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Background: Adolescence and early adulthood represent a critical period that shapes long-term health outcomes and lays the foundation for a healthy and productive life. Understanding the influence of health risk behaviors on physical activity and dietary habits is essential for targeted public health interventions. Objective: The primary objective of this study was to assess the impact of various dimensions of health risk behaviors on physical activity among college students and to examine the differences in physical activity and dietary patterns based on gender. Methodology: This cross-sectional study investigated students’ attitudes and behaviours related to health risks and physical activity. The analysis encompassed six dimensions of health risk behaviour: smoking, alcohol use, illicit drug use, diet, and risky sexual behaviour. A total of 95 students (30 females and 65 males), aged 20–30 years, were selected through random sampling. Data were collected using the Leah Health Risk Behaviours Inventory. Results: Descriptive statistics revealed gender-based differences in physical activity levels, with males exhibiting higher engagement compared to females. Correlation analysis indicated that diet and smoking behaviours significantly correlated with physical activity. Furthermore, smoking, alcohol use, drug use, and risky sexual behaviour showed significant correlations with dietary patterns. Alcohol consumption was also significantly associated with both drug use and risky sexual behaviours, while risky sexual behaviour was strongly linked with illicit drug use. Conclusion: The study highlights the interrelationships among various health risk behaviours. These findings underscore the importance of inclusive health education programs thataddress multiple dimensions of risk to promote healthier lifestyles among young adults.

Behavioral differences exist between countries, regions, and religions. With rapid development in recent decades, an increasing number of international immigrants from different regions with different religions have settled in China. The degrees to which sexual behaviors-particularly risky sexual behaviors-differ by religion and geographical areas are not known. We aim to estimate the associations of religion and geographical areas with sexual behaviors of international immigrants and provide evidence for promoting the sexual health of international immigrants. A cross-sectional study was conducted via the internet with a snowball sampling method among international immigrants in China. In our study, risky sexual behaviors included having multiple sexual partners and engaging in unprotected sex. Descriptive analysis was used to analyze the basic characteristics of international immigrants as well as their sexual behaviors, religious affiliations, and geographical regions of origin. Multivariate binary logistic regression analyses with multiplicative and additive interactions were used to identify aspects of religion and geography that were associated with risky sexual behaviors among international immigrants. A total of 1433 international immigrants were included in the study. South Americans and nonreligious immigrants were more likely to engage in risky sexual behaviors, and Asian and Buddhist immigrants were less likely to engage in risky sexual behaviors. The majority of the Muslims had sexually transmitted infection and HIV testing experiences; however, Muslims had a low willingness to do these tests in the future. The multivariate analysis showed that Muslim (adjusted odds ratio [AOR] 0.453, 95% CI 0.228-0.897), Hindu (AOR 0.280, 95% CI 0.082-0.961), and Buddhist (AOR 0.097, 95% CI 0.012-0.811) immigrants were less likely to report engaging in unprotected sexual behaviors. Buddhist immigrants (AOR 0.292, 95% CI 0.086-0.990) were also less likely to have multiple sexual partners. With regard to geography, compared to Asians, South Americans (AOR 2.642, 95% CI 1.034-6.755), Europeans (AOR 2.310, 95% CI 1.022-5.221), and North Africans (AOR 3.524, 95% CI 1.104-11.248) had a higher probability of having multiple sexual partners. The rates of risky sexual behaviors among international immigrants living in China differed depending on their religions and geographical areas of origin. South Americans and nonreligious immigrants were more likely to engage in risky sexual behaviors. It is necessary to promote measures, including HIV self-testing, pre-exposure prophylaxis implementation, and targeted sexual health education, among international immigrants in China.

