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A Case Study on Risky Sexual Behaviour of Undergraduate Students in

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DOI: 10.4172/2329-891X.1000306

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 l Diseases &
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Journal of Tropical Diseases
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Sendekie and Worku, J Trop Dis 2019, 7:3

DOI: 10.4172/2329-891X.1000306
Jo

ISSN: 2329-891X

Research Article Open Access

A Case Study on Risky Sexual Behaviour of Undergraduate Students in

Ethiopia
Desalegn B Sendekie1,2 and Netsanet Worku3*
1Bole Subcity, Addis Ababa, Ethiopia
2Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
3Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
*Corresponding authors: Netsanet Worku, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia, Tel:
+251911941866; E-mail: [email protected]
Received date: January 10, 2019; Accepted date: February 13, 2019; Published date: February 27, 2019
Copyright: © 2019 Sendekie DB, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Studies across Ethiopia’s public universities indicated the presence of risky sexual practice. But,
there is limited data among students in private universities. This study was conducted to identify patterns and
predisposing factors of risky sexual behavior, as well as analyze knowledge, risk perception and attitude to HIV
infection.

Method: Cross-sectional survey was conducted using a self-administered questionnaire containing four sections
of questions addressing the socio-economic-and-demographic characteristics; substance use and sexual practice of
students in one of the randomly selected private universities in Addis Ababa. Statistical analysis was performed
using SPSS (V.16) software.

Results: 502 questionnaires were distributed, 425 were completed (with 84.7% response rate). Among students
who ever had sex: we found 45 (26.3%) with the early sexual debut, 71 (40.3%) with multiple lifetime partners and
14 (7.8%) had sex for money. In the last 12 months: 157 students were sexually active. 44 (28%) of them had
multiple partners. Six male students had sex with other males; 18 males had sex with commercial sex workers. Four
of five respondents (145; 81.9%) had ever used a condom. Two third of them used condom-at first or last sex and
always with a new partner. The identified factors predisposing to risky sexual behavior were individual factors, social
factors, living and cultural conditions. Students with high knowledge of HIV were observed to practice sex with low
self-risk perception and HIV testing.

Conclusion: Risky sexual behavior exists among private university students. It is suggested that the academic
institutions need to collaborate with local health organizations-to study further and mitigate the identified risks.

Keywords: Risky sexual behavior; Undergraduate students; HIV/ than females. Among those reported to have multiple sex partnerships,
AIDS; Private university, Ethiopia nearly 47% used a condom at their last sex during the interview [2].
HIV prevalence increased in accordance with the number of lifetime
Introduction sex partners. For instance, females with 5-9 partners encountered 8.7%
prevalence. Similarly, males with more than 10 partners encountered
Ethiopia is one of the sub-Saharan African countries severely 6.8% HIV prevalence [2]. High prevalence of HIV was also observed in
affected by HIV pandemic [1]. About 42% of the urban population in men and women with secondary education and higher income [2].
Ethiopia, age 15-34 years is at great risk of HIV infection [2]. University students are young and part of the educated society. Unless
According to the national statistical agency report in 2012, HIV they get youth-friendly reproductive health services, they are at risk of
prevalence was the second highest in Addis Ababa reaching 5.2%, STI/HIV infection, unplanned pregnancies, and associated
which is next to the 6.5% prevalence recorded in Gambela region [2]. complications [1]. These risks may be worsened if they use substances
In Addis Ababa, comprehensive knowledge about HIV/AIDS is very [1]. Substance use in general, Khat and alcohol use by the Ethiopian
low (31.8% in females and 43.7% in males) [2]. Comprehensive youth, ages between 15-24 years, in particular, were significantly
knowledge is defined as 1) knowing that both condom use and limiting associated with unprotected sex. This was found to be a challenge in
the number of sex partner to one uninfected partner are HIV- the national prevention of HIV [3].
prevention methods; 2) being aware that a healthy-looking person can
have HIV; and 3) rejecting the two most common local Despite the continuous effort of the Ethiopian government and
misconceptions-that HIV/AIDS can be transmitted through mosquito donor agencies, the incidence of new HIV infections is still increasing-
bites and by sharing food [2]. though at a slower pace [1]. Some studies in Ethiopia also indicated the
presence of high-risk sexual behavior among students in public
The national survey also showed among all participants aged 15-24 universities [4-10].
years, more males were observed to have multiple sex partnerships

J Trop Dis, an open access journal Volume 7 • Issue 3 • 1000306

ISSN:2329-891X
Citation: Sendekie DB, Worku N (2019) A Case Study on Risky Sexual Behaviour of Undergraduate Students in Ethiopia. J Trop Dis 7: 306. doi:
10.4172/2329-891X.1000306

