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Archives of Sexual Behavior

, Volume 48, Issue 7, pp 2117–2123 | Cite as

Risky Sexual Behaviors and Associated Factors Among College Students in Lusaka, Zambia

  • Xu-hao Yang
  • Shuai Yuan
  • Rui Zhang
  • Jun-feng Yu
  • Selestine H. Nzala
  • Pei-gang Wang
  • Qi-qiang HeEmail author
Original Paper

Abstract

Risky sexual behaviors are important factors driving the HIV/AIDS epidemic. Although Zambia experiences a high HIV prevalence, especially among youth, there is a dearth of information regarding risky sexual behaviors among young adults. Therefore, we investigated the prevalence and associated factors of risky sexual behaviors among college students in Lusaka, Zambia. A cross-sectional study was conducted in February 2017 among 427 college students at the University of Zambia. Participants reported their sexual behaviors, sexual attitudes, and lifestyle using self-administered questionnaires. Multinomial logistic regression models were employed to assess potential determinants of risky sexual behaviors. Among the 205 students who reported ever having sex, 148 (72.2%) engaged in risky sexual behaviors in the last 12 months. Participants who were older (OR 1.30, 95% CI 1.12–1.51), engaged in low physical activity (OR 2.25, 95% CI 1.05–4.84), and reported liberal sexual attitudes (OR 1.88, 95% CI 1.02–3.47) were more likely to engage in any risky sexual behavior, while frequent alcohol use (OR 8.38, 95% CI 4.60–15.27) and suicide attempts (OR 6.42, 95% CI 2.03–20.29) predicted multiple risky sexual behaviors. In conclusion, this study indicates that Zambian college students’ risky sexual behaviors are associated with multiple behavioral health risks. Future research should consider using a multiple-behavior change intervention.

Keywords

College students Sexual behaviors Sexual attitudes Lifestyle Sexual risk 

Notes

Acknowledgments

We very gratefully acknowledge the participation of the study children and their parents.

Compliance with Ethical Standards

Conflict of interest

The authors have no conflicts of interest to declare.