Human immuno-deficiency virus (HIV) counseling affirms that people exercise the right to know their HIV status, which opens the gateway to care, treatment, and support for a person in need. HIV counseling and testing uptake among sexually active males in Ethiopia is too low. Moreover, existing studies were not done at country level and the contributing factors were not well studied. Therefore, the aim of this study is to determine the status of uptake and identify its correlates using the 2016 Ethiopia Demographic and Health Survey. Data on 12,688 participants were utilized in this study. Descriptive statistics and multilevel logistic regression were used to summarize the data and investigate the associations between predictors and HIV counseling and testing uptake. The overall HIV voluntary counseling and testing uptake among sexually active men in Ethiopia was 45.69%; 95% CI [43.08%, 48.33%]. About 13% of the variation in the likelihood of being tested for HIV was due to the variation among the regions. On the other hand, age, religion, education, occupation, marital status, HIV knowledge, health insurance coverage, wealth status, risky sexual behavior, family planning discussion with health workers, owning a mobile, frequency of watching television, and listening to the radio were significantly associated with the uptake of HIV voluntary counseling and testing. HIV voluntary counseling and testing uptake in Ethiopia is still low and varies across the regions, which might hamper the ambitious plan of Ethiopia to end AIDS as a public health threat by 2030. Therefore, giving due consideration to scale up HIV knowledge to avoid risky sexual behavior, improving access to health insurance and media, and working on the significant modifiable sociodemographic determinants are worthy to boost HIV voluntary counselling and testing uptake, which is an integral component of the strategies to efficiently prevent and control HIV.

Background Evidence shows that HIV prevalence among young women in sub-Saharan Africa increases almost five-fold between ages 15 and 24, with almost a quarter of young women infected by their early-to mid-20s. Transactional sex or material exchange for sex is a relationship dynamic that has been shown to have an association with HIV infection. Methods Using five focus group discussions and 19 in-depth interviews with young women enrolled in the HPTN 068 conditional cash transfer trial (2011–2015), this qualitative study explores young women’s perceptions of transactional sex within the structural and cultural context of rural South Africa. The analysis also considers the degree to which young women perceive themselves as active agents in such relationships and whether they recognise a link between transactional sex and HIV risk. Results Young women believe that securing their own financial resources will ultimately improve their bargaining position in their sexual relationships, and open doors to a more financially independent future. Findings suggest there is a nuanced relationship between sex, love and gifts: money has symbolic meaning, and money transfers, when framed as gifts, indicates a young woman’s value and commitment from the man. This illustrates the complexity of transactional sex; the way it is positioned in the HIV literature ignores that “exchanges” serve as fulcrums around which romantic relationships are organised. Finally, young women express agency in their choice of partner, but their agency weakens once they are in a relationship characterised by exchange, which may undermine their ability to translate perceived agency into STI and HIV risk reduction efforts. Conclusions This research underscores the need to recognise that transactional sex is embedded in adolescent romantic relationships, but that certain aspects make young women particularly vulnerable to HIV. This is especially true in situations of restricted choice and circumscribed employment opportunities. HIV prevention educational programmes could be coupled with income generation trainings, in order to leverage youth resilience and protective skills within the confines of difficult economic and social circumstances. This would provide young women with the knowledge and means to more successfully navigate safer sexual relationships.

In Poland, there is little research on university students’ risky sexual behaviours. Additionally, existing studies analyse the behaviours selectively and do not group them into clusters. Hence, effective prevention is impossible. The research aims to gather information regarding the prevalence, forms and clusters of students’ risky sexual experiences. In 2019, a cross-sectional study was conducted in 12 universities in south-eastern Poland on a random sample (n = 2764). Fifteen risky sexual experiences, both condom-protected and unprotected, were analysed; they were mainly unprotected vaginal, oral, anal contacts; protected and unprotected sexual experiences while intoxicated and with unknown persons. Thanks Ward’s hierarchical method, four inseparable clusters of students with similar risky experiences were distinguished. Their dominant features were: (A) (24% of interviewees)—drunk partners, (B) (4.8%)—partners intoxicated with drugs, (C) (3.1%)—partner abuse and exceeding partner sexual norms, (D) (17.8%)—the anonymity of partners and going beyond the convention. It was stated that 60.3% of the respondents do not belong to any of the identified clusters. Sex education and the promotion of student sexual health should be intensified; the development of attitudes of avoiding risky sexual behaviours and dealing with their consequences should be considered.

