Risky Sexual Behavior and its Determinants among Undergraduate Hostellers of Kathmandu Metropolitan City

ABSTRACT Background Risky sexual behavior (RSB) includes practices of unprotected sex, sex with multiple partners, and/or sex under substance abuse, increasing vulnerability to reproductive health problems. This study explored the risky sexual behavior and its associated factors among Nepalese undergraduates. Methods A cross-sectional study was executed among 361 undergraduates residing in hostels of Kathmandu Metropolitan. The data was collected through a self-administered questionnaire. Pearson’s chi-square test and multivariable logistic regression analysis was performed to determine factors associated with risky sexual behavior at 5% level of significance. Result The prevalence of risky sexual behavior among undergraduates was found to be 64.3% (95% CI: 59.8-69.8%). Risky sexual behavior was found to be associated with higher age (aOR: 3.938; 95% CI: 1.707-8.673), male gender (aOR: 3.233; 95% CI: 1.623-6.439), being in past/current relationship (aOR: 3.914, 95% CI: 2.099-7.012), lower education of mother (aOR: 3.655; 95% CI: 1.189-9.237), and peer pressure to have a sexual relationship (aOR: 2.356; 95% CI: 1.260-4.349). Notably, bivariate analysis illustrated problematic pornographic consumption to have a statistical relation with risky sexual behavior. However, this association weakened and became non-significant after accounting for other factors in the adjusted model (aOR:1.213, 95% CI: 0.331-4.442). Conclusion The study highlights a significant prevalence of risky sexual behaviour among undergraduate students, linked to the factors such as age, gender, relationship status, parental education, and peer pressure. These findings suggest the need for comprehensive sex education programs that equip students with the knowledge and skills to navigate healthy relationships, make safe choices, and embrace responsible sexual practices. Key Messages What is already known on this topic Nepalese adolescents and youth have scant knowledge about sexual and reproductive health. Despite Nepal’s commitments to adolescent health, a gap persisted in the utilization of sexual and reproductive health services among youths and very little is known about their sexual practice. What this study adds Issues such as early sexual engagement, unprotected sex, multiple partners, and engagement in commercial sex work are prominent concerns among Nepalese youths. Despite existing laws and programs, risky sexual behaviors persist, emphasizing the urgency for effective interventions tailored to Nepalese adolescents. How this study might affect research, practice or policy The findings underscore urgent necessity for targeted interventions such as comprehensive sex education to address the concerning prevalence of RSB among Nepalese undergraduates.