Page 2 of 12

To the best of our knowledge, there were no available studies research, the university used to participate in the city’s environmental
investigating the patterns of risky sexual behavior in private protection, HIV/AIDS awareness, and prevention programs [21].
universities in Ethiopia. No information is available about the
prevalence of sexual debut, multiple sex partnership, condom use, or Study design and study population
other risky sexual behavior. Majority of undergraduate students are
adolescents/young adults-a period associated with sexual The study design was an institution based cross-sectional survey.
experimentation. This fact, by itself, may put them at risk of unsafe Our source population was “students who were studying in the
sexual practices [11]. They are part of the educated society and so aforementioned programs (full-time or part-time)”. The study target
could have a high level of knowledge-about STI/HIV. In Nigeria and population comprised of undergraduate students.
Uganda, studies (among university students) indicated that this
knowledge might not be followed by the appropriate risk perception Sampling procedure and sample size determination
and safe sexual practices [12,13].
The study was conducted in a randomly selected department.
In Ethiopia, students in private higher institutions live in off- Hence, the department of accounting was chosen among eleven
campus facilities-without school regulations. This may give them the undergraduate programs. There were 890 undergraduate students
freedom to partake in risky behaviors. In Ethiopia and Nigeria, high- registered in this department. The inclusion criterion was to be a full-
risk sex was observed in studies among undergraduate students living time undergraduate student and to have grown up in Ethiopia. We
off-campus [4,14]. Some of the students rent and live alone in a single excluded 355 students for they were studying part-time (students
room. This might give them freedom from parental supervision. In the categorized as Extension/Advanced Standing). Most of these students
youth age group, poor parental supervision was significantly associated had full-time work on weekdays; they used their weekends for their
with risky sexual practices in eight African countries [15]. Private studies. They did not spend much time in the university environment.
university students are mostly under twenty-one and may be easily Unlike part-timers, regular students were younger and spent their
influenced by their peers. As they are likely to be from a high-income weekdays around the university environment. Therefore, we included
family, they may be capable of buying and using substances. Studies all regular students in accounting department-except two Ethiopians
indicated this age group is easily influenced by peer pressure- to (who grew up in Yemen), two Somalis and one South Sudanese. We
experience risky health behaviors (unprotected/unsafe sex, alcohol or excluded them for they grew up in different cultures.
khat or tobacco use) [3,4,8,16]. Unlike students in public universities,
The sample size was calculated using a single proportion formula.
private university students need to pay tuition fees and associated
Prevalence of risky sexual behavior among private university students
expenses. Therefore, some may have financial problems and may try to
(p) was not known; it was assumed to be 50% in order to get the
solve these by partaking in transactional sex. For instance, in Ethiopia
maximum sample size. The sample size was then calculated to be 403,
and Nigeria, studies reported university students engaging in
after allowing 5% for an expected margin of error (d) with a 95%
unprotected sex for the benefit of money or gift [4,14,17].
confidence interval (z=1.96) and 5% non-response rate. The calculated
In public universities, HIV Initiatives (“Modelling and sample size was near to the total number of students who study full-
Reinforcement to Combat HIV/AIDS, MARCH project in Addis time and categorized as “Regular” (from freshman to a graduating
Ababa University”) exist to prevent and control the spread of HIV class). Therefore, we included the whole regular students fulfilling the
infection among students [18]. Students in private universities are so selection criteria (n=530).
far not privileged to take part in similar programs. Such disadvantages
may put them at great risk of unsafe sexual practices. Therefore, we Data collection instrument
tried to point out risky sexual practices and associated predisposing
factors- among private university students. Since there is limited data, A self-administered questionnaire modified from Ethiopia’s DHS
we hope to fill the gap. Besides, policymakers may use the study 2011 [2] and Ethiopia’s HIV/AIDS Behavioral Surveillance Survey
findings for addressing the observed risky behaviors. The results may (BSS) 2005 [22] was used. The questionnaire was translated from
be used in HIV prevention and control programs. English to Amharic, the national language of Ethiopia, by a
professional translator. Pre-test of the questionnaire was done among
The general aim of the current study was to assess the patterns of ten students from another department. After we had discussed the
risky sexual behavior among undergraduates in a private university, ambiguous and sensitive questions with these students, some questions
Addis Ababa, Ethiopia. Specifically, the project has tried to identify the were reformulated to fit the study context in a clear way. The
patterns of risky sexual behavior among undergraduate students; questionnaire consisted of four sections with variables addressing the
identify predisposing factors to risky sexual behaviors (e.g. individual objectives of the study. Socio-demographic and economic
factors like age, sex, substance use) and analyze students’ knowledge, characteristics included: age, sex, year of study, religion, ethnicity,
risk perception and attitude to HIV infection. pocket money, marital status, history of participation in health or
sports clubs, parents’ income, educational status, and residence.
Materials and Methods Substance use included types of substances with their frequency of use.
Sexual practice included: age at sexual debut, condom use, number of
Study area sexual partners, sex for the benefit of money/gift, sex after alcohol
bout, homosexuality in male students, sexual contact with sex workers,
The survey was conducted at Unity University-which is the first and STI symptoms. Perception of students about HIV testing and risk
private university in Ethiopia [19,20]. The university provides four to HIV infection included: risk perception, ways of HIV transmission,
different programs: undergraduate, postgraduate, “Technical and methods of HIV/AIDS prevention, and HIV testing.
Vocational Education and Training” (TVET), and distance and
continuing education [20]. Besides its emphasis on teaching and

J Trop Dis, an open access journal Volume 7 • Issue 3 • 1000306

ISSN:2329-891X
Citation: Sendekie DB, Worku N (2019) A Case Study on Risky Sexual Behaviour of Undergraduate Students in Ethiopia. J Trop Dis 7: 306. doi:
10.4172/2329-891X.1000306

