accessed by youths and its effects on sexual and reproductive health among students at public Universities,in Addis Ababa, Ethiopia,2023:A cross- sectional study Girma Abdissa, Faniswa Honest Mfidi This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6478240/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background- Studies conducted in both developed and developing countries suggest that social media can have both negative and positive impacts on the sexual practices of youth. While it can spread knowledge in various areas, there is a rise in addiction to digital social networks. The correlation between social media exposure and sexual initiation remains complex, but many young people in Ethiopia frequently use social media, raising concerns about its potential risks to their sexual and reproductive health. The aim of this study is to determine and describe the benefits and threats of digital social media information on sexual and reproductive health among public university students in Addis Ababa, Ethiopia. Methods and Materials The descriptive cross-sectional study was conducted from May 2023 to October 2023 among youth at selected public universities in Addis Ababa city Administration,Ethiopia to examine digital social network information accessed by youths and its benefits and threats on sexual and reproductive health. A sample size of 413 was determined using a single percentage formula. All consecutive youth who participated during the study period were included. Data was collected using a systematic self-administered questionnaire, which was double-checked for accuracy. The information was analyzed using the Statistical Package for Social Sciences (SPSS) 25, and presented in tables and graphs. Associations were made to demonstrate the effects of variables. Results: 97.5% of respondents actively used various digital social network platforms,71.6% viewed these platforms as reliable sources of sexual reproductive health information, though 45.8% considered them harmful, and 43.2% saw benefits for youth.Over half (52.4%) had encountered sexual initiation content online, and 77.9% felt they lacked sufficient sexual reproductive health information. Frequent digital social network use and absence of sexual reproductive health-related courses at universities were linked to higher engagement in risky sexual behaviors. Specifically, increased digital social network usage was associated with a 2.266 times higher likelihood of such behaviors. The study concluded that unregulated use of digital social network contributes to misconceptions about sexual reproductive health and risky sexual practices. It emphasized the need for comprehensive sexual reproductive health education and accessible services within universities to mitigate these risks. DSN DSN sites risky sexual behaviour sexual and reproductive health university students youth-friendly health Figures Figure 1 Figure 2 1. INTRODUCTION Several theories of media effects have documented the central role of content in influencing sexual and reproductive health through media. One such theory is the Social Normative theory proposed by Perkins and Berkowitz (1986), which suggests that the digital social network environment influencing the sexuality and reproductive health of young people. In recent years, the rapid development and increasing popularity of social networking sites (SNSs) such as Instagram and Facebook, has been remarkable. Recent statistics suggest that 92% of adolescents go online daily, while 89% are members of at least one social networking site, and 88% have access to a cell phone.In 2016, there were 2.34 billion social media users worldwide, with 22.9% of the global population utilising it the same year. Comparatively, in the United Kingdom, the average digital social network user spent 1.5 hours per day, while in the United States, the average daily digital social network user spent 1.7 hours online in 2015.(1). Ethiopia had 23.96 million internet users in January 2021, accounting for 20.6% of the population, with 6.7 million actively using digital social network, which represented 5.7% (Digital 2021 Report). Adolescents have been identified as early adopters of new technologies such as mobile phones and computers(2).Young people are the top subscribers to internet and mobile phone services, as well as active users of digital social network. They also frequently use networked computer systems to enable data transmission and access services such as online chat, email, file transfer, linked web pages, and other World Wide Web documents. These tools are primarily utilized for sexual health information and social networking (3). These significant and productive segments of the population are often exposed to various sexual and reproductive health risks, including pornographic content, engaging in premarital sexual activity, sexual coercion, early marriage or sexual debut, unplanned pregnancies, abortions, sexually transmitted infections (STIs), and HIV/AIDS(3),(1) The prevalence of internet addiction among Ethiopian adolescents was 35.2%, with severe addiction accounting for 1.8% and mild addiction for 33.4% of participants. Internet addiction rates were higher among female students compared to male students (38.3% vs. 33.4%). The majority of Ethiopian teenagers spend between 30 and 60 minutes per session on social media, visiting it once every few days, which places them in the ‘addicted’ category(4). Early sexual activity poses health risks for both young women and men, as the majority of the sexually active individuals aged 15 to 19 are unmarried(5). Numerous empirical findings from studies in Ethiopia reveal that a high number of school children, approximately 77.2%, are exposed to sexually explicit materials through mass media and internet access (5),(6). The lack of parental contentedness and the school's role in providing sexual and reproductive health education are often blamed for this. High-speed internet connections allow access to large amounts of data in a short time, potentially influencing the amount of sexually explicit content viewed (7),(8) &(9). A noticeable under use of sexual reproductive health (SRH) services among school youths in Ethiopia has been reported by Tesso, Fantahun, and Enquselassie)(10). Regions like Nekemte, Mekele town, and Gojjam zone statistically reflect 21.2% of its population using SRH services, which confirms the minimal use of these services. This suggests that other means of sourcing information on sexual and reproductive health may be at play, which prompted the researcher to investigate the role that modern social media plays in youth sexual and reproductive health. 1.2 DESCRIPTION OF THE STUDY PROBLEM Numerous studies have shown that digital social network negatively affects the sexual practices of youth. However, digital social network communication has had a positive impact on knowledge dissemination in various aspects of life, including health(11),(12). While there is no specific study on digital social network usage patterns in Ethiopia, data from the DHS (2019) indicates that a large number of youth are active users, with most Ethiopian youths spending between 30 to 60 minutes per session on digital social network and visiting it once every few days. This is supported by studies on the prevalence of digital social network addiction among graduate students in Ethiopian universities(11),(13), which reported a 35.2% prevalence of internet addiction, with higher addiction rates among female students. Pornographic content and sexting were common among university students and it impacts their sexual practices, such as premarital sex, early marriage, unplanned pregnancies, abortion, and sexually transmitted infections, including HIV/AIDS. While research in Western and Asian countries suggests a strong link between exposure to sexually explicit content on social media and risky sexual behaviors, there is limited empirical evidence on this topic in Ethiopia. Therefore, this study sought to investigate the benefit and threats of digital social media on youths' sexual and reproductive health in Ethiopia. Understanding the sexual and reproductive health patterns of university students in the digital social Network(DSN) environment and the sociocultural influences on their sexual behaviors could help in developing appropriate intervention for health promotion programs. 2. LITERATURE REVIEW 2.1 DIGITAL SOCIAL NETWORK UTILISATION AND SEXUAL REPRODUCTIVE HEALTH OF THE YOUTH University students' perceptions and use of DSN regarding their sexual reproductive health are influenced by various factors. Research indicates that youths who are exposed to sexual content on digital social network may come to accept misinformation about consent, which could be harmful(14). However, studies conducted by Suyanto(15) have shown a positive relationship between digital social network exposure and sexual behaviour among the youth. Understanding and addressing university students' behaviour in relation to sexual and reproductive health in the digital age is crucial. It is essential to consider the impact of digital social network exposure, content, and platforms on their attitudes and actions.(16) Digital Social network is the term used to describe human interactions in which individuals build and share information and ideas in online communities and networks. Users can actively share information, create content, cooperate, and communicate with one another through digital media and web-based platforms that are accessible through mobile and computer technology(17). Social networking services allow users to create public or semi-public accounts, which can be linked to other profiles to create a personal network . New digital technologies that have changed networking, communication, and nature are rapidly changing the planet. It is crucial to comprehend how various people use digital technologies and social media before looking into how they could improve social and health results. Over the past several years, SNSs like Facebook and Instagram have experienced a fantastic surge in popularity and use. In 2004, Facebook launched as an online community for students at Harvard University, and since then, it has expanded to become the most widely used social networking platform(3),(19). Youngsters now frequently visit Facebook because of the instantaneousness which it permits online (20),(21). In 2016, there were 2.34 billion digital social network users worldwide, and 22.9% of the people on the planet utilised it the same year. In comparison to the UK, where the average social media user spent 1.5 hours per day, and in the US, the average daily digital social network user spent 1.7 hours online in 2015(22). In Ethiopia, 23.96 million People used the internet in January 2021. This number increased by 2.8 million (+13%). Furthermore, 20.6% of people had access to the internet in January 2021, and 6.7 million active users of social media users rose by 500 trillion (+8.1%). For 5.8% of the population, mobile connections increased by 710 trillion (1.6%) to reach 44.86 million in 2021 (Digital 2021 Report). Digital Social network users frequently use additional forms of informal social control, such as constructing constrictive normative environments, prohibiting particular actions, and more, to manage sexual activity. According to earlier research, adolescents are more inclined to participate in sexual behaviours if they believe that their friends are doing it(23). The study of health communications focuses on using communication strategies to enlighten individuals and communities about their health and persuade them to make the best health management decisions. Today’s internet world has easy access to health information. Youngsters in Ethiopia are more aware of health issues due to the Internet's quick development, particularly their digital social network usage (6),(7)&(24). With the growth and popularity of SNSs, such as Instagram and Facebook, recent data suggests that 92% of youngsters who go online every day, 89% of them are members of at least one digital social networking site, and 88% of them have access to a mobile phone(25) . Digital Mass media, particularly the internet, is one of the most popular ways that young people get sexual information, with an increasing proportion of young people engaging in online pornography. Given that early exposure to pornography is a substantial risk factor for problematic sexual behaviour, early diagnosis of indicators of sexual material intake and exploration of the drivers of this behaviour are critical (26) . Recent studies have found that the internet, in particular, is one of the most popular sources of sexual knowledge for young people, with a growing number of them engaging in online pornography. Early detection of signs of sexual material intake and investigation into the causes of this behaviour is crucial, given that early exposure to pornography is a significant risk factor for problematic sexual conduct (27),(28). Young people spend an average of nine hours per day connected to media and sending or receiving an average of between 20 and 80 text messages per day. They increasingly use online social networking technologies, such as Facebook, to learn about their peers’ attitudes and behaviors. These virtual networks influence health behaviors(29). According to statistics from the National Adolescence Observatory (2018), over half (54%) of the Italian youth use the internet to check their social accounts, and 94% of them use it to chat with friends. Youngsters often check social media postings at the start and end of the day. Therefore, social media has grown to play a crucial role in the social structure that supports the youngsters' healthy lifestyles(1),(30). According to the social network literature on sexual behavior, the current study aimed to determine whether the images shared on social networking sites (SNSs) could influence people's perceptions of social norms and their intentions towards sexual health behavior. These images act as informational resources on specific sexual practices, potential partners, and often facilitate connections with future sexual partners(9),(31). Digital Social network has legal and ethical issues, even if it can be helpful for students and professionals. When people use social media inappropriately and irresponsibly, they peril themselves, their employers, and organization like tertiary education institutions and healthcare facilities. The inappropriate use of digital social network may also impair one’s integrity, nurse-patient connections, nurse-colleague relationships, and present and future employment possibilities (New Zealand Nurses Organization, 2021). Institutions, academic bodies, and teachers should think about privacy and internet security threats while designing digital social network use policies (32) . New media has sparked a revolution in the medical industry, as clinicians and laypeople alike use digital social network and the internet as resources for delicate medical concerns. Digital Social network usage in health requires more research because of the consequences on the general public’s awareness of health issues (27),(28)&(33). Youths balance self-preservation and sexual health discussion on digital social network by navigating the risks and benefits of online platforms. While digital social network can be a valuable tool for sexual and reproductive health education, it also poses risks that need to be addressed through responsible use and effective health education strategies (34) . 