This research examined gender-specific perceptions of risky sexual behavior norms among college students and their relationship with one's own sexual behavior. We expected that students would misperceive the risky sexual behavior of their peers and that these perceptions would positively relate to their sexual behavior. Undergraduate students from the United States (N=687; 57.6% female) completed measures assessing perceived sexual behavior, sexual behavior, and other behaviors (e.g., marijuana use, alcohol consumption). Findings demonstrated that students perceived that others engaged in more risky sexual behavior than they do and that perceived norms were positively associated with one's own behavior. The incorporation of personalized normative feedback regarding risky sexual behavior into brief interventions aimed at reducing risky sexual behavior is discussed. Adapted from the source document.

Background Sexual violence against women is a major public health issue and a breach of human rights. Although various consequences of sexual violence on health have been described in a large number of scientific publications, very little is known about this topic in Estonia. The aim of this study was to examine the prevalence of sexual violence and associations between exposure to sexual violence and risky health and sexual behaviours among women in Estonia. Methods A population-based cross-sectional study was carried out in Estonia in 2014. Self-reported data regarding selected indicators of risky health and sexual behaviours were collected from 1670 women, aged 18–44 years, via a self-administered questionnaire. To measure the prevalence of sexual violence, questions from the NorVold Abuse Questionnaire were included. Chi-square and multivariate logistic regression were used to analyse the data. Results Of the respondents, 22.7% ( n  = 379) reported being exposed to sexual violence during their lifetime, and over half of these women had had these experiences before the age of 18. Statistically significant associations were found between sexual violence and smoking (adjusted odds ratio (AOR) 1.32, 95% CI 1.03–1.70), alcohol consumption (AOR 1.52, 95% CI 1.18–1.95), illicit drug use (AOR 2.21, 95% CI 1.70–2.89), sexual intercourse for money or other material reward (AOR 3.51, 95% CI 1.62–7.61), concurrent sexual relationships (AOR 2.64; 95% CI 1.80–3.86), and being diagnosed with sexually transmitted infections (AOR 1.48, 95% CI 1.09–2.01). Conclusions In Estonia, sexual violence against women is widespread and is associated with several risky health and sexual behaviours. Efforts should be made, both among the general public and professionals, to raise awareness regarding the prevalence and negative impact of sexual violence. Women who have been exposed to sexual violence are in need of professional medical, legal and psychological help free from prejudice to help them recover from such traumatic events.

Age at sexual debut is an important determinant of HIV infection. The paper investigates the effects of age at sexual debut on sexual behaviour among South African youth. Among 2 875 respondents who ever had sexual intercourse, 39% had early sexual debut (sexual debut at age 16 years and below). Males (44.6%) were significantly more likely than females (35.1%) to report early sexual debut (odds ratio (OR)=1.45, p-value <0.001). Multiple sexual partners are significantly more common among those that had early sexual debut (10.4% vs. 4.8%) than those who had late sexual debut, (OR=2.29, p-value<0.001). Those aged 15 to 19 years were 1.4 times more likely to report multiple partners compared to those aged 20 to 24 years. Delaying sexual debut is a strategy many national programmes are promoting. The results of this study provide additional arguments to support such initiatives and show the need to strengthen intervention targeting youth. L'âge lors du rapport sexuel initial est un déterminant de l'infection du VIH. L'article étudie les effets de l'âge lors du rapport sexuel initial sur le comportement sexuel chez la jeunesse de l'Afrique de sud. Parmi les 2875 répondants qui n'ont jamais eu des rapports sexuels, 39% ont eu des rapports sexuels initiaux précoces (rapport sexuel initial à l'âge de 16 ans ou au - dessous). Les mâles (44,6%) avaient beaucoup plus de possibilité que les femelles (35,1%) de signaler le rapport sexuel initial précoce (l'indice de cote (IC) = 1,45, valeur - p < 0,001). Les partenaires sexuels multiples sont considérablement plus communs chez ceux qui ont eu des rapports sexuels initiaux précoces (10,4% contre 4,8%) que ceux qui ont eu des rapports sexuels tardifs (IC = 2,29, valeur - p < 0,001). Ceux qui ont 15 ans jusqu'à 19 ans avaient 1,4 fois la possibilité de signaler d'avoir des partenaires multiples par rapport à ceux qui ont entre 20 et 24 ans. Le rapport sexuel initial tardif est une stratégie que beaucoup de programmes nationaux encouragent. Les résultats de cette étude fournissent davantage des arguments qui soutiennent telles initiatives et montrent la nécessité de renforcer l'intervention qui vise la jeunesse.