Page 3 of 12

Data collection, data management, and statistical analyses educated parents comprised nearly two-thirds of all the participants
(Table 1). More than ninety percent of students were less than 26 years
Classrooms were identified with the help of students’ council of age. The age range was 17-34 years; the median age is 21 years for
representative. Individual teachers were communicated to spare 15-20 females and 22 years for males. Near fifty percent of participants had
minutes of their lecture time. Questionnaires were then distributed in Amhara ethnicity and had never participated in health/sports clubs. 4
classrooms (by the main investigator and research assistant), to of 5 respondents were never married and had parents residing in Addis
selected students in the accounting department. Students were asked to Ababa.
sit far apart in order to avoid side talks. In the meantime, we tried to
make the surrounding quiet. Participants were given enough time to Characteristic All Sex Chi-Square
ask questions or complete the questionnaire. We tried to find and s Responses Test p-value
include some of the absentees on the following day. (n=425) No.
(%) Female Male (n=141;
Data were manually checked for completeness. We discarded 77 (n=272; 34.1%) No.
65.9%) No. (%)
questionnaires with incomplete data. The collected data was cleaned, (%)
translated back to English and coded before entry into statistical
software (SPSS version 16.0 for Windows). Data consistency and Year of study 0.953
completeness was rechecked using SPSS. Data findings were described
First year 129 (30.3) 83 (30.5) 41 (29.0)
using frequency tables and descriptive statistics. Crosstabs of
independent variables with outcome variables were performed. Chi- Second Year 183 (43.1) 118 (43.4) 62 (44.0)
Square test was applied to analyze statistical associations, where p-
value<0.05 was considered as statistically significant. Binary logistic Third year 113 (26.6) 71 (26.1) 38 (27.0)
regression was also used to determine predisposing factors for risky Total 425 (100.0) 272 (100.0) 141 (100.0)
sexual behaviors. This method was chosen for we have categorical
dichotomous outcome variables. First independent variables with Age in years 0.005
sexual behavior variables were analyzed. During the bivariate analysis,
≤ 20 128 (31.6) 92 (35.6) 31 (22.8)
only variables with p ≤ 0.20 values were chosen. Then Adjusted Odds
Ration (AOR) was calculated once those variables were put together 21-25 239 (59.0) 148 (57.4) 85 (62.5)
into the final regression model. Odds Ratio (OR) with its 95%
Confidence Interval (CI) was used to express the strength of the ≥ 26 38 (9.4) 18 (7.0) 20 (14.7)
association between independent and outcome variables (p-value
Total 405 (100.0) 258 (100.0) 136 (100.0)
<0.05, two-tailed, considered as significant).
History of marriage/union 0.486
Operational definitions Yes 87 (21.8) 59 (23.5) 27 (19.9)
Risky sexual behavior included homosexuality in males, early sexual
No 312 (78.2) 192 (76.5) 109 (80.1)
debut, sex without condom/inconsistent condom use, sexual contact
with a sex worker, sex with a non-regular partner for the sake of money Total 399 (100.0) 251 (100.0) 136 (100.0)
or gift, sex after an alcohol bout, and having multiple sexual partners.
“Ever had sex” was to mean sexual experience in the past. Religion 0.124

Orthodox 296 (69.8) 199 (73.2) 91 (64.5)

Ethical considerations
Protestant 73 (17.2) 45 (16.5) 24 (17.0)
Though the private university had no ethical review board at the
time of data collection, administrative officials found the study Muslim 37 (8.7) 19 (7.0) 17 (12.1)
consistent with Unity University’s regulation. They allowed the study to Others¥ 18 (4.3) 9 (3.3) 9 (6.4)
be conducted. Ethical issues, based on the declaration of Helsinki [23],
were kept to the maximum. The voluntary nature of the study was Total 424 (100.0) 272 (100.0) 141 (100.0)
orally explained to participants by the main investigator. Signed
Ethnicity 0.305
consent forms were then obtained from students willing to participate.
Questionnaires were anonymous and collected in sealed envelopes. Oromo 64 (15.6) 41 (15.5) 20 (14.7)
Their teachers were not around during data collection. Confidentiality
of respondents was kept intact. Amhara 210 (51.2) 140 (52.8) 65 (47.8)

Tigray 49 (12.0) 30 (11.3) 19 (14.0)

Results and Discussion
SNNP* 69 (16.8) 46 (17.4) 22 (16.1)
Of the 502 questionnaires distributed, a total of 425 questionnaires
were included in the final analysis. This gave us a response rate of Others 18 (4.4) 8 (3.0) 10 (7.4)
84.7%. Total 410 (100.0) 265 (100.0) 136 (100.0)

Socio-demographic characteristics Parents’ residence 0.574

Those study participants who were: females, Orthodox Christians, Addis Ababa 340 (80.0) 214 (78.7) 115 (81.6)
living with their parents, with less pocket money, and from highly

J Trop Dis, an open access journal Volume 7 • Issue 3 • 1000306

ISSN:2329-891X
Citation: Sendekie DB, Worku N (2019) A Case Study on Risky Sexual Behaviour of Undergraduate Students in Ethiopia. J Trop Dis 7: 306. doi:
10.4172/2329-891X.1000306

Page 4 of 12

Other City/ 85 (20.0) 58 (21.3) 26 (18.4) females is to keep virginity till marriage. This might also be a reason
Town for underreporting of sexual initiation in females.

