Risky sexual behavior and associated factors among secondary school students in Harari regional state: Multicenter centers study

Adolescents are vulnerable to engaging in risky sexual behavior. Being in a new environment makes them makes them susceptible to social networks, which potentially leads to the development of new sexual behaviors. There is limited data in the region that assessed risky sexual behavior (RSB) among sexually active secondary school students. Methods: An institutional-based cross-sectional study design was employed from April 10 to May 10, 2022. A total of 1498 secondary school students were randomly selected to a survey. The Epi-data 3.1 version was used to enter the data and exported and analyzed using Stata version 14. Poisson regression with robust variance was used to evaluate the association between the independent variable and risky sexual behaviors. Adjusted prevalence ratios (APRs) with 95 % CI were used to report the results. Result: Of the total study participants, 544 (36 %) had experienced sexual intercourse. Of sexually active respondents, 50.36 % (95 % CI: 46.2, 54.56) of the students had engaged in risky sexual behaviors. Poisson regression model showed that being female (APR = 1.37; 95 % CI: 1.33, 2.74), use of internet (APR = 1.55; 95 % CI: 1.10, 2.01), below 15 of age (APR = 7.07; 95 % CI: 2.12, 23.56), aged 15–18 years old (APR = 5.90; 95 % CI: 2.97, 11.72), and being single (APR = 1.37; 95 % CI: 1.01, 1.88) were independently associated with risky sexual behavior. Conclusion: About half of sexually active students in the secondary school of Harari regional state participated in RSB. Thus, intervention at the school level should be encouraged by counselling students about safe internet usage, including components of RSB in the curriculum and paying attention to the identified factors might reduce risky sexual behavior.