Background: Sexual behaviour of HIV-infected youths is very important in determining the direction of the HIV epidemic, as these youths are reservoirs of HIV and can propagate its transmission if they engage in risky sexual behaviours. However, support structures for secondary prevention are weak even in healthcare settings. There is a need to understand the sexual behaviour of these youths and, in turn, tailor appropriate secondary prevention strategies, hence the current study was designed to assess sexual behaviour and attitudes towards safe sex of youth receiving antiretroviral care at public health facilities in Palapye district, Botswana. Method: This quantitative, descriptive cross-sectional survey was used to describe the sexual behaviour and attitudes towards safe sex and identify factors associated with risky sexual behaviours among HIV-infected youths aged between 15 and 19 years receiving antiretroviral therapy (ART) care from public healthcare facilities in Palapye District, Botswana. Results: A total of 188 youths participated in this study, 56% being females while 44% were males. We reported that 15.4% had ever had sex. At their last sexual encounter, more than half of the youths (51.7%) had not used condoms. More than a third of the participants were under the influence of alcohol during their last sexual experience. Generally, the youths had good attitudes towards safe sex, as most youths said they would prioritise protecting their sexual partners and themselves from HIV and STIs. Alcohol use, substance use and not considering religion as important were strongly associated with having ever had sex. Conclusions: A significant proportion of HIV-infected youths are sexually active, whereas their preventive practices such as condom use are poor despite good attitudes towards safe sex. Alcohol use, substance use and not perceiving religion as important were associated with risky sexual behaviours.

The surge of sexually transmitted infections (STIs) among young people is of public health importance, and the notification and treatment of sex partners after the diagnosis of an STI is a public health approach to prevent and reduce further transmissions. There are limited studies that investigate partner notification among young people in general, and university students in South Africa in particular. We investigated self-reported STIs and partner notification practice, intentions, and preferences among university students. We also assessed their STI knowledge and risky sexual behaviour in relation to STIs. The study was a descriptive cross-sectional survey that used multistage sampling to select 918 students across the five schools of a health sciences university in South Africa. Descriptive statistics and bivariate logistic analysis were performed using Stata IC version 16. More males (54.1%) than females were currently in a sexual relationship (47.3%), more males reported multiple sexual partners (n = 114, 46%), engaged in transactional sex (n = 13, 5.3%), and had one-night stands (n = 68, 28.1%) in the past 12 months (p = 0.001). Moreover, half (55.9%) had poor knowledge of STIs with an overall mean knowledge score of 2.9 ± 2.0, and the majority (85.8%) perceived themselves to be at low risk of acquiring STIs. The odds of intentions to disclose an STI infection to a sexual partner and delivering a partner notification slip to ex-sexual partners were not statistically significant (p = 0.95; p = 0.10), with the likelihood of disclosure being 1.3 times for female students compared to males. Female students were 1.5 times as likely to prefer a doctor to send an SMS notification to their sexual partners (p = 0.02) compared to their male counterparts, while the preference of an SMS notification was 41% (p = 0.03) among female students. Students engaged in risky behaviours but had a low perception of the risks of acquiring STIs. Although they had preferences of different methods of partner notification, both male and female students preferred SMS partner notifications from a doctor, even though women were in the majority. Health care providers should put in place interventions so that young people can safely inform their partners about STIs.