Total 425 (100.0) 272 (100.0) 141 (100.0) More than sixty percent of students began sex and substance use
before joining the university. Above eighty percent (84.6%) of whom
Parents’ education 0.071 did it during their high school time. This finding is consistent with
High 288 (68.2) 191 (71.0) 87 (61.7)
studies across Ethiopia’s public universities [4,5,7,8]. This might
indicate the failure of abstinence promotion in HIV prevention
Low 134 (31.8) 78 (29.0) 54 (38.3) programs. The result suggests there is an urgent need for safe sex
education and practice during high school.
Total 422 (100.0) 269 (100.0) 141 (100.0)

Parents’ monthly income 1 Patterns of sexual behavior

High 183 (45.0) 117 (45.2) 62 (44.9) A quarter of respondents who had sexual experience had their first
sex before they become 18 years of age. This finding is lower than the
Low 224 (55.0) 142 (54.8) 76 (55.1)
results of similar studies in Ethiopia [4,10] and other African countries
Total 407 (100.0) 259 (100.0) 138 (100.0) [14,27]. Ethiopia’s DHS indicated, late sexual debut in urban females
(the highest median age in Addis Ababa). There, however, was no
Pocket money 1 difference of median age at first sex (sexual debut) in males all over the
country [2]. In our study, eighty percent of respondents had their
Less 277 (68.4) 173 (67.8) 93 (67.4)
parents in Addis Ababa. This might explain the low prevalence of early
More 128 (31.6) 82 (22.2) 45 (32.6) sexual debut among respondents. Although its prevalence is relatively
low, early sexual debut has serious health consequences. Studies
Total 405 (100.0) 255 (100.0) 138 (100.0) indicated significant associations of the early sexual debut with STI
Participation in health or sport clubs 0.001 (including HIV) [35,36], invasive cervical carcinoma [37], substance
use and difficulties in school work [38].
No 222 (57.2) 157 (63.1) 57 (44.9)
It has been observed that two out of five students (with sexual
Yes 166 (42.8) 92 (36.9) 70 (55.1) experience) reporting multiple lifetime partners. This finding is in line
with similar studies at Jimma and Addis Ababa Universities in Ethiopia
Total 388 (100.0) 249 (100.0) 127 (100.0)
[5,9] and countries like Uganda [27]. Among students who already
Living with 0.817 began sexual intercourse, ninety percent were sexually active in the last
12 months. This finding is higher than the result of a similar study in
Parents 284 (68.9) 178 (67.4) 94 (69.1) western Ethiopia (51%) [5]. But, it is lower than a study finding among
Others≠ 128 (31.1) 86 (32.6) 42 (30.9)
Nigerian undergraduates (100%) [14], in our study, a quarter of those
students who are sexually active had two or more sexual partners. This
Total 412 (100.0) 264 (100.0) 136 (100.0) indicates the presence of a high percentage of high-risk sexual groups-
¥Catholic,
which might worsen the spread of HIV among students. Besides,
Seventh Day Adventist, Traditional Belief, No Religion
eighteen male students had a history of sexual contact with sex
*SNNP denotes indigenous ethnic groups from Southern Nations, Nationalities, workers. These students might also bridge the STI transmission from
and People the high-risk group (sex workers) to the student population.
≠Others include those living with relatives, sibling, partner, friends or alone It was also found that 14 students were paid for sex. These findings
are lower than the results of similar studies in Ethiopia [4,7] and
Table 1: Socio-demographic characteristics of study participants. Botswana [9]. If a student is paid for sex, the power to negotiate safe
sex might also be lost. Hence, it might put students at risk of STI/HIV
According to the current study, near half of the respondents (197; infection. Results revealed there are significant associations (p<0.05) of
48.2%) had already begun sexual intercourse. This finding is higher “ever had sex” and “multiple lifetimes sexual partnership” with-
than the results of other studies in Ethiopia (16.7% to 39.6% in public cigarette smoking, khat chewing, heavy alcohol drinking and frequent
universities) [4-10], China [24], India [25], and Nepal [26]. But, it is use of a substance (Tables 2 and 3). Accordingly, twenty-five percent of
lower than the results of studies in other African countries students who had sexual experience had drunk alcohol on their latest
[14,17,27-31]. The observed differences might be due to factors sex. This finding is consistent with the result of a similar study in
associated with socioeconomic/cultural situations. Uganda [27,39]. Studies also indicated a significant positive association
of alcohol-use with unprotected casual sex [40,41].
Most students (80.7%) began sex with their boyfriend/girlfriend.
More males mentioned curiosity as a reason for sex initiation while Variables All responses Sex Chi-Square
falling in love was the case in females. This finding is consistent with (n=425) No. Test p-value
(%)
similar studies in Ethiopia’s public universities [7,8]. We observed
Female Male
more male students (70.3%) with sexual experience than females (n=272; (n=141;
(38.5%). This was similar to other studies across Ethiopia [4-9] and 65.9%) No. 34.1%) No.
Africa [27,29,32]. The same pattern was also observed across Asia (%) (%)
[24-26,33] and Latin America [34]. In Ethiopia: the cultural norm in Ever had sex 0