3. METHODS AND MATERIALS 3.1 Study setting and population The research was carried out at three governmental universities within Addis Ababa city administration Addis Ababa Ethiopia were randomly chosen for the study labeled as university(AAU,AASTU and KUE) .The sample is then distributed proportionately to each university's student population to recruit subjects from each faculty. Programme or schools were randomly selected from each faculty, and study subjects were chosen using the lottery technique. The randomly selected students remained in their classes on the day of data collection. 3.2 Study design The descriptive cross-sectional study was conducted among youth at selected three public universities in Addis Ababa city administration, Ethiopia,to examine the impact of digital social network usage on sexual and reproductive health behaviors. 3.4 Inclusion criteria The respondents included in this phase of research met the following criteria: registered students at selected universities in the Addis Ababa City Administration, willing to participate voluntarily in the research, ability to read and understand the consent letter to facilitate informed consent, or obtain permission through parental assent, and age greater than 18 years. 3.5 Sample size & sampling procedures A representative sample is drawn based on sampling criteria, which are defined by Burns and Grove (2009) as qualities that must be present for a person to be considered part of the target population. The sample is drawn from the accessible population within the target group, as these criteria define the target population. This sample consists of individuals present on campus on the specific day and time of the study. The sample size is determined by using a single proportion for a finite population, with assumptions of 95% confidence level, marginal error (d) of 5%, and the prevalence (P) of 50% The sample size (n) is calculated according to the formula n= {z2 * p * (1 - p) / e2] / [1 + (z2 * p * (1 - p) / (e2 * N))] Where: z = 1.96 for a confidence level (α) of 95%, p = proportion (expressed as a decimal) N = population size, e = margin of error z = 1.96, p = 0.5, N =40940 e = 0.05 n ≈413 3.6 Data collection instrument and procedure Data collection involves a series of interconnected steps aimed at gathering information to answer the research questions. Structured self-reports are frequently used as data-collection tools in quantitative research. For this study, data were collected using a pretested semi-structured self- administered questionnaire. The questionnaire included social media questions adapted from the Pew Internet Project's Teen Survey, as well as sexual behaviour questions adapted from the US Department of Health and Human Services Office of Adolescent Health and the CDC Youth Risk Behaviour Surveillance Survey. Additionally, vast literature sources were reviewed to refine the instrument 3.7 Data quality assurance The study's data quality was ensured throughout the study period, beginning with the design phase of the data gathering technique. During the preparation phase, the ease with which the questions could be understood and the importance of the variables in the study were assessed, followed by pretesting and, based on the results, adjustments to the questionnaire. Before beginning the actual data collection, data collectors and the supervisor were given training in data collection, classification, and coding. On a daily basis during data collection, the designated supervisor checked the collected data for completeness, accuracy, and clarity. 3.8 Data analysis Data was entered into the EPI INFO program version 3.5.1, processed with the statistical package for social sciences (SPSS) 27, and displayed in tables and graphs.Both descriptive and inferential statistics were used in the study Additionally, two- way frequency tables were calculated to determine if the respondents' views were influenced by their biographical characteristics. 3 .9 Ethics approval and consent to participate The UNISA’s College of human science research Research Ethical review Committee (CREC,ref. 10206019-CREC-CHS-2023) granted the research clearance, and permission letter to conduct the study from the three public universities (PRT/LT-182/15/23,A/A13843/227/15 and Unisa-ET/KA/ST/29/31-05-23) was obtained from each university’s research ethical committee. The following basic ethical principles were applied to this research: principle of autonomy, fairness, beneficence, and non-maleficence for the participants, institution, and researcher (Polit & Beck, 2018: 134).Prior to data collection, a letter of permission was given to and accepted by the Addis Ababa Health Bureau,(A/A/13843/227 ) the purpose and procedure for data collection were clarified, and confidentiality and privacy were guaranteed. All participants provided verbal informed consent and were informed that their participation was entirely voluntary 4. RESULTS 4.1 DEMOGRAPHIC PROFILE OF THE RESPONDANTS The sociodemographic data included the respondents' age, gender, study program, and university. A total of 413 university students participated in the survey, but only 393 returned the questionnaire, resulting in a 95.3% response rate and a 4.8% non-response rate. The majority of the respondents (87.0%) were enrolled in undergraduate programs, while 51 (13.0%) were enrolled in postgraduate programs. Most of the respondents (265) (67.4%) were male, while 128 (32.6%) were female, and the median age of the respondents was 21, with an average mean age of 21.5 (+2.2 SD) years.348 (88.5%) lived in dormitories, while a few (45) (11.5%) lived off-campus (as shown in table 4.1). Most of the parents of the youths who participated in the study were college or university graduates. Seventy-four (18.8%) of the participants had parents with no formal education, 67 (17.0%) had parents with primary school education, 42 (10.7%) had parents with completed secondary education, and 54 (13.7%) had parents who attended high school. Additionally, 156 (39.7%) of the participants' parents have a diploma or higher qualification as summarized ( Table 1 ) below Table 1: Socio-demographic characteristics of respondents in public universities Addis Ababa, Ethiopia,2023 (N=393) Variables AAU (N=218) AASTU(N=75) KUE(N=100) Total(N=393) n % n % n % n % Gender M 152 69.7 72 96.0 41 41.0 265 67.4 F 66 30.3 3 4.0 59 59.0 128 32.6 Total 218 100 75 100 100 100 393 100 Age 18-20yrs 88 40.3 0 0.0 5 5.0 94 23.9 21-22yrs 65 29.8 42 56.0 55 55.0 162 41.2 23-24yrs 24 11.0 36 34.6 38 38.0 88 22.4 25+yrs 41 18.9 7 9.4 7 2.0 49 12.5 Total 218 100 75 100 100 100 393 100 Paternal Educational status No formal education 46 21.1 15 20.0 13 13.0 74 18.8 Primary school 42 19.2 10 13.3 18 18.0 67 17.0 Secondary school 25 11.5 14 18.6 9 9.0 42 10.7 High school 34 15.6 17 22.6 9 9.0 54 13.7 University/college graduate 71 32.6 19 25.5 51 51.0 156 39.7 Total 218 100 75 100 100 100 393 100 Place of residence Dormitory 177 78.4 74 98.6 97 97.0 348 88.5 Off dormitory 41 21.6 1 2.4 3 3.0 45 11.5 Total 218 100 75 100 100 100 393 100 4.2 TYPES AND FREQUENCY OF DIGITAL SOCIAL NETWWORK USE The importance of the type and frequency of DSN lies in the significant amount of sexual information posted on these platforms. This exposes young people to risky sexual activities that can have serious implications that influence their psychological views and thoughts towards sex. Additionally, as most students spend hours conversing and engaging in unproductive activities on digital social network, their attitudes towards academic activities are deteriorating . In this study the most utilized digital social network platforms by the respondents were Telegram (268) (68.2%) (AOR=1.358), Facebook (52) (13.2%), YouTube (38) (9.2%), and TikTok (20)(5.1%). Instagram, WhatsApp, and Twitter were used by 2.0%, 1.3%, and 0.5%, respectively, as shown in ( Figure 1 ) Regarding the frequency of digital social network use by the respondents, the majority (186) (47.3%) reported using it several times a day (AOR=2.250). Additionally, 121 (30.8%) said they used it almost constantly every other day, 52 (13.2%) used it once a day, and the remaining 17 (4.3%) used it once a week or less often. Male respondents reported more frequent use (46%) compared to female respondents (9.4%), as summarised in ( Figure 2 ) 4.3 BENEFITS AND RISKS OF DIGITAL SOCIAL NETWORK Regarding the impact of digital social network on youths, more than half of the respondents (180) (45.8%) reported harmful effects (AOR=1.576), while 168 (43.0%) reported beneficial effects for the youth. The remaining 40 (10.2%) and four (1%) reported neither negative nor positive effects, which deemed it not important for the youths' sexual and reproductive health. The majority of the respondents use digital social network for communication with friends and family (26.9%), and for obtaining health information. The remaining respondents mentioned using it to meet people with similar interests (24.1%), find happiness and for entertainment.(22.1%) Regarding the risks of digital social network, the majority of the respondents expressed concerns about harmful relationships and communication (29.7%) (AOR=1.191), early initiation of sexual intercourse (26.1%) (AOR=1.51), encouraging peer pressure (23.4%), encouraging multiple sexual partners (20.8%), and spreading rumour s. This is summarized by ( Table 2 ) Table 2 Multiple responses of the respondents regarding the benefits and risks of digital social Network information Addis Ababa, Ethiopia ,2023 Variables Response Male Female Total Number % Number % Number % The benefit of DSN in terms of SRH Communication with friends and families 81 25.7 41 29.7 122 26.9 Getting sexual reproductive health information 87 27.6 35 25.3 122 26.9 Meeting people with similar interests 78 24.7 31 22.5 109 24.1 Finding happiness and entertainment 69 23.0 31 22.5 109 22.1 Total 315 100.0 138 100.0 453 100.0 Risks of DSN use stated by the students Having multiple partners and rumor-spreading 51 18.2 42 22.2 93 20.8 Harmful relationships and communication 85 30.4 48 25.4 133 29.7 Initiation of early sexual desire 80 28.6 37 19.6 117 26.1 peer pressure influences 64 27.8 62 32.8 126 23.4 Total 280 100.0 189 100.0 469 100.0 4.4 RELATIONSHIP BETWEEN THE IMPORTANT VARIABLES IN THIS STUDY In order to demonstrate a strong relationship between two variables, it is important to use statistical techniques that accurately reflect the type and strength of the relationship. Different strategies can be employed, depending on the type of data and the nature of the relationship . These techniques offer unique insights into the relationship between variables, which range from correlation coefficients to more complex statistical models. The frequency of using digital networks, a lack of knowledge, or inadequate education on sexuality and sexual reproductive health issues, and their correlation to the risk of engaging in sexual behaviour, were all significant factors in this study. In this study, a relationship exists between family education level and various factors related to DSN usage and sexual and reproductive health problems. Family education level was found to be negatively correlated with the frequency of DSN usage and sexual reproductive health problems, with correlation coefficients of -0.230 and -0.207, respectively, at a 95% confidence interval. On the other hand, the respondents' DSN usage showed a positive correlation with watching films about sexual activity and a negative correlation with receiving SRH services at a university, with correlation coefficients of 0.230 and -0.188, respectively. Furthermore, pornographic images and films depicting sexual activity were positively correlated with the respondents' histories of engaging in sexual activity and experiencing reproductive issues, with correlation coefficients of 0.263 and 0.206, respectively, at a 95% confidence interval. The study also revealed a positive correlation between viewing pornographic images and films depicting sexual activity and the respondents' histories of engaging in sexual activity and experiencing reproductive issues, with correlation coefficients of 0.263 and 0.206, respectively Logistic regression was conducted to determine how the frequency of digital social network usage and the absence of sexual reproductive health-related courses in university affect the students' likelihood of engaging in risky sexual activity. A total of 393 students were included in the analysis. The model accounted for 48% of the variability in risky sexual behaviour and accurately classified 58% cases. For each additional increase in the frequency of digital social network use, there was a 2.266 increase in the odds of students engaging in risky sexual practices. Additionally, the absence of sexual and reproductive health courses in a university is associated with a 13% increase in the likelihood of viewing sexual films, with 55% of the cases correctly classified. Furthermore, each additional increase in digital social network usage frequency was linked to a 1.655 increase in the odds of the youth engaging in sexual intercourse. This is summarized in ( Table 3 ). Table 3 Crude and adjusted odds ratio from logistic regression of factors associated with risky sexual and reproductive health practice among public university students Addis Ababa Ethiopia ,2023 (N=393) Variables Category Risky sexual reproductive health COR(95%CI) AOR(95%CI) P value Yes (%) No(%) Paternal educational level No formal education 39(52.7%) 35(47.3%) 2.737(1.396-5.365) 0.604(0.275-0.922) P<0.003* Primary education 42(62.7%) 25(37.3%) 2.632(1.256-5.523) 0.840(0.39-1.788) P<0.01 Secondary education 30(71.4%) 12(28.6%) 1.768(.984-3.178) 0.543(0.211-1.350) P<0.57 high school 39(72.2%) 15(27.8%) 1.173(.674-2.041) 0.558(0.25-1.235) P<0.572 University/college graduate 76(48.7%) 80(51.3%) 1 Digital Social network Used 173(63.1%) 101(36.9%) 2.133(1.378-3.302) 0.476(0.271-0.836) P<001* Not 53(44.5%) 66(55.5%) 1 Sexual inflicting pictures Accessed 45(72.6%) 17(27.4%) 0.456(0.251-0.829) 0.329(0.150-0.724) P<006* Not 181(54.7%) 150(45.3%) 1 Seen pornographic films Yes 121(70.3%) 51(29.7%) 1.063(0.858-2.084) 0.382(0.251-0.581) P<000* No 105(47.5%) 116(52,5%) 1 Peer pressure Yes 191(61.0%) 122(39.0%) 2.618(1.181-5.807) 0.473(0.254-0.881) P<018 No 20(42.6%) 27(57.4%) 1 Experience course attending/service of SRH in university Attended 65(74.7%) 22(25.3%) 1 Not 161(52.6%) 145(57.4%) 0376(0.221-0.640) 0.422(0.221-0.805) P<009* 5. DISCUSSION 5.1 HIGH RELIANCE ON DIGITAL SOCIAL MEDIA FOR SEXUAL AND REPRODUCTIVE HEALTH INFORMATION Digital Social network, especially among young people, is becoming an increasingly important source of information on SRH. This trend is mainly driven by digital social network platforms due to their accessibility and ease of use which offer a wide range of information that is often not available through more traditional methods. However, the reliability and accuracy of this information can vary greatly, leading to potential misinformation and health risks(35). In this study, 97.5% of the students use various social media sites, and 71.6% believe that digital social network provides reliable information on SRH. However, they do not know the source of this information. A small percentage (8.4%) reported using social media to view sexually explicit content, which is strongly associated with sexual and reproductive health (AOR=0.456; 95% CI 0.25 to 0.829). Additionally, the majority of the respondents reported using digital social network several times a day, with the most commonly used digital social network platforms being Telegram (AOR=1.358) and Facebook, which is strongly associated with sexual and reproductive health risks (AOR=2.13; 95% CI 1.378 to 3.302). This is similar to recent research statistics which suggest that 92% of adolescents go online daily, 89% belong to at least one social networking site, and 88% have access to a cell phone (36). Recent studies conducted in northern and southern Nigeria found that 98.4% had accessed the internet. Of these, 96.3% had visited digital social network sites and 99.3% accessed the internet.Iliyasu, Mohammed and Dipeolu support this finding.