Ethical Approval

All procedures involving human participants were in accordance with the ethical standards of Wuhan University and UNZA Medical Research Committee and with the 1964 Helsinki declaration and its later amendments.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. Alamrew, Z., Bedimo, M., & Azage, M. (2013). Risky sexual practices and associated factors for HIV/AIDS infection among private college students in Bahir Dar City, northwest Ethiopia. ISRN Public Health, 2013, 1–9.  https://doi.org/10.1155/2013/763051.Google Scholar
  2. Brandelli Costa, A., Pasley, A., Machado, W. L., Alvarado, E., Dutra-Thome, L., & Koller, S. H. (2017). The experience of sexual stigma and the increased risk of attempted suicide in young Brazilian people from low socioeconomic group. Frontiers in Psychology, 8, 192.  https://doi.org/10.3389/fpsyg.2017.00192.PubMedPubMedCentralGoogle Scholar
  3. Central Statistical Office/Zambia, Ministry of Health/Zambia, University of Zambia Teaching Hospital Virology Laboratory, University of Zambia Department of Population Studies, Tropical Diseases Research Centre/Zambia, & ICF International. (2015). Zambia demographic and health survey 20132014. Retrieved from Rockville, Maryland, USA. http://dhsprogram.com/pubs/pdf/FR304/FR304.pdf.
  4. Chapman, H. J., & Bottentuit-Rocha, J. (2016). Medical students’ perceptions about the added educational value of student-run HIV/AIDS educational campaigns in the Dominican Republic. Global Health Research and Policy, 1, 12.  https://doi.org/10.1186/s41256-016-0011-x.PubMedPubMedCentralGoogle Scholar
  5. Chen, X. G., Elliott, A. L., & Shuang, W. (2018). Cross-country association of press freedom and LGBT freedom with prevalence of persons living with HIV: Implication for global strategy against HIV/AIDS. Global Health Research and Policy, 3(1), 6.  https://doi.org/10.1186/s41256-018-0061-3.PubMedPubMedCentralGoogle Scholar
  6. Chen, Y. L., Hou, C. J., Yao, S. Q., & Fu, L. (2013). Reliability and validity of the attitudes toward sexuality scale for Chinese adolescents. Chinese Journal of Clinical Psychology, 21(1), 1–4.Google Scholar
  7. Cherie, A., & Berhane, Y. (2012). Peer pressure is the prime driver of risky sexual behaviors among school adolescents in Addis Ababa, Ethiopia. World Journal of AIDS, 2(03), 159–164.Google Scholar
  8. Coldiron, M. E., Stephenson, R., Chomba, E., Vwalika, C., Karita, E., Kayitenkore, K., … Haworth, A. (2008). The relationship between alcohol consumption and unprotected sex among known HIV-discordant couples in Rwanda and Zambia. AIDS and Behavior, 12(4), 594–603.PubMedGoogle Scholar
  9. David, D. (2012). Substance use and risky sexual behaviours among sexually experienced Ghanaian youth. BMC Public Health, 12(1), 571.  https://doi.org/10.1186/1471-2458-12-571.Google Scholar
  10. DiClemente, R. J., Salazar, L. F., & Crosby, R. A. (2007). A review of STD/HIV preventive interventions for adolescents sustaining effects using an ecological approach. Journal of Pediatric Psychology, 32(8), 888–906.PubMedGoogle Scholar
  11. Dinger, M. K., Brittain, D. R., & Hutchinson, S. R. (2014). Associations between physical activity and health-related factors in a national sample of college students. Journal of American College Health, 62(1), 67–74.PubMedGoogle Scholar
  12. Dinger, M. K., & Vesely, S. K. (2001). Relationships between physical activity and other health-related behaviors in a representative sample of U.S. College students. American Journal of Health Education, 32(2), 83–88.Google Scholar
  13. Fisher, T. D. (2009). The impact of socially conveyed norms on the reporting of sexual behavior and attitudes by men and women. Journal of Experimental Social Psychology, 45(3), 567–572.Google Scholar
  14. Fisher, T. D., & Hall, R. G. (1988). A scale for the comparison of the sexual attitudes of adolescents and their parents. Journal of Sex Research, 24(1), 90–100.PubMedGoogle Scholar
  15. Golbasi, Z., & Kelleci, M. (2011). Sexual experience and risky sexual behaviours of Turkish University students. Archives of Gynecology and Obstetrics, 283(3), 531–537.PubMedGoogle Scholar
  16. Gouws, E., & Cuchi, P. (2012). Focusing the HIV response through estimating the major modes of HIV transmission: A multi-country analysis. Sexually Transmitted Infections, 88(Suppl 2), i76.  https://doi.org/10.1136/sextrans-2012-050719.PubMedPubMedCentralGoogle Scholar
  17. Hackman, C. L., & Knowlden, A. P. (2014). Theory of reasoned action and theory of planned behavior-based dietary interventions inadolescents and young adults: A systematic review. Adolescent Health, Medicine and Therapeutics, 5, 101–114.PubMedPubMedCentralGoogle Scholar
  18. Heeren, G. A., Jemmott, J. B., 3rd, Ngwane, Z., Mandeya, A., & Tyler, J. C. (2013). A randomized controlled pilot study of an HIV risk-reduction intervention for sub-Saharan African university students. AIDS and Behavior, 17(3), 1105–1115.PubMedPubMedCentralGoogle Scholar
  19. Hills, A. P., Dengel, D. R., & Lubans, D. R. (2015). Supporting public health priorities: Recommendations for physical education and physical activity promotion in schools. Progress in Cardiovascular Diseases, 57(4), 368–374.PubMedGoogle Scholar
  20. Kassa, G. M., Degu, G., Yitayew, M., Misganaw, W., Muche, M., Demelash, T., … Ayehu, M. (2016). Risky sexual behaviors and associated factors among Jiga high school and preparatory school students, Amhara region, Ethiopia. International Scholarly Research Notices, 2016, 4315729.  https://doi.org/10.1155/2016/4315729.PubMedPubMedCentralGoogle Scholar
  21. Kerridge, B. T., Tran, P., & Hasin, D. S. (2015). Intoxication at last sexual intercourse and unprotected sex among HIV-positive and HIV-negative individuals in Uganda: An event-level analysis. AIDS and Behavior, 19(3), 412–421.PubMedPubMedCentralGoogle Scholar