J Trop Dis, an open access journal Volume 7 • Issue 3 • 1000306

ISSN:2329-891X
Citation: Sendekie DB, Worku N (2019) A Case Study on Risky Sexual Behaviour of Undergraduate Students in Ethiopia. J Trop Dis 7: 306. doi:
10.4172/2329-891X.1000306

Page 5 of 12

Yes 197 (48.2) 100 (38.5) 97 (70.3) Total 134 (100.0) 67 (100.0) 67 (100.0)

No 212 (51.8) 160 (61.5) 41 (29.7) STI symptoms¥ (Multiple responses)

Total 409 (100.0) 260 (100.0) 138 (100.0) Penile discharge 8 (11.8) N/A 8 (11.8)

Age at first sex* 0.001 Painful urination 8 (5.9) 5 (7.5) 3 (4.4)

<18 years=Early 45 (26.3) 11 (13.9) 34 (37.0) Abnormal vaginal 8 (11.9) 8 (11.9) N/A
discharge
≥ 18 years=Late 126 (73.7) 68 (86.1) 58 (63.0)
Genital ulcer/ 1 (0.7) 1 (1.5) 0 (0.0)
Total 171 (100.0) 79 (100.0) 92 (100.0) Sore

Contraceptive used at first sexual experience* 0.017 Groin swellings 1 (0.7) 0 (0.0) 1 (1.5)

No 60 (33.7) 36 (43.4) 24 (25.3) Genital itching 7 (5.2) 4 (6.0) 3 (4.4)

Yes 118 (66.3) 47 (56.6) 71 (74.7) STI treatment¥ 0.516

Total 178 (100.0) 83 (100.0) 95 (100.0) Yes 10 (35.7) 6 (40.0) 4 (30.8)

No. of Lifetime sex partners* 0 No 17 (60.7) 8 (53.3) 9 (69.2)

<3=low 105 (59.7) 70 (84.3) 35 (37.6) Not sure 1 (3.6) 1 (6.7) 0 (0.0)

≥ 3=high/multiple 71 (40.3) 13 (15.7) 58 (62.4) Total 28 (100.0) 15 (100.0) 13 (100.0)

Total 176 (100.0) 83 (100.0) 93 (100.0) At risk of HIV infection* 0.051

No. of current sex partners* 0 Yes 16 (8.9) 4 (4.3) 12 (13.8)

<2=low 132 (75.0) 79 (95.2) 53 (57.0) No 163 (91.1) 88 (95.7) 75 (86.2)

≥ 2=high/multiple 44 (25.0) 4 (4.8) 40 (43.0) Total 179 (100.0) 92 (100.0) 87 (100.0)

Total 176 (100.0) 83 (100.0) 93 (100.0) Among respondents who started sex, N/A: Not Applicable,

¥For
Sexual contact with CSW* those with STI symptoms

Yes 18 (20.7) N/A 18 (20.7)

Table 2: Sexual Behavior among respondents.
No 69 (79.3) N/A 69 (79.3)
Substance Ever had sex Multiple lifetime sex partners
Total 87 (100.0) N/A 87 (100.0)
s Used
N (%) Total (%)* p- N (%) Total (%)* p-
Sex for the benefit of money* 0.019
value value
Yes 14 (7.8) 2 (2.3) 12 (12.9)
Cigarette smoking
No 165 (92.2) 84 (97.7) 81 (87.1)
Yes 48 (77.4) 62 (100.0) 0.032 32 (66.7) 48 (100.0) 0.051
Total 179 (100.0) 86 (100.0) 93 (100.0)
No 49 (59.0) 83 (100.0) 20 (44.4) 45 (100.0)
Alcohol use on latest sex* 0.164
Khat chewer
Yes 44 (25.3) 16 (19.8) 28 (30.1)
Yes 52 (78.8) 66 (100.0) 0.009 36 (72.0) 50 (100.0) 0.002
No 130 (74.7) 65 (80.2) 65 (69.9)
No 45 (57.0) 79 (100.0) 16 (37.2) 43 (100.0)
Total 174 (100.0) 81 (100.0) 93 (100.0)
Substance use frequency
Homosexuality (for males)*
More 60 (75.9) 79 (100.0) 0.009 39 (68.4) 57 (100.0) 0.014
Yes 6 (6.6) N/A 6 (6.6)
Less 35 (53.8) 65 (100.0) 13 (39.4) 33 (100.0)
No 85 (93.4) N/A 85 (93.4)
Heavy drinking
Total 91 (100.0) N/A 91 (100.0)
More 47 (83.9) 56 (100.0) 0.001 33 (75.0) 44 (100.0) 0.001
Current STI symptoms* 0.524
Less 51 (56.0) 91 (100.0) 19 (38.8) 49 (100.0)
Yes 28 (20.9) 16 (23.9) 12 (17.9)

No 106 (79.1) 51 (76.1) 55 (82.1)

J Trop Dis, an open access journal Volume 7 • Issue 3 • 1000306

ISSN:2329-891X
Citation: Sendekie DB, Worku N (2019) A Case Study on Risky Sexual Behaviour of Undergraduate Students in Ethiopia. J Trop Dis 7: 306. doi:
10.4172/2329-891X.1000306