(37),(38). The studies conducted at universities in Ethiopia show that 91.3% of the respondents at Madda Walabu University were reported as digital social network users in the country(29),(39). Additionally, 87.5% of students at Oda Bultum University have access to various digital social network accounts(40). This percentage is slightly lower than the study finding of 92.1% vs. 87.5%, which may be attributed to the universities' locations, which are far from the centre of Ethiopia, leading to inadequate internet access. findings of this study are similar to those of a study conducted at a private university in southern Nigeria. Almost equal numbers of respondents used digital social network, with 72.7% accessing news, 63.6% for academics, and 6.5% for sexually explicit content (7),(41). However, there was a difference in the use for watching sexually explicit content, with 8.4% vs. 6.5%, which may be attributed to the sample size of the study. A study in Ethiopia by Bayleyegn and Buta (2019). supported that students used social media for non-academic issues (53.5%), academic issues (44.64%), and exchanging sexually related video content (10.7%). Male respondents used DSN more frequently than female respondents (76.1% vs. 23.9%). A recent survey at Raya University in Ethiopia contradicted this finding, showing that 53% of female students spent two to three hours a day on digital social network for entertainment rather than academic goals (42). The study at Wollo University showed that the majority of the students used digital social network platforms like Telegram, Facebook, Email, and YouTube for teaching and learning (25)(43). However, studies by Bayleyegn and Buta (2019) (85.7% vs. 60.7%), Wanamo, Abadir (2021) (69.8% vs. 60.7%), and Lisanu (2020) contradicted this, suggesting that many students preferred using Facebook for educational purposes. This difference may be due to institutional and personal variations in the students' preferences for digital social network platforms on campus.Earlier research in Ethiopia among university and secondary school students found that having a nearby health facility and discussing SRH with friends and family were important predictors of service consumption. Many students turned to the digital social network to learn about SRH(25),(44). This study revealed that 68.2% of the students easily accessed sexual and reproductive health information from digital social network, and 71.6% believed that digital social network provided reliable information about SRH, although they were unsure about reputable sites. Similarly, in Ethiopia, most students preferred receiving SRH information from digital mass media (57.1%), followed by peer educators (28.2%), and close friends (26.8%)(45). The internet was the most accessed source for SRH information (34),(46). 5.2 INFLUENCE OF DIGITAL SOCIAL NETWORK ON SEXUAL BEHAVIOURS Digital social network has a significant influence on individuals' sexual behaviour, particularly among adolescents and young adults. The exposure to unregulated and often explicit content on these platforms can shape sexual attitudes and behavior, leading to both positive and negative outcomes. While social media can offer sexual health information, it also poses risks by promoting risky sexual behaviors through exposure to inappropriate content.(47). This study shows that students enrolled in undergraduate programme are associated with sexual and reproductive risk (AOR=0.93; 95% CI 0.33 to 1.265). This finding is consistent with a similar study conducted at Adekunle Ajasin University. Observations over the past decade suggest a significant increase in the proportion of undergraduate students engaging in sexual activity during their time at the university(48).Young people whose parents had no formal education are significantly linked to sexual reproductive risk (AOR=2.737; 95% CI 1.396 to 5.365) compared to those whose parents had a high level of education. A comparable study done in Vietnam on higher education institutional students revealed that the parents' educational level is indirectly associated with sexual reproductive risk.An educated family decreases the risk of sexual reproductive health (AOR=1.7; 95% CI) (21),(49). In this study, half of the respondents (45.8%) reported experiencing harmful effects of DSN (AOR=1.576), while 43% found it beneficial for youths. The reasons cited for the risks of digital social network included harmful relationships and communication (29.75%), early initiation of sexual intercourse (26.1%), encouragement of peer pressure (23.4%), promotion of multiple sexual partners, and spreading rumours (20.8%). Additionally, the respondents mentioned that digital social network is important for communication with friends and family (26.9%), obtaining health information (27%), and meeting people with similar interests for happiness and entertainment (24.1% and 22.1%, respectively). Even though some studies have suggested that digital social network may negatively impact young adults' sexual behaviour, there are advantages to digital social network for adolescents and young people in terms of providing essential information on sexual health and healthy relationships (50). digital socialo network platforms often include sex-related content that is not thoroughly researched or education-focused. The internet can randomly direct visitors to unhealthy, purely entertainment-oriented, and sexually explicit websites even when not requested(7),(51). A recent study conducted in Ethiopia supported the benefits of DSN for school assignments (20%), making new friends (25%), and using digital social network for entertainment (55%)(52). This suggests that most adolescents in the survey are aware of the benefits of DSN for youth reproductive health information. However, 45.8% reported the harmful effects of digital social network. This aligns with the findings of Kunnuji (2012), who revealed that 44% of students using digital social network had unintentionally accessed websites with sexual content, while 46% admitted to engaging in sexual activities, including viewing pornography online and participating in sexually stimulating acts. This study found that nearly an equal number of the respondents reported seeing sexual activity films and pornography on DSN (52.4% vs. 43.8%), which is strongly associated with sexual reproductive health risk (AOR=0.333; 95% CI 0.22 to 0.509 vs. AOR=1.063; 95% CI 0.838 to 2.934).The majority of the participants stated that the risks associated with DSN include negative health consequences related to sleep, as well as relational risks such as sexting, bullying, unwanted predation, and engaging with risky sexual partners. A study in India revealed that one of the most common ways that young people obtain sexual knowledge is through digital mass media, especially DSN, where a growing percentage are using online pornography, which is a significant risk factor for unhealthy sexual behaviour(53). Another study in Hawassa, Ethiopia, showed that overall exposure to sexually explicit materials in school youths was 77.2%. (2)(39),(54). These variations could be explained by differences in methodologies, study subjects, sampling procedures, and data collection techniques. 6. CONCLUSION The study found a gap in sexual and reproductive health information for youths in Ethiopian universities. University students lacked knowledge about sexual health services and the risks of digital social network, leading to risky behaviour like unprotected sex. There was a link between using digital social network for explicit content and engaging in risky sexual activities. Limited access to SRH services on campus further increased the risk of sexual health issues. 7. RECOMMANDATION Based on the findings of the study, recommendation suggested for the following institution; Ministry of Education, university administrators, instructors, and health professionals within the university unit. A review and update of the current approach to delivering Youth Sexual and Reproductive Health (YSRH) education should focus on minimizing the risks of digital social network while maximizing its benefits. The educational curriculum should be revised to include credit hours for YSRH theory and practice as well as digital social network ethics. Educational sessions on healthy digital social network usage should be conducted for teachers, along with training on addressing behaviour changes that may lead to risky sexual behaviour. Provide opportunities for new university students to receive training on digital social network information usage and sexual and reproductive health services. Engage in activities and events at universities, youth centers, media outlets, and religious organizations to promote Youth Sexual and Reproductive Health (YSRH) services. 8. LIMITATION OF THE STUDY The study was conducted in Addis Ababa, the capital city of Ethiopia, which has the highest internet coverage including 5G. The focus was on three public universities in Addis Ababa, which may not represent universities in other areas. The qualitative findings from the study may not apply to other higher institutions. 9. FURTHER RESEARCH The researcher suggests in depth multistage research will be conducted on using digital social network for sexual and reproductive health services in urban and rural universities and.educational institutions need to assess readiness for offering youth sexual and reproductive health services, emphasizing digital social network use. Abbreviations AAU: Addis Ababa University AASTU : Addis Ababa Science and Technology University AIDS: Acquired Immune Deficiency Syndrome BMC: Bio-med Central CDC : Central Disease Control DHS : Demographic Health Survey DSN: Digital social network, FMOE : Federal Ministry of Education FMOH: Federal Ministry of Health, HIV: Human Immune Deficiency Virus, IEC: Information, Education, and Communication KUE: Kotebe University of Education , RH: Reproductive Health SRH : Sexual and Reproductive Health STIs: Sexually Transmitted Infections UNAIDS: United Nations Program on HIV and AIDS UNICEF : United Nations International Children Emergency Fund, USAID: United States Agency for International Development, WHO: World Health Organization, YSRH : youth sexual reproductive health UG :undergraduate, PG :postgraduate Declarations Ethics and consents of the participants The studies involving humans were approved by the College of Human Science Research Ethics Review Committee. The NHREC Registration number is Rec-240816-052 and the CREC Reference number is 10206019_CREC_CHS_2023.The medium-risk applications were reviewed by the College of Human Science Research Ethics Review Committee in compliance with the UNISA policy on research ethics and the standardized operating procedures on research risk assessment. The studies were conducted in accordance with local legislation and institutional requirements. Written informed consent for participation in this study was provided. Author contributions GA : Conceptualization, Data curation, Formal analysis, Methodology, Resources, Writing – original draft, Writing – review & editing. FM: Supervision, Validation, Writing – review & editing. All authors read and approved the final manuscript. Authors’ information GA Lecture in Menelik II Medical and Health Sciences College. Prof. Faniswa Honest Mfidi ,Associate Professor worked @ University of South Africa department Of Health sciences Acknowledgments The authors would like to thank the University of South Africa(UNISA),Prof. Faniswa Honest Mfdi, University of South Africa(UNISA) PhD research supervisor and Reviewed the manuscript, the Addis Ababa City Administration Health Bureau, the management and staff of the universities in which the study was conducted,would like to extend our appreciation to the study participants who dedicated their time to providing information for this study. The authors would also like to acknowledge all the staff at the College of Menelik II Health Science and Medicine for their cooperation and support. Additionally, we thank the staff at regional branch of South Africa university in Ethiopia office for their collaboration,data collectors and supervisors, Funding The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article Consent for publication - Not applicable as the manuscript contains no any individual person’s data in any form including individual details, images or videos. Availability of data and materials- All data are within a manuscript. However, the data set is available from the authors upon reasonable request through the email address of [email protected] with permission of the college within a college library. Competing interests -The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest Clinical trial number - not applicable. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6478240","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"comment","associatedPublications":[],"authors":[{"id":549672626,"identity":"9de208a3-df1c-4674-97e4-d4760c33ef1d","order_by":0,"name":"Girma Abdissa","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABBElEQVRIiWNgGAWjYFACHgRp/OOHDZBibDxAtJZixp40kJYGorSAwWcGtsNgBl4t8u69Bx8X1NTKmE87/HBzAc95u7Xth4G21NhE49JieOZcsvGMY8d5ZG6nGRvPsLidvO1MIlDLsbTcBlxaZuSYSfOwHeORkE4wM+DhuZ1sdgCohbHhMD4t5r95/oG0pH//wcN2Ltns/EP8WuQlcsyYedtqgFpyDIx52A7Ymd0gYIsBz7lkad6+AyAtBYYze5ITzG4AbUnA4xf59t6Dn3m+1dkDHbbB4MMPO3uz8+kPH3yoscFtywEwdRgukAhWmYBDOdgWiFl1cAF7PIpHwSgYBaNghAIAz5xh2e7kEK4AAAAASUVORK5CYII=","orcid":"","institution":"Menelik II Medical and Health Science College","correspondingAuthor":true,"prefix":"","firstName":"Girma","middleName":"","lastName":"Abdissa","suffix":""},{"id":549672627,"identity":"f95cc02c-981a-4aa1-b81b-32563a0ed005","order_by":1,"name":"Faniswa Honest Mfidi","email":"","orcid":"","institution":"University of South Africa","correspondingAuthor":false,"prefix":"","firstName":"Faniswa","middleName":"Honest","lastName":"Mfidi","suffix":""}],"badges":[],"createdAt":"2025-04-18 10:23:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6478240/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6478240/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":96903176,"identity":"4660646b-1a6a-483c-909b-2a95f5f1b481","added_by":"auto","created_at":"2025-11-27 11:49:58","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":29828,"visible":true,"origin":"","legend":"\u003cp\u003eTypes of digital social network used by the study respondents in public Universities,Addis Ababa, Ethiopia.2023 (N=393)\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6478240/v1/934ec69f68eac987dc13d96a.png"},{"id":96903177,"identity":"d45a1155-5b8a-485a-a28b-b79d31d1ae6d","added_by":"auto","created_at":"2025-11-27 11:49:58","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":11062,"visible":true,"origin":"","legend":"\u003cp\u003eFrequency of Digital social network used by respondents in public universities Addis Ababa , Ethiopia ,2023 (N=393)\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6478240/v1/637d1632f29e16f8e1f0c669.png"},{"id":97136058,"identity":"450c9a9c-b836-4847-a85d-3525096879aa","added_by":"auto","created_at":"2025-12-01 09:55:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1203910,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6478240/v1/d02193fb-fbbf-467b-a227-63a0af079d6a.pdf"},{"id":96920771,"identity":"a21471b9-f389-4a2c-b9e0-01ccdf55b7ad","added_by":"auto","created_at":"2025-11-27 14:15:24","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":154189,"visible":true,"origin":"","legend":"","description":"","filename":"ResearchTools.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6478240/v1/834fa0de94879efe706e7cf0.pdf"},{"id":96903180,"identity":"6d5b0bd5-eaa9-4bad-89aa-56c2ddbaf80a","added_by":"auto","created_at":"2025-11-27 11:49:58","extension":"spv","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":34347,"visible":true,"origin":"","legend":"","description":"","filename":"mulitpleresgressionVsSRH.spv","url":"https://assets-eu.researchsquare.com/files/rs-6478240/v1/b209dcd9c36df67b91025bdd.spv"},{"id":96903178,"identity":"3dae8fc8-e887-4444-be08-40cce22ca39c","added_by":"auto","created_at":"2025-11-27 11:49:58","extension":"sav","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":55901,"visible":true,"origin":"","legend":"","description":"","filename":"QuntitativeData.sav","url":"https://assets-eu.researchsquare.com/files/rs-6478240/v1/e909c33411da25b0c11b05f0.sav"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eDigital social network information accessed by youths and its effects on sexual and reproductive health among students at public Universities,in Addis Ababa, Ethiopia,2023:A cross- sectional study\u003c/p\u003e","fulltext":[{"header":"1. INTRODUCTION","content":"\u003cp\u003eSeveral theories of media effects have documented the central role of content in influencing sexual and reproductive health through media. One such theory is the Social Normative theory proposed by Perkins and Berkowitz (1986), which suggests that the digital social network environment influencing the sexuality and reproductive health of young people.\u003c/p\u003e\n\u003cp\u003eIn recent years, the rapid development and increasing popularity of social networking\u0026nbsp;sites\u0026nbsp;(SNSs)\u0026nbsp;such\u0026nbsp;as\u0026nbsp;Instagram\u0026nbsp;and\u0026nbsp;Facebook,\u0026nbsp;has\u0026nbsp;been\u0026nbsp;remarkable. Recent statistics suggest that 92% of adolescents go online daily, while 89% are members of at least one social networking site, and 88% have access to a cell phone.In 2016, there were 2.34 billion social media users worldwide, with 22.9% of the global\u0026nbsp;population\u0026nbsp;utilising\u0026nbsp;it\u0026nbsp;the\u0026nbsp;same\u0026nbsp;year.\u0026nbsp;Comparatively,\u0026nbsp;in\u0026nbsp;the\u0026nbsp;United\u0026nbsp;Kingdom, the\u0026nbsp;average\u0026nbsp;digital\u0026nbsp;social\u0026nbsp;network\u0026nbsp;user\u0026nbsp;spent\u0026nbsp;1.5\u0026nbsp;hours\u0026nbsp;per\u0026nbsp;day,\u0026nbsp;while\u0026nbsp;in\u0026nbsp;the\u0026nbsp;United\u0026nbsp;States, the average daily digital social network user spent 1.7 hours online in 2015.(1). Ethiopia had 23.96 million internet users in January 2021, accounting for 20.6% of the population, with 6.7 million actively using digital social network, which represented 5.7% (Digital 2021 Report).\u003c/p\u003e\n\u003cp\u003eAdolescents have been identified as early adopters of new technologies such as mobile phones and computers(2).Young people are the top subscribers to internet\u0026nbsp;and mobile phone services, as\u0026nbsp;well\u0026nbsp;as\u0026nbsp;active users\u0026nbsp;of digital social\u0026nbsp;network.\u0026nbsp;They also\u0026nbsp;frequently\u0026nbsp;use\u0026nbsp;networked\u0026nbsp;computer\u0026nbsp;systems\u0026nbsp;to\u0026nbsp;enable\u0026nbsp;data\u0026nbsp;transmission\u0026nbsp;and access services such as online chat, email, file transfer, linked web pages, and other World Wide Web documents. These tools are primarily utilized for sexual health information and social networking (3).\u003c/p\u003e\n\u003cp\u003eThese\u0026nbsp;significant\u0026nbsp;and\u0026nbsp;productive\u0026nbsp;segments\u0026nbsp;of\u0026nbsp;the\u0026nbsp;population\u0026nbsp;are\u0026nbsp;often\u0026nbsp;exposed\u0026nbsp;to various sexual and reproductive health risks, including pornographic content, engaging in premarital sexual activity, sexual coercion, early marriage or sexual debut, unplanned pregnancies, abortions, sexually transmitted infections (STIs), and HIV/AIDS(3),(1)\u003c/p\u003e\n\u003cp\u003eThe prevalence of internet\u0026nbsp;addiction\u0026nbsp;among\u0026nbsp;Ethiopian\u0026nbsp;adolescents\u0026nbsp;was\u0026nbsp;35.2%,\u0026nbsp;with\u0026nbsp;severe\u0026nbsp;addiction accounting\u0026nbsp;for\u0026nbsp;1.8%\u0026nbsp;and\u0026nbsp;mild\u0026nbsp;addiction\u0026nbsp;for\u0026nbsp;33.4%\u0026nbsp;of\u0026nbsp;participants.\u0026nbsp;Internet\u0026nbsp;addiction rates were higher\u0026nbsp;among\u0026nbsp;female\u0026nbsp;students compared to male\u0026nbsp;students (38.3%\u0026nbsp;vs. 33.4%).\u0026nbsp;The\u0026nbsp;majority\u0026nbsp;of\u0026nbsp;Ethiopian\u0026nbsp;teenagers\u0026nbsp;spend\u0026nbsp;between\u0026nbsp;30 and\u0026nbsp;60\u0026nbsp;minutes\u0026nbsp;per\u0026nbsp;session\u0026nbsp;on\u0026nbsp;social\u0026nbsp;media,\u0026nbsp;visiting\u0026nbsp;it\u0026nbsp;once\u0026nbsp;every\u0026nbsp;few\u0026nbsp;days,\u0026nbsp;which places them in the ‘addicted’ category(4).\u003c/p\u003e\n\u003cp\u003eEarly sexual activity poses health risks for both young women and men, as the majority of the sexually active individuals aged 15 to 19 are unmarried(5).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNumerous empirical findings from studies in Ethiopia reveal that a high number of school children, approximately 77.2%, are exposed to sexually explicit materials through mass media and internet access (5),(6). The lack of parental contentedness and the school's role in providing sexual and reproductive health education are often blamed for this. High-speed internet connections allow access to large amounts of data in a short time, potentially influencing the amount of sexually explicit content viewed\u0026nbsp;(7),(8)\u0026nbsp;\u0026amp;(9).\u003c/p\u003e\n\u003cp\u003eA\u0026nbsp;noticeable\u0026nbsp;under use\u0026nbsp;of\u0026nbsp;sexual\u0026nbsp;reproductive\u0026nbsp;health\u0026nbsp;(SRH)\u0026nbsp;services\u0026nbsp;among\u0026nbsp;school youths in Ethiopia has been reported by Tesso, Fantahun, and Enquselassie)(10). Regions like Nekemte, Mekele town, and Gojjam zone statistically reflect 21.2% of its population using SRH services, which confirms the minimal use of these services.\u0026nbsp;This suggests that other means of sourcing information on sexual\u0026nbsp;and\u0026nbsp;reproductive\u0026nbsp;health\u0026nbsp;may\u0026nbsp;be\u0026nbsp;at\u0026nbsp;play, which\u0026nbsp;prompted\u0026nbsp;the\u0026nbsp;researcher\u0026nbsp;to investigate the role that modern social media plays in youth sexual and reproductive health.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.2 DESCRIPTION\u0026nbsp;OF\u0026nbsp;THE\u0026nbsp;STUDY PROBLEM\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNumerous studies have shown that digital social network negatively affects the sexual practices of youth. However, digital social network communication has had a positive impact on knowledge dissemination in various aspects of life, including health(11),(12). While there is no specific study on digital social network usage patterns in Ethiopia, data from the DHS (2019) indicates that a large number of youth are active users, with most Ethiopian youths spending between 30 to 60 minutes per session on digital social network and visiting it once every few days. This is supported by studies on the prevalence of digital social network addiction among graduate students in Ethiopian universities(11),(13), which reported a 35.2% prevalence of internet addiction, with higher addiction rates among female students. Pornographic content and sexting were common among university students and it impacts their sexual practices, such as premarital sex, early marriage, unplanned pregnancies, abortion, and sexually transmitted infections, including HIV/AIDS.\u003c/p\u003e\n\u003cp\u003eWhile research in Western and Asian countries suggests a strong link between exposure to sexually explicit content on social media and risky sexual behaviors, there is limited empirical evidence on this topic in Ethiopia. Therefore, this study sought to investigate the benefit and threats of digital \u0026nbsp;social media on youths' sexual and reproductive health in Ethiopia. Understanding the sexual and reproductive health patterns of university students in the digital social Network(DSN) environment and the sociocultural influences on their sexual behaviors could help in developing appropriate intervention for health promotion programs.\u003c/p\u003e"},{"header":"2. LITERATURE REVIEW","content":"\u003cp\u003e2.1 DIGITAL SOCIAL NETWORK \u0026nbsp;UTILISATION AND SEXUAL REPRODUCTIVE HEALTH OF THE YOUTH\u003c/p\u003e\n\u003cp\u003eUniversity students\u0026apos; perceptions and use of DSN regarding their sexual reproductive health are influenced by various factors. Research indicates that youths who are exposed to sexual content on digital social network may come to accept misinformation about consent, which could be harmful(14). However, studies conducted by Suyanto(15) have shown a positive relationship between digital social network exposure and sexual behaviour among the youth. Understanding and addressing university students\u0026apos; behaviour in relation to sexual and reproductive health in the digital age is crucial. It is essential to consider the impact of digital social network exposure, content, and platforms on their attitudes and actions.(16)\u003c/p\u003e\n\u003cp\u003eDigital Social network is\u0026nbsp;the\u0026nbsp;term\u0026nbsp;used\u0026nbsp;to\u0026nbsp;describe\u0026nbsp;human\u0026nbsp;interactions in\u0026nbsp;which\u0026nbsp;individuals build\u0026nbsp;and\u0026nbsp;share\u0026nbsp;information\u0026nbsp;and\u0026nbsp;ideas\u0026nbsp;in\u0026nbsp;online\u0026nbsp;communities\u0026nbsp;and\u0026nbsp;networks.\u0026nbsp;Users can actively share information, create content, cooperate, and communicate with one another through digital media and web-based platforms that are accessible through mobile and computer technology(17). Social networking services allow users to create public or semi-public accounts, which can be linked to other profiles to create a personal network .\u003c/p\u003e\n\u003cp\u003eNew digital technologies that have changed networking, communication, and nature are rapidly changing the planet. It is crucial to comprehend how various people use digital technologies and social media before looking into how they could improve social and health results. Over the past several years, SNSs like Facebook and Instagram have experienced a fantastic surge in popularity and use.\u0026nbsp;In\u0026nbsp;2004,\u0026nbsp;Facebook\u0026nbsp;launched\u0026nbsp;as\u0026nbsp;an\u0026nbsp;online\u0026nbsp;community\u0026nbsp;for\u0026nbsp;students\u0026nbsp;at\u0026nbsp;Harvard University,\u0026nbsp;and\u0026nbsp;since\u0026nbsp;then,\u0026nbsp;it\u0026nbsp;has\u0026nbsp;expanded\u0026nbsp;to\u0026nbsp;become\u0026nbsp;the\u0026nbsp;most\u0026nbsp;widely\u0026nbsp;used\u0026nbsp;social networking\u0026nbsp;platform(3),(19).\u0026nbsp;Youngsters now\u0026nbsp;frequently\u0026nbsp;visit\u0026nbsp;Facebook\u0026nbsp;because\u0026nbsp;of\u0026nbsp;the\u0026nbsp;instantaneousness\u0026nbsp;which\u0026nbsp;it\u0026nbsp;permits online (20),(21).\u003c/p\u003e\n\u003cp\u003eIn 2016, there were 2.34 billion digital social network users worldwide, and 22.9% of the people\u0026nbsp;on\u0026nbsp;the\u0026nbsp;planet\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eutilised\u0026nbsp;it\u0026nbsp;the\u0026nbsp;same\u0026nbsp;year.\u0026nbsp;In\u0026nbsp;comparison\u0026nbsp;to\u0026nbsp;the\u0026nbsp;UK,\u0026nbsp;where\u0026nbsp;the average social media user spent 1.5 hours per day, and in the US, the average daily digital social network user spent 1.7 hours online in 2015(22). In Ethiopia, 23.96 million People used the internet in January 2021. This number increased by 2.8 million (+13%). Furthermore,\u0026nbsp;20.6%\u0026nbsp;of\u0026nbsp;people\u0026nbsp;had\u0026nbsp;access\u0026nbsp;to\u0026nbsp;the\u0026nbsp;internet\u0026nbsp;in\u0026nbsp;January\u0026nbsp;2021,\u0026nbsp;and\u0026nbsp;6.7 million\u0026nbsp;active\u0026nbsp;users\u0026nbsp;of\u0026nbsp;social\u0026nbsp;media\u0026nbsp;users\u0026nbsp;rose\u0026nbsp;by\u0026nbsp;500\u0026nbsp;trillion\u0026nbsp;(+8.1%).\u0026nbsp;For\u0026nbsp;5.8%\u0026nbsp;of the\u0026nbsp;population,\u0026nbsp;mobile\u0026nbsp;connections\u0026nbsp;increased\u0026nbsp;by\u0026nbsp;710\u0026nbsp;trillion\u0026nbsp;(1.6%)\u0026nbsp;to\u0026nbsp;reach\u0026nbsp;44.86 million in 2021 (Digital 2021 Report).\u003c/p\u003e\n\u003cp\u003eDigital Social network users frequently use additional forms of informal social control, such as constructing constrictive normative environments, prohibiting particular actions, and more, to manage sexual activity. According to earlier research, adolescents are more inclined to participate in sexual behaviours if they believe that their friends are doing it(23).