  22. Li, S., Huang, H., Xu, G., Cai, Y., Huang, F., & Ye, X. (2013). Substance use, risky sexual behaviors, and their associations in a Chinese sample of senior high school students. BMC Public Health, 13, 295.  https://doi.org/10.1186/1471-2458-13-295.PubMedPubMedCentralGoogle Scholar
  23. Luquis, R. R., Brelsford, G. M., & Rojas-Guyler, L. (2012). Religiosity, spirituality, sexual attitudes, and sexual behaviors among college students. Journal of Religion and Health, 51(3), 601.PubMedGoogle Scholar
  24. Mahy, M., Garciacalleja, J. M., & Marsh, K. A. (2012). Trends in HIV prevalence among young people in generalised epidemics: Implications for monitoring the HIV epidemic. Sexually Transmitted Infections, 88(Suppl_2), i65–i75.PubMedPubMedCentralGoogle Scholar
  25. Malhotra, N., & Yang, J. (2011). Risky behaviour and HIV prevalence among Zambian men. Journal of Biosocial Science, 43(2), 155–165.PubMedGoogle Scholar
  26. Mazeingia, Y. T., Olijjira, L., & Dessie, Y. (2017). Anal sexual experience and HIV risk awareness among female sex workers in Dire Dawa, eastern Ethiopia. Global Health Research & Policy, 2(1), 27.Google Scholar
  27. Mengistu, T. S., Melku, A. T., Bedada, N. D., & Eticha, B. T. (2013). Risks for STIs/HIV infection among Madawalabu University students, southeast Ethiopia: A cross sectional study. Reproductive Health, 10(1), 38.  https://doi.org/10.1186/1742-4755-10-38.PubMedPubMedCentralGoogle Scholar
  28. Mohamed, B. A., & Mahfouz, M. S. (2013). Factors associated with HIV/AIDS in Sudan. BioMed Research International, 2013, 971203.PubMedPubMedCentralGoogle Scholar
  29. Mulu, W., Yimer, M., & Abera, B. (2014). Sexual behaviours and associated factors among students at Bahir Dar University: A cross sectional study. Reproductive Health, 11(1), 84.  https://doi.org/10.1186/1742-4755-11-84.PubMedPubMedCentralGoogle Scholar
  30. Noubiap, J. J. N., Nansseu, J. R. N., Ndoula, S. T., Wang, B., Jingi, A. M., Bigna, J. J. R., … Fokom-Domgue, J. (2015). Prevalence and correlates of HIV-risky sexual behaviors among students attending the medical and social welfare center of the University of Maroua, Cameroon. BMC Research Notes, 8(1), 635.  https://doi.org/10.1186/s13104-015-1638-2.PubMedPubMedCentralGoogle Scholar
  31. Nshindano, C., & Maharaj, P. (2008). Reasons for multiple sexual partnerships: Perspectives of young people in Zambia. African Journal of AIDS Research, 7(1), 37–44.PubMedGoogle Scholar
  32. Ntirampeba, D., Neema, I., & Kazembe, L. N. (2017). Joint spatial modelling of disease risk using multiple sources: An application on HIV prevalence from antenatal sentinel and demographic and health surveys in Namibia. Global Health Research and Policy, 2, 22.  https://doi.org/10.1186/s41256-017-0041-z.PubMedPubMedCentralGoogle Scholar
  33. Pinchoff, J., Boyer, C. B., Mutombo, N., Chowdhuri, R. N., & Ngo, T. D. (2017). Why don’t urban youth in Zambia use condoms? The influence of gender and marriage on non-use of male condoms among young adults. PLoS ONE, 12(3), e0172062.  https://doi.org/10.1371/journal.pone.0172062.PubMedPubMedCentralGoogle Scholar
  34. Reyna, V. F., & Farley, F. (2006). Risk and rationality in adolescent decision making: Implications for theory, practice, and public policy. Psychological Science in the Public Interest, 7(1), 1–44.PubMedGoogle Scholar
  35. Richards, J., Jiang, X., Kelly, P., Chau, J., Bauman, A., & Ding, D. (2015). Don’t worry, be happy: Cross-sectional associations between physical activity and happiness in 15 European countries. BMC Public Health, 15, 53.  https://doi.org/10.1186/s12889-015-1391-4.PubMedPubMedCentralGoogle Scholar
  36. Sandoy, I. F., Michelo, C., Siziya, S., & Fylkesnes, K. (2007). Associations between sexual behaviour change in young people and decline in HIV prevalence in Zambia. BMC Public Health, 7, 60.  https://doi.org/10.1186/1471-2458-7-60.PubMedPubMedCentralGoogle Scholar
  37. Steinberg, L. (2008). A social neuroscience perspective on adolescent risk-taking. Developmental Review, 28(1), 78–106.PubMedGoogle Scholar
  38. Stephenson, R. (2009). Community influences on young people’s sexual behavior in 3 African countries. American Public Health Association, 99(1), 102–109.Google Scholar
  39. Thullen, M. J., Taliaferro, L. A., & Muehlenkamp, J. J. (2016). Suicide ideation and attempts among adolescents engaged in risk behaviors: A latent class analysis. Journal of Adolescent Health, 26(3), 587–594.Google Scholar
  40. Tsutsumi, A., Izutsu, T., & Matsumoto, T. (2012). Risky sexual behaviors, mental health, and history of childhood abuse among adolescents. Asian Journal of Psychiatry, 5(1), 48–52.PubMedGoogle Scholar
  41. Weeden, J., & Sabini, J. (2007). Subjective and objective measures of attractiveness and their relation to sexual behavior and sexual attitudes in university students. Archives of Sexual Behavior, 36(1), 79–88.PubMedGoogle Scholar
  42. Yip, P. S., Zhang, H., Lam, T. H., Lam, K. F., Lee, A. M., Chan, J., & Fan, S. (2013). Sex knowledge, attitudes, and high-risk sexual behaviors among unmarried youth in Hong Kong. BMC Public Health, 13(1), 1–10.  https://doi.org/10.1186/1471-2458-13-691.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Xu-hao Yang
    • 1
  • Shuai Yuan
    • 1
  • Rui Zhang
    • 1
  • Jun-feng Yu
    • 1
  • Selestine H. Nzala
    • 2
  • Pei-gang Wang
    • 1
  • Qi-qiang He
    • 1
    Email author
  1. 1.School of Health SciencesWuhan UniversityWuhanPeople’s Republic of China
  2. 2.School of MedicineUniversity of ZambiaLusakaZambia

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