Page 6 of 12

*The total is for the substance used in each row, including those with and without quarter of respondents with condom use experience were not
the sexual behavior in the columns confident about their correct use of a condom. In comparison, nearly
forty percent of Malawian students reported they had confidence in the
Table 3: Cross-tabulation of sexual behavior with types and frequency correct use of condom [32]. Our finding revealed the presence of an
of substance use among respondents. unsafe sense of protection-which might need attention by STI/HIV
prevention programs. At the same time, forty percent of students who
Our findings also revealed that there were six male students who ever used condom had sex without condom use in the last 12 months.
had sex with other males (MSM) (Tables 2 and 4). This finding is lower This is higher than the findings of similar studies in Ethiopia [4,7]. The
than the results of similar studies in Brazil [34] and China [42]. The differences might be due to variations in sample size.
observed difference might be due to cultural and religious influences.
Variables All Sex Chi-Square
Besides, underreporting might be the main reason, for homosexuality Responses Test p-value
is stigmatized and illegal in Ethiopia. In sub-Saharan Africa: studies (n=425) No.
among MSM revealed the presence of transactional sex and (%) Female Male (n=141,
unprotected anal sex-with high HIV prevalence [42-45]. One in ten (n=272, 34.1%) No.
65.9%) No. (%)
respondents who ever had sex reported STI symptoms. Among whom (%)
only one-third of them had sought for treatment. These findings
revealed a vulnerable group of students, which need to be addressed in Ever used condom¥ 0.001
HIV prevention programs.
Yes 145 (81.9) 61 (71.8) 84 (91.3)

Variables First Year Second Third Total No (%)* Chi- No 32 (18.1) 24 (28.2) 8 (8.7)
No (%) Year No (%) Year No square
(%) p-value
Total 177 (100.0) 85 (100.0) 92 (100.0)
Ever had sex 0.025
Condom used at first Sex* 0.011
Yes 55 (27.9%) 78 (39.6%) 64 197 (100.0%)
Yes 93 (65.0) 32 (52.5) 61 (74.4)
(32.5%)
No 50 (35.0) 29 (47.5) 21 (25.6)
No 66 (31.1%) 102 (48.1%) 44 212 (100.0%)
(20.8%)
Total 143 (100.0) 61 (100.0) 82 (100.0)
Sex with CSW≠ 0.22
Condom used always with a new sex partner* 0.189
Yes 8 (44.4%) 3 (16.7%) 7 (38.9%) 18 (100.0%)
Yes 87 (64.9) 31 (57.4) 56 (70.0)
No 13 (18.8%) 34 (49.3%) 22 69 (100.0%)
No 47 (35.1) 23 (42.6) 24 (30.0)
(31.9%)

≠Only Total 134 (100.0) 54 (100.0) 80 (100.0)

significant analyses are displayed. *No. (%) is for the row, ≠CSW for males
having sex with the commercial sex worker
Correct condom use* 0.069

Table 4: Cross-tabulation of sexual behavior variables with a year of Yes 106 (75.2) 40 (66.7) 66 (81.5)
study among respondents. No 35 (24.8) 20 (33.3) 15 (18.5)

According to the current study, eighty percent of students with Total 141 (100.0) 60 (100.0) 81 (100.0)
sexual experience had ever used a condom at one time or another
(Table 5). This finding is in line with similar studies in Addis Ababa Condom used during latest sexual intercourse* 0.063

[9], Nigeria [14] and Brazil [34]. The main reason for never using Consistent 91 (66.4) 31 (56.4) 60 (73.2)
condom trusted a partner. This is similar to the findings of other
studies in Ethiopia (among public universities) [45]. Among students Inconsistent 46 (33.6) 24 (43.6) 22 (26.8)
who ever used a condom, sixty percent had reported condom use at
Total 137 (100.0) 55 (100.0) 82 (100.0)
first sex. A similar observation was reported in Jimma University
(southwest Ethiopia) [5]. But, our finding is higher than the results of Current sex without condom* 0.024
studies in other parts of Ethiopia [4,7], South Africa [29] and Nepal
[26]. Since it is easy to remember recent condom use with a regular Yes 56 (39.7) 30 (51.7) 26 (31.3)

partner, it can be considered condom use on the latest sex as a measure No 85 (60.3) 28 (48.3) 57 (68.7)
of consistency. Accordingly, 66.4% of students who ever used condom
reported consistent condom use. This finding is higher than the results Total 141 (100.0) 58 (100.0) 83 (100.0)
of similar studies in Ethiopia [4,7] and other African countries [17,32].
Reasons for never using condom (Multiple
But, our finding is lower than that of Ugandan students (82.7%) [27]. responses)$
Three of five students who ever used a condom always used a Inaccessibility 1 (3.7) 0 (0.0) 1 (12.5)
condom with a new sex partner (non-regular one). This finding is in
line with other studies in Ethiopia [4,5] and Uganda [27]. But, it was Not 2 (7.4) 2 (10.5) 0 (0.0)
lower than the result of a study in Botswana [39]. Surprisingly a Comfortable

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Citation: Sendekie DB, Worku N (2019) A Case Study on Risky Sexual Behaviour of Undergraduate Students in Ethiopia. J Trop Dis 7: 306. doi:
10.4172/2329-891X.1000306