\u003c/p\u003e\n\u003cp\u003eThe study of health communications focuses on using communication strategies to\u0026nbsp;enlighten\u0026nbsp;individuals\u0026nbsp;and\u0026nbsp;communities\u0026nbsp;about\u0026nbsp;their\u0026nbsp;health\u0026nbsp;and\u0026nbsp;persuade\u0026nbsp;them\u0026nbsp;to make the best health management decisions. Today\u0026rsquo;s internet world has easy access to health information. Youngsters in Ethiopia are more aware of health issues due to the Internet\u0026apos;s quick development, particularly their digital social network usage (6),(7)\u0026amp;(24).\u003c/p\u003e\n\u003cp\u003eWith\u0026nbsp;the\u0026nbsp;growth\u0026nbsp;and\u0026nbsp;popularity\u0026nbsp;of\u0026nbsp;SNSs,\u0026nbsp;such\u0026nbsp;as\u0026nbsp;Instagram\u0026nbsp;and\u0026nbsp;Facebook,\u0026nbsp;recent data suggests that 92% of youngsters who go online every day, 89% of them are members of at least one digital social networking site, and 88% of them have access to a mobile phone(25) .\u003c/p\u003e\n\u003cp\u003eDigital Mass media, particularly the internet, is one of the most popular ways that young people get sexual information, with an increasing proportion of young people engaging in online pornography. Given that early exposure to pornography is a substantial risk factor for problematic sexual behaviour, early diagnosis of indicators\u0026nbsp;of\u0026nbsp;sexual\u0026nbsp;material\u0026nbsp;intake\u0026nbsp;and\u0026nbsp;exploration\u0026nbsp;of\u0026nbsp;the\u0026nbsp;drivers\u0026nbsp;of\u0026nbsp;this\u0026nbsp;behaviour are critical (26) .\u003c/p\u003e\n\u003cp\u003eRecent studies have found that the internet, in particular, is one of the most popular\u0026nbsp;sources\u0026nbsp;of\u0026nbsp;sexual\u0026nbsp;knowledge\u0026nbsp;for\u0026nbsp;young\u0026nbsp;people,\u0026nbsp;with\u0026nbsp;a\u0026nbsp;growing\u0026nbsp;number\u0026nbsp;of them engaging in online pornography. Early detection of signs of sexual material intake\u0026nbsp;and\u0026nbsp;investigation\u0026nbsp;into\u0026nbsp;the\u0026nbsp;causes\u0026nbsp;of\u0026nbsp;this\u0026nbsp;behaviour\u0026nbsp;is\u0026nbsp;crucial,\u0026nbsp;given\u0026nbsp;that\u0026nbsp;early exposure\u0026nbsp;to\u0026nbsp;pornography\u0026nbsp;is\u0026nbsp;a\u0026nbsp;significant\u0026nbsp;risk\u0026nbsp;factor\u0026nbsp;for\u0026nbsp;problematic\u0026nbsp;sexual\u0026nbsp;conduct (27),(28).\u003c/p\u003e\n\u003cp\u003eYoung people spend an average of nine hours per day connected to media and sending or receiving an average of between 20 and 80 text messages per day. They increasingly use online social networking technologies, such as Facebook, to learn about their peers\u0026rsquo; attitudes and behaviors. These virtual networks influence health behaviors(29).\u003c/p\u003e\n\u003cp\u003eAccording to statistics from the National Adolescence Observatory (2018), over half (54%)\u0026nbsp;of the Italian youth use the internet to check\u0026nbsp;their\u0026nbsp;social\u0026nbsp;accounts, and 94% of them use it to chat with friends. Youngsters often check social media postings\u0026nbsp;at\u0026nbsp;the\u0026nbsp;start\u0026nbsp;and\u0026nbsp;end\u0026nbsp;of\u0026nbsp;the\u0026nbsp;day.\u0026nbsp;Therefore,\u0026nbsp;social\u0026nbsp;media\u0026nbsp;has\u0026nbsp;grown\u0026nbsp;to\u0026nbsp;play a\u0026nbsp;crucial\u0026nbsp;role\u0026nbsp;in\u0026nbsp;the\u0026nbsp;social\u0026nbsp;structure\u0026nbsp;that\u0026nbsp;supports\u0026nbsp;the\u0026nbsp;youngsters\u0026apos;\u0026nbsp;healthy\u0026nbsp;lifestyles(1),(30).\u003c/p\u003e\n\u003cp\u003eAccording to the social network literature on sexual behavior, the current study aimed\u0026nbsp;to\u0026nbsp;determine\u0026nbsp;whether\u0026nbsp;the\u0026nbsp;images\u0026nbsp;shared\u0026nbsp;on\u0026nbsp;social\u0026nbsp;networking\u0026nbsp;sites\u0026nbsp;(SNSs) could influence people\u0026apos;s perceptions of social norms and their intentions towards sexual health behavior. These images act as informational resources on specific sexual practices, potential partners, and often facilitate connections with future sexual partners(9),(31).\u003c/p\u003e\n\u003cp\u003eDigital Social\u0026nbsp;network\u0026nbsp;has\u0026nbsp;legal\u0026nbsp;and\u0026nbsp;ethical\u0026nbsp;issues,\u0026nbsp;even\u0026nbsp;if\u0026nbsp;it\u0026nbsp;can\u0026nbsp;be\u0026nbsp;helpful\u0026nbsp;for\u0026nbsp;students\u0026nbsp;and professionals. When people use social media inappropriately and irresponsibly, they peril themselves, their employers, and organization like tertiary education institutions and healthcare facilities. The inappropriate use of digital social network may also impair one\u0026rsquo;s integrity, nurse-patient connections, nurse-colleague relationships, and present and future employment possibilities (New Zealand Nurses Organization, 2021). Institutions, academic bodies, and teachers should think\u0026nbsp;about\u0026nbsp;privacy\u0026nbsp;and\u0026nbsp;internet\u0026nbsp;security\u0026nbsp;threats\u0026nbsp;while\u0026nbsp;designing\u0026nbsp;digital\u0026nbsp;social network use policies (32) .\u003c/p\u003e\n\u003cp\u003eNew media has sparked a revolution in the medical industry, as clinicians and laypeople alike use digital social network and the internet as resources for delicate medical concerns. Digital Social network usage in health requires more research because of the consequences on the general public\u0026rsquo;s awareness of health issues (27),(28)\u0026amp;(33). Youths balance self-preservation and sexual health discussion on digital social network by navigating the risks and benefits of online platforms. While digital social network can be a valuable tool for sexual and reproductive health education, it also poses risks that need to be addressed through responsible use and effective health education strategies (34) .\u003c/p\u003e"},{"header":"3. METHODS AND MATERIALS","content":"\u003cp\u003e\u003cstrong\u003e3.1 Study setting and population\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research was carried out at three governmental \u0026nbsp;universities within \u0026nbsp;Addis Ababa city administration Addis Ababa Ethiopia were randomly chosen for the study labeled as university(AAU,AASTU and KUE)\u0026nbsp;.The sample is then distributed proportionately to each university's student population to recruit subjects from each faculty. Programme or schools were randomly selected from each faculty, and study subjects were chosen using the lottery technique. The randomly selected students remained in their classes on the day of data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Study design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe descriptive cross-sectional study was conducted among youth at selected three public universities in Addis Ababa city administration, Ethiopia,to examine the impact of digital social network usage on sexual and reproductive health behaviors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4 Inclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe respondents included in this phase of research met the following criteria: registered students at selected universities in the Addis Ababa City Administration, willing to participate voluntarily in the research, ability to read and understand the consent letter to facilitate informed consent, or obtain permission through parental assent, and age greater than 18 years.\u003c/p\u003e\n\u003ch2\u003e3.5 Sample\u0026nbsp;size\u0026nbsp;\u0026amp;\u0026nbsp;sampling\u0026nbsp;procedures\u003c/h2\u003e\n\u003cp\u003eA representative sample is drawn based on sampling criteria, which are defined by Burns and Grove (2009) as qualities that must be present for a person to be considered part of the target population. The sample is drawn from the accessible population within\u0026nbsp;the target\u0026nbsp;group,\u0026nbsp;as these criteria\u0026nbsp;define the target population.\u0026nbsp;This\u0026nbsp;sample\u0026nbsp;consists\u0026nbsp;of\u0026nbsp;individuals\u0026nbsp;present\u0026nbsp;on\u0026nbsp;campus\u0026nbsp;on\u0026nbsp;the\u0026nbsp;specific day and time of the study.\u003c/p\u003e\n\u003cp\u003eThe\u0026nbsp;sample\u0026nbsp;size\u0026nbsp;is\u0026nbsp;determined\u0026nbsp;by\u0026nbsp;using\u0026nbsp;a\u0026nbsp;single\u0026nbsp;proportion\u0026nbsp;for\u0026nbsp;a\u0026nbsp;finite\u0026nbsp;population, with assumptions of 95% confidence level, marginal error (d) of 5%, and the prevalence (P) of 50%\u003c/p\u003e\n\u003cp\u003eThe\u0026nbsp;sample\u0026nbsp;size\u0026nbsp;(n)\u0026nbsp;is\u0026nbsp;calculated\u0026nbsp;according\u0026nbsp;to\u0026nbsp;the\u0026nbsp;formula n= {z2\u0026nbsp;* p * (1 - p) / e2] / [1 + (z2\u0026nbsp;* p * (1 - p) / (e2\u0026nbsp;* N))]\u003c/p\u003e\n\u003cp\u003eWhere: z\u0026nbsp;= 1.96\u0026nbsp;for a\u0026nbsp;confidence level (α) of 95%, p =\u0026nbsp;proportion (expressed\u0026nbsp;as a decimal)\u003c/p\u003e\n\u003cp\u003eN\u0026nbsp;=\u0026nbsp;population size, e\u0026nbsp;=\u0026nbsp;margin of error\u003c/p\u003e\n\u003cp\u003ez\u0026nbsp;=\u0026nbsp;1.96,\u0026nbsp;p\u0026nbsp;=\u0026nbsp;0.5,\u0026nbsp;N\u0026nbsp;=40940\u0026nbsp;e\u0026nbsp;= 0.05\u003c/p\u003e\n\u003cp\u003en\u0026nbsp;≈413\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.6 Data\u0026nbsp;collection\u0026nbsp;instrument\u0026nbsp;and procedure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData collection involves a series of interconnected steps aimed at gathering information to answer the research questions. Structured self-reports are frequently used as data-collection tools in quantitative research. For this study, data were collected using a pretested semi-structured self- administered questionnaire. The questionnaire included social media questions adapted\u0026nbsp;from\u0026nbsp;the\u0026nbsp;Pew\u0026nbsp;Internet\u0026nbsp;Project's\u0026nbsp;Teen\u0026nbsp;Survey,\u0026nbsp;as\u0026nbsp;well\u0026nbsp;as\u0026nbsp;sexual\u0026nbsp;behaviour questions\u0026nbsp;adapted\u0026nbsp;from\u0026nbsp;the\u0026nbsp;US\u0026nbsp;Department\u0026nbsp;of\u0026nbsp;Health\u0026nbsp;and\u0026nbsp;Human\u0026nbsp;Services\u0026nbsp;Office of Adolescent Health and the CDC Youth Risk Behaviour Surveillance Survey.\u0026nbsp;Additionally,\u0026nbsp;vast\u0026nbsp;literature\u0026nbsp;sources\u0026nbsp;were\u0026nbsp;reviewed\u0026nbsp;to\u0026nbsp;refine\u0026nbsp;the instrument\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.7 Data\u0026nbsp;quality\u0026nbsp;assurance\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe\u0026nbsp;study's\u0026nbsp;data\u0026nbsp;quality\u0026nbsp;was\u0026nbsp;ensured\u0026nbsp;throughout\u0026nbsp;the\u0026nbsp;study\u0026nbsp;period,\u0026nbsp;beginning\u0026nbsp;with\u0026nbsp;the\u0026nbsp;design\u0026nbsp;phase of the data gathering technique. During the preparation phase, the ease with which the questions could be understood and the importance of\u0026nbsp;the variables in the study\u0026nbsp;were assessed, followed by pretesting\u0026nbsp;and,\u0026nbsp;based\u0026nbsp;on\u0026nbsp;the\u0026nbsp;results,\u0026nbsp;adjustments\u0026nbsp;to\u0026nbsp;the\u0026nbsp;questionnaire.\u0026nbsp;Before\u0026nbsp;beginning\u0026nbsp;the\u0026nbsp;actual data collection, data collectors and the supervisor were given training in data collection, classification, and coding. On a daily basis during data collection, the designated supervisor checked the collected data for completeness, accuracy, and clarity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.8 Data analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData\u0026nbsp;was\u0026nbsp;entered\u0026nbsp;into\u0026nbsp;the\u0026nbsp;EPI\u0026nbsp;INFO\u0026nbsp;program\u0026nbsp;version\u0026nbsp;3.5.1,\u0026nbsp;processed\u0026nbsp;with\u0026nbsp;the\u0026nbsp;statistical\u0026nbsp;package for social sciences (SPSS) 27, and displayed in tables and graphs.Both\u0026nbsp;descriptive\u0026nbsp;and inferential\u0026nbsp;statistics\u0026nbsp;were\u0026nbsp;used\u0026nbsp;in\u0026nbsp;the\u0026nbsp;study \u0026nbsp;Additionally,\u0026nbsp;two- way\u0026nbsp;frequency\u0026nbsp;tables\u0026nbsp;were\u0026nbsp;calculated\u0026nbsp;to\u0026nbsp;determine\u0026nbsp;if\u0026nbsp;the\u0026nbsp;respondents'\u0026nbsp;views\u0026nbsp;were influenced by their biographical characteristics.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3 .9 Ethics\u0026nbsp;approval\u0026nbsp;and consent\u0026nbsp;to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe UNISA’s College of human science research \u0026nbsp;Research Ethical review Committee (CREC,ref. 10206019-CREC-CHS-2023) granted the research clearance, and permission letter to conduct the study from the three public universities (PRT/LT-182/15/23,A/A13843/227/15 and Unisa-ET/KA/ST/29/31-05-23) was obtained from each university’s research ethical committee. The following basic ethical principles were applied to this research: principle of autonomy, fairness, beneficence, and non-maleficence for the participants, institution, and researcher (Polit \u0026amp; Beck, 2018: 134).Prior to data collection, a letter of permission was given to and accepted by the Addis Ababa Health Bureau,(A/A/13843/227 ) the purpose and procedure for data collection were clarified, and confidentiality and privacy were guaranteed. All participants provided verbal informed consent and were informed that their participation was entirely voluntary\u003c/p\u003e"},{"header":"4. RESULTS","content":"\u003cp\u003e\u003cstrong\u003e4.1 DEMOGRAPHIC PROFILE OF THE RESPONDANTS\u0026nbsp;\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe sociodemographic data included the respondents\u0026apos; age, gender, study program, and university. A total of 413 university students participated in the survey, but only 393 returned the questionnaire, resulting in a 95.3% response rate and a 4.8% non-response rate. The majority of the respondents (87.0%) were enrolled in undergraduate programs, while 51 (13.0%) were enrolled in postgraduate programs. Most of the respondents (265) (67.4%) were male, while 128 (32.6%) were female, and the median age of the respondents was 21, with an average mean age of 21.5 (+2.2 SD) years.348 (88.5%) lived in dormitories, while a few (45) (11.5%) lived off-campus (as shown in table 4.1). Most of the parents of the youths who participated in the study were college or university graduates. Seventy-four (18.8%) of the participants had parents with no formal education, 67 (17.0%) had parents with primary school education, 42 (10.7%) had parents with completed secondary education, and 54 (13.7%) had parents who attended high school. Additionally, 156 (39.7%) of the participants\u0026apos; parents have a diploma or higher qualification as summarized\u003cem\u003e\u0026nbsp;(\u003c/em\u003e\u003cem\u003eTable 1\u003c/em\u003e\u003cem\u003e)\u003c/em\u003e below\u003c/p\u003e\n\u003cp\u003eTable 1: Socio-demographic characteristics of respondents \u0026nbsp;in public universities Addis Ababa, Ethiopia,2023 (N=393)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAAU (N=218)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAASTU(N=75)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKUE(N=100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal(N=393)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e69.