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Partner 3 (11.1) 1 (5.3) 2 (25.0) might be underreporting for fear of stigmatization. With their current
Disagree sexual behavior, sixteen students (8.9% of those with sexual initiation)
considered themselves to be at risk of HIV (Table 2). This indirectly
Sex in hurry 2 (7.4) 1 (5.3) 1 (12.5) indicated the presence of sexually active students who are at the risk of
Not Necessary 5 (18.5) 2 (10.5) 3 (37.5) STI/HIV infection. However, only one-third of who received medical
help. This could be due to embarrassment to ask help or lack of money
Don’t Like 4 (14.8) 3 (15.8) 1 (12.5) for treatment or may be due to lower health-seeking behavior.
Ethiopia’s DHS shows more prevalence of HIV among those with STI
Trust partner 10 (37.0) 7 (36.8) 3 (37.5)
symptoms than those without STI [2]. There is a need to address
Less Pleasure 1 (3.6) 0 (0.0) 1 (11.1) health-seeking behaviors in order to reduce or avoid pooling of high-
risk group across the student population.
Both HIV 8 (29.6) 6 (31.6) 2 (25.0)
negative
Factors associated with sexual behavior
Both HIV 1 (3.7) 0 (0.0) 1 (12.5)
positive This study indicated the significant association of different factors
with sexual behavior. When it comes to religion, Orthodox Christians
¥Analyzed only among students who started sex, *Analyzed among those who
and Protestants were less likely to have early sexual debut than
ever used a condom, $among students who never used a condom
Muslims or others (Table 6). Early marriage is common in Ethiopia,
especially in Muslim societies. But, this might not be the explanation,
Table 5: Condom use among study participants. for the number of married Muslims was small in our study. We did not
see other significant association of ethnicity or religion with risky
Our current results also showed ten percent of respondents who had sexual behavior.
sexual experiences had STI symptoms in the last 12 months. There

Variables Ever Had Sex Early Sexual Debut

No Yes p' AOR† (95% CI) No Yes p' AOR† (95% CI)

Sex 0 0.001

Female 160 (61.5) 100 (38.5) 1 68 (86.1) 11 (13.9) 1

Male 41 (29.7) 97 (70.3) 3.14*** (1.72,5.72) 58 (63.0) 34 (37.0) 3.88* (1.14,13.21)

Year of study 0.025 0.705

First 66 (54.5) 55 (45.5) 1 30 (75.0) 10 (25.0) N/A

Second 102 (56.7) 78 (43.3) 0.80 (0.41,1.58) 50 (70.4) 21 (29.6)

Third 44 (40.7) 64 (59.3) 0.84 (0.36,1.96) 46 (76.7) 14 (23.3)

Age in years 0 0.008

≤ 20 80 (65.6) 42 (34.4) 1 15 (51.7) 14 (48.3) 1

21-25 114 (49.6) 116 (50.4) 1.91 (0.99,3.66) 88 (80.0) 22 (20.0) 0.22* (0.05,0.95)

≥ 26 7 (18.4) 31 (81.6 3.56* (1.11,11.41) 19 (70.4) 8 (29.6) 0.69 (0.11,4.26)

History of marriage 0 0.111

Yes 21 (24.4) 65 (75.6) 1 43 (82.7) 9 (17.3) 1

No 172 (57.5) 127 (42.5) 0.23*** (0.11,0.47) 80 (69.6) 35 (30.4) 1.53 (0.39,6.01)

Religion 0.51 0

Orthodox Christian 151 (53.2) 133 (46.8) N/A 89 (77.4) 26 (22.6) 1

Protestant 31 (44.3) 39 (55.7) 30 (85.7) 5 (14.3) 0.82 (0.17,3.93)

Muslim 21 (56.8) 16 (43.2) 5 (41.7) 7 (58.3) 11.48*

(1.65,79.96)

Others≠ 8 (47.1) 9 (52.9) 2 (22.2) 77 (77.8) 16.11*

(1.43,182.02)

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ISSN:2329-891X
Citation: Sendekie DB, Worku N (2019) A Case Study on Risky Sexual Behaviour of Undergraduate Students in Ethiopia. J Trop Dis 7: 306. doi:
10.4172/2329-891X.1000306

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Ethnicity 0.07 0.001

Oromo 34 (54.8) 28 (45.2) 1 18 (75.0) 6 (25.0) 1

Amhara 107 (52.7) 96 (47.3) 1.66 (0.74,3.73) 64 (73.6) 23 (26.4) 0.49 (0.10,2.41)

Tigre 16 (33.3) 32 (66.7) 3.47* (1.19,10.15) 18 (69.2) 8 (30.8) 2.31 (0.39,13.70)

SNNP‡ 38 (59.4) 26 (40.6) 1.04 (0.39,2.77) 21 (100.0) 0 (0.0) 0

Others 8 (44.4) 10 (55.6) 7.50* (1.40,40.01) 2 (25.0) 6 (75.0) 1.14 (0.09,13.72)

Living with 0 0.092

Parents 165 (60.4) 108 (39.6) 1 78 (80.4) 19 (19.6) 1

Others± 42 (34.1) 81 (65.9) 2.99** (1.59,5.63) 46 (67.6) 22 (32.4) 0.24 (0.04,1.36)