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e96.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e41.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e265\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e67.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eF\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e30.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e59.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e32.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e218\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e393\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e18-20yrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e40.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e5.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e23.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e21-22yrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e29.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e56.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e55.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e162\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e41.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e23-24yrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e11.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e34.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e38.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e22.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e25+yrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e18.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e9.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e218\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e393\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cbr\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePaternal Educational status\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;formal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e21.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e13.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e18.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003ePrimary school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e18.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eSecondary\u0026nbsp;school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e11.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e18.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e9.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e10.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e15.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e22.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e9.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e13.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eUniversity/college\u003c/p\u003e\n \u003cp\u003egraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e32.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e25.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e51.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e156\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e39.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e218\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e393\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of residence\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eDormitory\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e177\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e78.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e98.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e97.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e348\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e88.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eOff dormitory\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e21.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e11.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003eTotal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6px;\"\u003e\n \u003cp\u003e218\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 11px;\"\u003e\n \u003cp\u003e393\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.2 TYPES AND FREQUENCY OF DIGITAL SOCIAL NETWWORK USE\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe importance of the type and frequency of DSN lies in the significant amount of sexual information posted on these platforms. This exposes young people to risky sexual activities that can have serious implications that influence their psychological views and thoughts towards sex. Additionally, as most students spend hours conversing and engaging in unproductive activities on digital social network, their attitudes towards academic activities are deteriorating . In this study the most utilized digital social network platforms by the respondents were Telegram (268) (68.2%) (AOR=1.358), Facebook (52) (13.2%), YouTube (38) (9.2%), and TikTok (20)(5.1%). Instagram, WhatsApp, and Twitter were used by 2.0%, 1.3%, and 0.5%, respectively, as shown in \u003cem\u003e(\u003c/em\u003e\u003cem\u003eFigure 1\u003c/em\u003e)\u003c/p\u003e\n\u003cp\u003eRegarding the frequency of digital social network use by the respondents, the majority (186) (47.3%) reported using it several times a day (AOR=2.250). Additionally, 121 (30.8%) said they used it almost constantly every other day, 52 (13.2%) used it once a day, and the remaining 17 (4.3%) used it once a week or less often. Male respondents reported more frequent use (46%) compared to female respondents (9.4%), as summarised in \u003cem\u003e\u0026nbsp;(\u003c/em\u003e\u003cem\u003e\u003cstrong\u003eFigure 2\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4.3 BENEFITS AND RISKS OF DIGITAL SOCIAL NETWORK\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRegarding the impact of digital social network on youths, more than half of the respondents (180) (45.8%)\u0026nbsp;reported\u0026nbsp;harmful\u0026nbsp;effects\u0026nbsp;(AOR=1.576),\u0026nbsp;while\u0026nbsp;168\u0026nbsp;(43.0%)\u0026nbsp;reported\u0026nbsp;beneficial effects for the youth. The remaining 40 (10.2%) and four (1%) reported neither negative nor positive effects, which deemed it not important for the youths\u0026apos; sexual and reproductive health. The majority of the respondents use digital social network for communication with friends and family (26.9%), and for obtaining health information. The remaining respondents mentioned using it to meet people with similar interests (24.1%), find happiness and for entertainment.(22.1%)\u003c/p\u003e\n\u003cp\u003eRegarding the risks of digital social network, the majority of the respondents expressed concerns about\u0026nbsp;harmful\u0026nbsp;relationships\u0026nbsp;and\u0026nbsp;communication\u0026nbsp;(29.7%)\u0026nbsp;(AOR=1.191),\u0026nbsp;early\u0026nbsp;initiation of sexual intercourse (26.1%) (AOR=1.51), encouraging peer pressure (23.4%), encouraging multiple sexual partners (20.8%), and spreading rumour s. This is summarized by \u003cem\u003e(\u003c/em\u003e\u003cstrong\u003e\u003cem\u003eTable 2\u003c/em\u003e\u003c/strong\u003e)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e2\u003c/strong\u003e Multiple \u0026nbsp;responses of the respondents regarding the benefits and risks of digital social Network information \u0026nbsp;Addis Ababa, Ethiopia ,2023\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResponse\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eThe\u0026nbsp;benefit\u0026nbsp;of\u0026nbsp;DSN in\u0026nbsp;terms of SRH\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eCommunication\u0026nbsp;with\u0026nbsp;friends\u0026nbsp;and families\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e25.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e29.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e26.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eGetting\u0026nbsp;sexual\u0026nbsp;reproductive\u0026nbsp;health information\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e27.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e25.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e26.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eMeeting\u0026nbsp;people\u0026nbsp;with\u0026nbsp;similar interests\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e24.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e22.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e24.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eFinding\u0026nbsp;happiness\u0026nbsp;and entertainment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e23.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e22.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e22.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e453\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRisks\u0026nbsp;of\u0026nbsp;DSN\u0026nbsp;use\u0026nbsp;stated\u0026nbsp;by\u0026nbsp;the students\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 61px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eHaving\u0026nbsp;multiple\u0026nbsp;partners\u0026nbsp;and\u0026nbsp;rumor-spreading\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e18.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e22.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e20.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eHarmful\u0026nbsp;relationships\u0026nbsp;and communication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e30.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e25.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e29.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eInitiation\u0026nbsp;of\u0026nbsp;early\u0026nbsp;sexual desire\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e28.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e19.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e26.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003epeer\u0026nbsp;pressure influences\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e27.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e32.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e23.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e280\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e469\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e4.4 RELATIONSHIP\u0026nbsp;BETWEEN\u0026nbsp;THE\u0026nbsp;IMPORTANT\u0026nbsp;VARIABLES\u0026nbsp;IN\u0026nbsp;THIS\u0026nbsp;STUDY\u003c/h2\u003e\n\u003cp\u003eIn order to demonstrate a strong relationship between two variables, it is important to use statistical techniques that accurately reflect the type and strength of the relationship.\u0026nbsp;Different\u0026nbsp;strategies\u0026nbsp; \u0026nbsp;can\u0026nbsp;be\u0026nbsp;employed,\u0026nbsp;depending\u0026nbsp;on\u0026nbsp;the\u0026nbsp;type\u0026nbsp;of data\u0026nbsp;and the nature of the relationship . These techniques offer unique insights into the relationship between variables, which range from correlation coefficients to more complex statistical models. The frequency of using digital networks, a lack of knowledge, or inadequate education on sexuality and sexual reproductive health issues, and their correlation to the risk of engaging in sexual behaviour, were all significant factors in this study.\u003c/p\u003e\n\u003cp\u003eIn this study, a relationship exists between family education level and various factors related to DSN usage and sexual and reproductive health problems. Family education level was found to be negatively correlated with the frequency of DSN usage and sexual\u0026nbsp;reproductive\u0026nbsp;health\u0026nbsp;problems,\u0026nbsp;with\u0026nbsp;correlation\u0026nbsp;coefficients\u0026nbsp;of\u0026nbsp;-0.230\u0026nbsp;and\u0026nbsp;-0.207, respectively, at a 95% confidence interval. On the other hand, the respondents\u0026apos; DSN usage showed a positive correlation with watching films about sexual activity and a negative correlation with receiving SRH services at a university, with correlation coefficients\u0026nbsp;of\u0026nbsp;0.230\u0026nbsp;and -0.188,\u0026nbsp;respectively.\u0026nbsp;Furthermore,\u0026nbsp;pornographic\u0026nbsp;images\u0026nbsp;and films\u0026nbsp;depicting\u0026nbsp;sexual\u0026nbsp;activity\u0026nbsp;were\u0026nbsp;positively\u0026nbsp;correlated\u0026nbsp;with\u0026nbsp;the\u0026nbsp;respondents\u0026apos;\u0026nbsp;histories of engaging in sexual activity and experiencing reproductive issues, with correlation coefficients of 0.263 and 0.206, respectively, at a 95% confidence interval.\u0026nbsp;The study also revealed a positive correlation between viewing pornographic images and films depicting sexual activity and the respondents\u0026apos; histories of engaging in sexual activity and\u0026nbsp;experiencing\u0026nbsp;reproductive\u0026nbsp;issues,\u0026nbsp;with\u0026nbsp;correlation\u0026nbsp;coefficients\u0026nbsp;of\u0026nbsp;0.263\u0026nbsp;and\u0026nbsp;0.206, respectively\u003c/p\u003e\n\u003cp\u003eLogistic regression was conducted to determine how the frequency of digital social network usage and the absence of sexual reproductive health-related courses in university affect the students\u0026apos; likelihood of engaging in risky sexual activity. A total of 393 students were included in the analysis. The model accounted for 48% of the variability in risky sexual behaviour and accurately classified 58% cases. For each additional increase in the frequency of digital social network use, there was a 2.266 increase in the odds of students engaging in risky sexual practices. Additionally, the absence of sexual and reproductive health courses in a university is associated with a 13% increase in the likelihood of viewing sexual films, with 55% of the cases correctly classified. Furthermore, each additional increase in digital social network usage frequency was linked to a 1.655 increase in the odds of the youth engaging in sexual intercourse. This is summarized in (\u003cstrong\u003eTable 3\u003c/strong\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e3\u003c/strong\u003e Crude and adjusted odds ratio from logistic regression of factors associated with risky sexual and reproductive health practice among public university students \u0026nbsp;Addis Ababa Ethiopia ,2023 \u0026nbsp;(N=393)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"99%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRisky\u0026nbsp;sexual reproductive\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003ehealth\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCOR(95%CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAOR(95%CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePaternal\u0026nbsp;educational\u0026nbsp;level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 17px;\"\u003e\n \u003cp\u003eNo formal\u0026nbsp;education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e39(52.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e35(47.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e2.737(1.396-5.365)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.604(0.275-0.922)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eP\u0026lt;0.003*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 17px;\"\u003e\n \u003cp\u003ePrimary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e42(62.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e25(37.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e2.632(1.256-5.523)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.840(0.39-1.788)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eP\u0026lt;0.01\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 17px;\"\u003e\n \u003cp\u003eSecondary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e30(71.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e12(28.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e1.768(.984-3.178)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.543(0.211-1.350)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eP\u0026lt;0.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 17px;\"\u003e\n \u003cp\u003ehigh\u0026nbsp;school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e39(72.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e15(27.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e1.173(.674-2.041)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.558(0.25-1.235)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eP\u0026lt;0.572\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 17px;\"\u003e\n \u003cp\u003eUniversity/college graduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e76(48.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e80(51.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDigital Social\u0026nbsp;network\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003eUsed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 10px;\"\u003e\n \u003cp\u003e173(63.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e101(36.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e2.133(1.378-3.302)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.476(0.271-0.836)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eP\u0026lt;001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003eNot\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 10px;\"\u003e\n \u003cp\u003e53(44.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e66(55.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSexual\u0026nbsp;inflicting pictures\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003eAccessed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 10px;\"\u003e\n \u003cp\u003e45(72.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e17(27.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e0.456(0.251-0.829)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.329(0.150-0.724)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eP\u0026lt;006*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003eNot\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 10px;\"\u003e\n \u003cp\u003e181(54.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e150(45.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSeen\u0026nbsp;pornographic films\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 10px;\"\u003e\n \u003cp\u003e121(70.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e51(29.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e1.063(0.858-2.084)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.382(0.251-0.581)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eP\u0026lt;000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 10px;\"\u003e\n \u003cp\u003e105(47.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e116(52,5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePeer pressure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 10px;\"\u003e\n \u003cp\u003e191(61.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e122(39.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e2.618(1.181-5.807)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.473(0.254-0.881)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eP\u0026lt;018\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 10px;\"\u003e\n \u003cp\u003e20(42.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e27(57.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 19px;\"\u003e\n \u003cp\u003eExperience course\u0026nbsp;attending/service of SRH in university\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003eAttended\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 10px;\"\u003e\n \u003cp\u003e65(74.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e22(25.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003eNot\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 10px;\"\u003e\n \u003cp\u003e161(52.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e145(57.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e0376(0.221-0.640)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e0.422(0.221-0.805)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10px;\"\u003e\n \u003cp\u003eP\u0026lt;009*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"5. DISCUSSION","content":"\u003cp\u003e5.1 HIGH RELIANCE ON DIGITAL SOCIAL MEDIA FOR SEXUAL AND REPRODUCTIVE HEALTH \u0026nbsp;INFORMATION\u003c/p\u003e\n\u003cp\u003eDigital Social network, especially among young people, is becoming an increasingly important source of information on SRH.\u0026nbsp;This trend is mainly driven by digital social network platforms due to their\u0026nbsp;accessibility\u0026nbsp;and ease\u0026nbsp;of use which offer\u0026nbsp;a wide range of information that is\u0026nbsp;often not available through more traditional methods. However, the reliability and accuracy of this information can vary greatly, leading to potential misinformation and health risks(35).\u003c/p\u003e\n\u003cp\u003eIn this study, 97.5% of the students use various social media sites, and 71.6% believe that digital social network provides\u0026nbsp;reliable\u0026nbsp;information\u0026nbsp;on\u0026nbsp;SRH.\u0026nbsp;However,\u0026nbsp;they\u0026nbsp;do\u0026nbsp;not\u0026nbsp;know\u0026nbsp;the\u0026nbsp;source\u0026nbsp;of this information.\u0026nbsp;A\u0026nbsp;small percentage (8.4%) reported using social media to view sexually explicit content, which is strongly associated with sexual and reproductive health (AOR=0.456;\u0026nbsp;95%\u0026nbsp;CI\u0026nbsp;0.25\u0026nbsp;to\u0026nbsp;0.829).\u0026nbsp;Additionally,\u0026nbsp;the\u0026nbsp;majority\u0026nbsp;of\u0026nbsp;the\u0026nbsp;respondents\u0026nbsp;reported using digital social network several times a day, with the most commonly used digital social network platforms\u0026nbsp;being\u0026nbsp;Telegram\u0026nbsp;(AOR=1.358)\u0026nbsp;and\u0026nbsp;Facebook,\u0026nbsp;which\u0026nbsp;is\u0026nbsp;strongly\u0026nbsp;associated\u0026nbsp;with sexual and reproductive health risks (AOR=2.13; 95% CI 1.378 to 3.302). This is similar to recent research statistics which suggest that 92% of adolescents go online daily, 89% belong to at least one social networking site, and 88% have access to a cell phone (36).\u0026nbsp;Recent\u0026nbsp;studies\u0026nbsp;conducted\u0026nbsp;in\u0026nbsp;northern\u0026nbsp;and southern\u0026nbsp;Nigeria\u0026nbsp;found\u0026nbsp;that\u0026nbsp;98.4%\u0026nbsp;had\u0026nbsp;accessed\u0026nbsp;the\u0026nbsp;internet.\u0026nbsp;Of\u0026nbsp;these,\u0026nbsp;96.3%\u0026nbsp;had\u0026nbsp;visited digital social network sites and 99.3% accessed the internet.Iliyasu, Mohammed and\u0026nbsp; Dipeolu \u0026nbsp; support this finding.(37),(38). The studies conducted at universities in Ethiopia show that 91.3% of the respondents at Madda\u0026nbsp;Walabu University were reported as digital social network users in the country(29),(39).\u0026nbsp;Additionally,\u0026nbsp;87.5%\u0026nbsp;of students\u0026nbsp;at\u0026nbsp;Oda\u0026nbsp;Bultum University have access to various digital social network accounts(40). This percentage is slightly lower than the study finding of 92.1% vs. 87.5%, which may be attributed to the universities\u0026apos; locations, which are far from the centre of Ethiopia, leading to inadequate internet access. findings of this study are similar to those of a study conducted at a private university in southern Nigeria.\u003c/p\u003e\n\u003cp\u003eAlmost equal numbers of respondents used digital social network, with 72.7% accessing news, 63.6% for academics, and 6.5% for sexually explicit content (7),(41).\u0026nbsp;However, there was\u0026nbsp;a difference\u0026nbsp;in\u0026nbsp;the\u0026nbsp;use\u0026nbsp;for\u0026nbsp;watching\u0026nbsp;sexually\u0026nbsp;explicit\u0026nbsp;content,\u0026nbsp;with\u0026nbsp;8.4%\u0026nbsp;vs.\u0026nbsp;6.5%,\u0026nbsp;which\u0026nbsp;may be attributed to the sample size of the study.\u003c/p\u003e\n\u003cp\u003eA study in Ethiopia by Bayleyegn and Buta (2019). supported that students used social media for non-academic issues (53.5%), academic issues (44.64%), and exchanging sexually related video content (10.7%). Male respondents used DSN more frequently than female respondents (76.1% vs. 23.9%).\u003c/p\u003e\n\u003cp\u003eA\u0026nbsp;recent\u0026nbsp;survey\u0026nbsp;at\u0026nbsp;Raya\u0026nbsp;University\u0026nbsp;in\u0026nbsp;Ethiopia\u0026nbsp;contradicted\u0026nbsp;this\u0026nbsp;finding,\u0026nbsp;showing\u0026nbsp;that\u0026nbsp;53% of\u0026nbsp;female\u0026nbsp;students\u0026nbsp;spent\u0026nbsp;two\u0026nbsp;to\u0026nbsp;three\u0026nbsp;hours\u0026nbsp;a\u0026nbsp;day\u0026nbsp;on\u0026nbsp;digital\u0026nbsp;social network for\u0026nbsp;entertainment\u0026nbsp;rather than academic goals (42). The study at Wollo University showed that the majority\u0026nbsp;of\u0026nbsp;the\u0026nbsp;students\u0026nbsp;used digital \u0026nbsp;social network platforms\u0026nbsp;like\u0026nbsp;Telegram,\u0026nbsp;Facebook,\u0026nbsp;Email,\u0026nbsp;and YouTube for teaching and learning (25)(43). However, studies by Bayleyegn and Buta (2019) (85.7% vs. 60.7%), Wanamo, Abadir (2021) (69.8% vs. 60.7%), and Lisanu (2020) contradicted this, suggesting that many students preferred using\u0026nbsp;Facebook\u0026nbsp;for\u0026nbsp;educational\u0026nbsp;purposes.\u0026nbsp;This\u0026nbsp;difference\u0026nbsp;may\u0026nbsp;be\u0026nbsp;due\u0026nbsp;to\u0026nbsp;institutional\u0026nbsp;and personal variations in the students\u0026apos; preferences for digital social network platforms on campus.Earlier research in Ethiopia among university and secondary school students found that having\u0026nbsp;a\u0026nbsp;nearby\u0026nbsp;health\u0026nbsp;facility\u0026nbsp;and\u0026nbsp;discussing\u0026nbsp;SRH\u0026nbsp;with\u0026nbsp;friends\u0026nbsp;and\u0026nbsp;family\u0026nbsp;were\u0026nbsp;important predictors\u0026nbsp;of\u0026nbsp;service\u0026nbsp;consumption.\u0026nbsp;Many\u0026nbsp;students\u0026nbsp;turned\u0026nbsp;to\u0026nbsp;the digital social network to\u0026nbsp;learn\u0026nbsp;about\u0026nbsp;SRH(25),(44).\u003c/p\u003e\n\u003cp\u003eThis study revealed that 68.2% of the students easily accessed sexual and reproductive health\u0026nbsp;information\u0026nbsp;from\u0026nbsp;digital social network,\u0026nbsp;and\u0026nbsp;71.6%\u0026nbsp;believed\u0026nbsp;that digital social network provided\u0026nbsp;reliable\u0026nbsp;information about\u0026nbsp;SRH,\u0026nbsp;although\u0026nbsp;they\u0026nbsp;were\u0026nbsp;unsure\u0026nbsp;about\u0026nbsp;reputable\u0026nbsp;sites.\u0026nbsp;Similarly,\u0026nbsp;in\u0026nbsp;Ethiopia,\u0026nbsp;most students\u0026nbsp;preferred\u0026nbsp;receiving\u0026nbsp;SRH\u0026nbsp;information\u0026nbsp;from\u0026nbsp;digital\u0026nbsp;mass\u0026nbsp;media\u0026nbsp;(57.1%),\u0026nbsp;followed\u0026nbsp;by\u0026nbsp;peer educators (28.2%), and close friends (26.8%)(45). The internet was the most accessed source for SRH information (34),(46).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e5.2 INFLUENCE\u0026nbsp;OF\u0026nbsp;DIGITAL\u0026nbsp;SOCIAL NETWORK ON\u0026nbsp;SEXUAL BEHAVIOURS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDigital social network has a significant influence on individuals\u0026apos; sexual behaviour, particularly among adolescents and young adults. The exposure to unregulated and often explicit content on these platforms can shape sexual attitudes and behavior, leading to both positive and negative outcomes.\u0026nbsp;While social media can offer sexual health information, it also poses risks by promoting risky sexual behaviors through exposure to inappropriate content.(47).\u003c/p\u003e\n\u003cp\u003eThis study shows that students enrolled in undergraduate programme are associated with\u0026nbsp;sexual\u0026nbsp;and\u0026nbsp;reproductive\u0026nbsp;risk\u0026nbsp;(AOR=0.93;\u0026nbsp;95%\u0026nbsp;CI\u0026nbsp;0.33\u0026nbsp;to\u0026nbsp;1.265).\u0026nbsp;This\u0026nbsp;finding\u0026nbsp;is\u0026nbsp;consistent with a similar\u0026nbsp;study\u0026nbsp;conducted\u0026nbsp;at\u0026nbsp;Adekunle\u0026nbsp;Ajasin University. Observations\u0026nbsp;over\u0026nbsp;the\u0026nbsp;past decade suggest a significant increase in the proportion of undergraduate students engaging in sexual activity during their time at the university(48).Young people whose parents had no formal education are significantly linked to sexual reproductive\u0026nbsp;risk\u0026nbsp;(AOR=2.737;\u0026nbsp;95%\u0026nbsp;CI\u0026nbsp;1.396\u0026nbsp;to\u0026nbsp;5.365)\u0026nbsp;compared\u0026nbsp;to\u0026nbsp;those\u0026nbsp;whose\u0026nbsp;parents had a high level of education.\u003c/p\u003e\n\u003cp\u003eA\u0026nbsp;comparable study done in Vietnam on higher education institutional students revealed that the parents\u0026apos; educational level is indirectly associated with sexual reproductive risk.An educated\u0026nbsp;family decreases the risk of sexual reproductive health (AOR=1.7;\u0026nbsp;95% CI) (21),(49).\u003c/p\u003e\n\u003cp\u003eIn this study, half of the respondents (45.8%) reported experiencing harmful effects of DSN (AOR=1.576), while 43% found it beneficial for youths. The reasons cited for the risks\u0026nbsp;of digital social network included\u0026nbsp;harmful\u0026nbsp;relationships\u0026nbsp;and\u0026nbsp;communication\u0026nbsp;(29.75%),\u0026nbsp;early\u0026nbsp;initiation of sexual intercourse (26.1%), encouragement of peer pressure (23.4%), promotion of multiple sexual partners, and spreading rumours (20.8%).\u0026nbsp;Additionally, the respondents mentioned that digital social network is important for communication with friends and family (26.9%), obtaining health information (27%), and meeting people with similar interests for happiness and entertainment (24.1% and 22.1%, respectively).\u003c/p\u003e\n\u003cp\u003eEven though some studies have suggested that digital social network may negatively impact young adults\u0026apos;\u0026nbsp;sexual\u0026nbsp;behaviour,\u0026nbsp;there\u0026nbsp;are\u0026nbsp;advantages\u0026nbsp;to\u0026nbsp;digital social network\u0026nbsp;for\u0026nbsp;adolescents\u0026nbsp;and\u0026nbsp;young\u0026nbsp;people in terms of providing essential information on sexual health and healthy relationships (50).\u0026nbsp;digital socialo network\u0026nbsp;platforms\u0026nbsp;often\u0026nbsp;include sex-related content that is not thoroughly researched or education-focused.\u0026nbsp;The internet can randomly direct visitors to unhealthy, purely entertainment-oriented, and sexually explicit websites even when not requested(7),(51).\u003c/p\u003e\n\u003cp\u003eA recent study conducted in Ethiopia supported the benefits of DSN for school assignments\u0026nbsp;(20%),\u0026nbsp;making\u0026nbsp;new\u0026nbsp;friends\u0026nbsp;(25%),\u0026nbsp;and\u0026nbsp;using\u0026nbsp;digital\u0026nbsp;social\u0026nbsp;network\u0026nbsp;for\u0026nbsp;entertainment (55%)(52). This suggests that most adolescents in the survey are aware of the benefits of DSN for youth reproductive health information. However, 45.8% reported the harmful effects of digital social network. This aligns with the findings of Kunnuji (2012), who revealed that 44% of students using digital social network had unintentionally accessed websites with sexual content, while 46% admitted to engaging in sexual activities, including viewing pornography online and participating in sexually stimulating acts.\u003c/p\u003e\n\u003cp\u003eThis\u0026nbsp;study\u0026nbsp;found that\u0026nbsp;nearly\u0026nbsp;an equal\u0026nbsp;number\u0026nbsp;of the respondents reported seeing\u0026nbsp;sexual activity films and pornography on DSN (52.4% vs. 43.8%), which is strongly associated with sexual reproductive health risk (AOR=0.333; 95% CI 0.22 to 0.509 vs.\u0026nbsp;AOR=1.063; 95% CI 0.838 to 2.934).The majority of the participants stated that the risks associated with DSN include negative health consequences related to sleep, as well as relational risks such as sexting, bullying, unwanted predation, and engaging with risky sexual partners.\u003c/p\u003e\n\u003cp\u003eA study in India revealed that one of the most common ways that young people obtain sexual knowledge is through digital mass media, especially DSN, where a growing percentage are using online pornography, which is a significant risk factor for unhealthy sexual behaviour(53). Another study in Hawassa, Ethiopia, showed that overall exposure to sexually explicit materials in school youths was 77.2%. (2)(39),(54). These variations could be explained by differences in methodologies, study subjects, sampling procedures, and data collection techniques.\u003c/p\u003e"},{"header":"6. CONCLUSION","content":"\u003cp\u003eThe study found a gap in sexual and reproductive health information for youths in Ethiopian universities. University students lacked knowledge about sexual health services and the risks of digital social network, leading to risky behaviour like unprotected sex. There was a link between using digital social network for explicit content and engaging in risky sexual activities. Limited access to SRH services on campus further increased the risk of sexual health issues.\u0026nbsp;\u003c/p\u003e"},{"header":"7. RECOMMANDATION","content":"\u003cp\u003eBased on the findings of the study, recommendation suggested for the following institution; Ministry of Education, university administrators, instructors, and health professionals within the university unit.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eA review and update of the current approach to delivering Youth Sexual and Reproductive Health (YSRH) education should focus on minimizing the risks of digital social network \u0026nbsp;while maximizing its benefits.\u003c/li\u003e\n \u003cli\u003eThe educational curriculum should be revised to include credit hours for YSRH theory and practice as well as digital social network ethics.\u003c/li\u003e\n \u003cli\u003eEducational sessions on healthy digital social network \u0026nbsp;usage should be conducted for teachers, along with training on addressing behaviour changes that may lead to risky sexual behaviour.\u003c/li\u003e\n \u003cli\u003eProvide\u0026nbsp;opportunities\u0026nbsp;for\u0026nbsp;new\u0026nbsp;university\u0026nbsp;students\u0026nbsp;to\u0026nbsp;receive\u0026nbsp;training on digital social network information usage and sexual and reproductive health services.\u003c/li\u003e\n \u003cli\u003eEngage in activities and events at universities, youth centers, media outlets, and religious organizations to promote Youth Sexual and Reproductive Health (YSRH) services.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"8. LIMITATION OF THE STUDY","content":"\u003cp\u003eThe study was conducted in Addis Ababa, the capital city of Ethiopia, which has the highest internet coverage including 5G. The focus was on three public universities in Addis Ababa, which may not represent universities in other areas. The qualitative findings from the study may not apply to other higher institutions.\u003c/p\u003e"},{"header":"9. FURTHER RESEARCH","content":"\u003cp\u003eThe researcher suggests in depth multistage \u0026nbsp;research will be conducted on using digital social network for sexual and reproductive health services in urban and rural universities and.educational institutions need to assess readiness for offering youth sexual and reproductive health services, emphasizing digital social network use.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eAAU:\u003c/strong\u003e Addis Ababa University \u003cstrong\u003eAASTU\u003c/strong\u003e: Addis Ababa Science and Technology University \u003cstrong\u003eAIDS:\u003c/strong\u003e Acquired Immune Deficiency Syndrome \u003cstrong\u003eBMC:\u003c/strong\u003e Bio-med Central \u003cstrong\u003eCDC\u003c/strong\u003e: Central Disease Control \u003cstrong\u003eDHS\u003c/strong\u003e: Demographic Health Survey \u003cstrong\u003eDSN:\u0026nbsp;\u003c/strong\u003eDigital social network, \u0026nbsp;\u003cstrong\u003eFMOE\u003c/strong\u003e: Federal Ministry of Education \u003cstrong\u003eFMOH:\u003c/strong\u003e Federal Ministry of Health,\u003cstrong\u003e\u0026nbsp;HIV:\u0026nbsp;\u003c/strong\u003eHuman Immune Deficiency Virus, \u003cstrong\u003eIEC:\u0026nbsp;\u003c/strong\u003eInformation, Education, and Communication \u003cstrong\u003eKUE:\u0026nbsp;\u003c/strong\u003eKotebe University of Education ,\u003cstrong\u003eRH:\u0026nbsp;\u003c/strong\u003eReproductive Health \u003cstrong\u003eSRH\u003c/strong\u003e: Sexual and Reproductive Health \u0026nbsp;\u003cstrong\u003eSTIs:\u003c/strong\u003e Sexually Transmitted Infections \u003cstrong\u003eUNAIDS:\u003c/strong\u003e United Nations Program on HIV and AIDS\u003cstrong\u003e\u0026nbsp;UNICEF\u003c/strong\u003e: United Nations International Children Emergency Fund, \u003cstrong\u003eUSAID:\u0026nbsp;\u003c/strong\u003eUnited States Agency for International Development, \u003cstrong\u003eWHO:\u003c/strong\u003e World Health Organization, \u003cstrong\u003eYSRH\u003c/strong\u003e: youth sexual reproductive health \u003cstrong\u003eUG\u003c/strong\u003e:undergraduate, \u003cstrong\u003ePG\u003c/strong\u003e:postgraduate\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics and consents of the participants\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe studies involving humans were approved by the College of Human Science Research Ethics Review Committee. The NHREC Registration number is Rec-240816-052 and the CREC Reference number is 10206019_CREC_CHS_2023.The medium-risk applications were reviewed by the College of Human Science Research Ethics Review Committee in compliance with the UNISA policy on research ethics and the standardized operating procedures on research risk assessment. The studies were conducted in accordance with local legislation and institutional requirements. Written informed consent for participation in this study was provided.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGA\u003c/strong\u003e: Conceptualization, Data curation, Formal analysis, Methodology, Resources, Writing – original draft, Writing – review \u0026amp; editing. \u003cstrong\u003eFM:\u003c/strong\u003e Supervision, Validation, Writing – review \u0026amp; editing. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGA Lecture in\u0026nbsp;Menelik II \u0026nbsp;Medical\u0026nbsp;and\u0026nbsp;Health\u0026nbsp;Sciences\u0026nbsp;College.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eProf. Faniswa Honest \u0026nbsp;Mfidi ,Associate Professor\u0026nbsp;worked\u0026nbsp;@\u0026nbsp;University of South Africa department Of Health sciences\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank the University of South Africa(UNISA),Prof. Faniswa Honest Mfdi, University of South Africa(UNISA) PhD research supervisor and Reviewed the manuscript,\u0026nbsp;the Addis Ababa City Administration Health Bureau, the management and staff of the universities in which the study was conducted,would like to extend our appreciation to the study participants who dedicated their time to providing information for this study. The authors would also like to acknowledge\u0026nbsp;all the staff at the College of Menelik II Health Science and Medicine for their cooperation and support. Additionally, we thank the staff at \u0026nbsp;regional branch \u0026nbsp;of South Africa university in Ethiopia office \u0026nbsp;for their collaboration,data collectors and \u0026nbsp;supervisors,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author(s) declare that no financial support was received for \u0026nbsp;the research, authorship, and/or publication of this article\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e- Not applicable as the manuscript contains no any individual person’s data in any form including individual details, images or videos.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials-\u003c/strong\u003eAll data are within a manuscript. However, the data set is available from the authors \u0026nbsp;upon reasonable request through the email address of [email protected] with permission of the college within a college library.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting\u0026nbsp;interests\u0026nbsp;\u003c/strong\u003e-The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e - not applicable.\u003c/p\u003e"},{"header":"REFERENCES","content":"\u003col\u003e\n\u003cli\u003eRankin K, Jarvis-Thi\u0026eacute;bault J, Pfeifer N, Engelbert M, Perng J, Yoon S, et al. 済無No Title No Title No Title. Reprod Health [Internet]. 1st ed. 2016;14(1):1\u0026ndash;11. Available from: http://dx.doi.org/10.1016/j.telpol.2015.04.003\u003c/li\u003e\n\u003cli\u003eBinu W, Marama T, Gerbaba M, Sinaga M. 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Available from: http://publications.aap.org/pediatrics/article-pdf/140/Supplement_2/S162/908304/peds_20161758x.pdf\u003c/li\u003e\n\u003cli\u003eTlaye KG, Belete MA, Demelew TM, Getu MA. Reproductive health services utilization and its associated factors among adolescents in Debre Berhan town , Central Ethiopia : a community-based cross-sectional study. 2018;1\u0026ndash;11. \u003c/li\u003e\n\u003cli\u003eTenkorang EY, Amo-Adjei J, Kumi-Kyereme A, Kundhi \u0026amp; G. Determinants of Sexual Violence at Sexual Debut against in-School Adolescents in Ghana. Available from: https://doi.org/10.1007/s10896-020-00220-x\u003c/li\u003e\n\u003cli\u003eHuang KY, Kumar M, Cheng S, Urcuyo AE, Macharia P. Applying technology to promote sexual and reproductive health and prevent gender based violence for adolescents in low and middle-income countries: digital health strategies synthesis from an umbrella review. BMC Health Serv Res [Internet]. 2022;22(1):1\u0026ndash;27. 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Available from: https://doi.org/10.1186/s12978-021-01183-y\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"DSN, DSN sites, risky sexual behaviour, sexual and reproductive health, university students, youth-friendly health","lastPublishedDoi":"10.21203/rs.3.rs-6478240/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6478240/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground-\u003c/strong\u003e Studies conducted in both developed and developing countries suggest that social media can have both negative and positive impacts on the sexual practices of youth. While it can spread knowledge in various areas, there is a rise in addiction to digital social networks. The correlation between social media exposure and sexual initiation remains complex, but many young people in Ethiopia frequently use social media, raising concerns about its potential risks to their sexual and reproductive health. The aim of this study is to determine and describe the benefits and threats of digital social media information on sexual and reproductive health among public university students in Addis Ababa, Ethiopia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods and Materials \u003c/strong\u003eThe descriptive cross-sectional study was conducted from May 2023 to October 2023 among youth at selected public universities in Addis Ababa city Administration,Ethiopia to examine digital social network information accessed by youths and its benefits and threats on sexual and reproductive health. A sample size of 413 was determined using a single percentage formula. All consecutive youth who participated during the study period were included. Data was collected using a systematic self-administered questionnaire, which was double-checked for accuracy. The information was analyzed using the Statistical Package for Social Sciences (SPSS) 25, and presented in tables and graphs. Associations were made to demonstrate the effects of variables.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003e97.5% of respondents actively used various digital social network platforms,71.6% viewed these platforms as reliable sources of sexual reproductive health information, though 45.8% considered them harmful, and 43.2% saw benefits for youth.Over half (52.4%) had encountered sexual initiation content online, and 77.9% felt they lacked sufficient sexual reproductive health information. Frequent digital social network use and absence of sexual reproductive health-related courses at universities were linked to higher engagement in risky sexual behaviors. Specifically, increased digital social network \u0026nbsp;usage was associated with a 2.266 times higher likelihood of such behaviors.\u003c/p\u003e\n\u003cp\u003eThe study concluded that unregulated use of digital social network contributes to misconceptions about sexual reproductive health and risky sexual practices. It emphasized the need for comprehensive sexual reproductive health \u0026nbsp;education and accessible services within universities to mitigate these risks.\u003c/p\u003e","manuscriptTitle":"Digital social network information accessed by youths and its effects on sexual and reproductive health among students at public Universities,in Addis Ababa, Ethiopia,2023:A cross- sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-27 11:49:54","doi":"10.21203/rs.3.rs-6478240/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6a9651fe-f63e-4729-b843-5fbd26f23d6e","owner":[],"postedDate":"November 27th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-27T11:49:54+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-27 11:49:54","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6478240","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6478240","identity":"rs-6478240","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}