Parents’ Income 0.413 0.071

Low 106 (49.5) 108 (50.5) N/A 73 (80.2) 18 (19.8) 1

High 97 (54.2) 82 (45.8) 50 (66.7) 25 (33.3) 0.75 (0.21,2.61)

Parents’ Education 0.162 0.492

Low 61 (46.6) 70 (53.4) 1 41 (69.5) 18 (30.5) N/A

High 150 (54.5) 125 (45.5) 1.06 (0.57,1.98) 84 (75.7) 27 (24.3)

Parents’ residence 0.002 0.164

Addis Ababa 182 (55.8) 144 (44.2) 1 99 (76.7) 30 (23.3) 1

Other town/city 30 (36.1) 53 (63.9) 1.40 (0.55,3.56) 27 (64.3) 15 (35.7) 28.11**

(3.87,204.48)

Pocket money 0.024 0.012

Less 149 (56.4) 115 (43.6) 1 81 (81.0) 19 (19.0) 1

More 55 (43.7) 71 (56.3) 1.19 (0.66,2.16) 39 (61.9) 24 (38.1) 4.26* (1.37,13.18)

Participation in health/ 0.057 0.527

sport club

No 121 (57.1) 91 (42.9) 1 56 (70.9) 23 (29.1) N/A

Yes 76 (46.6) 87 (53.4) 1.23 (0.69,2.16) 59 (76.6) 18 (23.4)

Substance Use 0 0.063

No 158 (63.5) 91 (36.5) 1 62 (67.4) 14 (18.7) 1

Yes 51 (33.3) 102 (66.7) 2.68** (1.48,4.83) 61 (81.3) 30 (32.6) 1.45 (0.42,5.06)

≠Others
include Catholics, Adventists, Traditional believers, and non-believers. ‡SNNP for indigenous ethnic groups of Southern Nations, Nationalities, and Peoples.
±Others:
relatives, siblings, partner, friend, or alone. N/A=Not Applicable in the multivariate analysis, n.s.=not significant (p-value ≥ 0.05,) p’=p-value for chi-square test.
†AOR=Adjusted Odds Ratio (only variables with p ≤ 0.20 in the bivariate analysis were entered in the multivariate analysis). *p-value<0.05, **p-value<0.01, ***p<0.001

Table 6: Bivariate and multivariate analyses of socio-demographic characteristics with outcome variables (ever had sex and early sexual debut)
among respondents.

Regarding the residence of parents, those students whose parents living with parents. In addition, they were 60% less likely to always use
reside in Addis Ababa were less likely to have early sexual debut than a condom with a new partner than students living with parents. It is
those whose parents reside in another city/town (Table 5). This might true that when students are not living with their parents, it is difficult
be due to parents’ control and guidance in postponing sexual debut. In for parents to have direct supervision. This situation will allow students
support of this hypothesis, our findings also indicated that students to experience the relative freedom to experiment with their sexual
who were not living with their parents were three times more likely to drive. Besides, they might also be influenced by their peers to take
start sex as compared to those living with parents. They were also less unnecessary risks.
likely to use a condom at first and last sexual exposures than students

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Respondents coming from high-income families were also three Cigarettes 63 (42.6) 24 (34.8) 38 (48.7) 0.124
times more likely to have multiple sexual partners than those from
low-income families. Similarly, students with more pocket money were Alcohol 121 (81.8) 57 (82.6) 63 (80.8) 0.941
four times more likely to have early sexual debut (than those with less
Khat 67 (45.3) 20 (29.0) 46 (59.0) 0
pocket money). This might be explained by the financial freedom
which might encourage students to experiment a risky sexual practice. Hashish 23 (5.4) 8 (11.6) 14 (17.9) 0.397

In this study, it is obvious that unmarried students were 77% less Shisha 35 (23.6) 15 (21.7) 20 (25.6) 0.719
likely to start sex than married ones. Besides, they were also 58% less
likely to have sex without a condom in the last 12 months (Table 6). It Morphine/ 4 (2.7) 3 (4.3) 1 (1.3)
Diazepam
was encouraging to see that one-third of respondents were observed to
participate in health/sports clubs. However, their participation in these Heroin/ 2 (1.4) 1 (1.4) 1 (1.3)
clubs had no significant impact on their risky sexual behavior. Cocaine

Our findings also showed males were more likely to begin sexual Substance used* 0
intercourse and have an early sexual debut than females. Having
Less 66 (45.2) 43 (65.2) 23 (29.1)
multiple sex partners were more likely in males than in females. These
Frequent
findings are consistent with similar studies in Ethiopia [5,8] and other
countries [30,31,34,46]. This might similarly be explained by cultural More 80 (54.8) 23 (34.8) 56 (70.9)
influence. In Ethiopia, females are advised to keep their virginity until Frequent
marriage. But, men are socially accepted if they need to have sex-even
Total 146 (100.0) 66 (100.0) 79 (100.0)
with multiple partners. Male students were more likely to use a
condom at first sex or another time compared to females. This might Heavy Drinking* 0.003
indicate the unplanned nature of female students’ sexual act-as
More 56 (37.3) 16 (23.5) 39 (48.8)
observed among college youth [47]. Males were also more likely to Frequent
report correct condom use than females. These differences might be
explained by the male dominant nature of the Ethiopian community. Less 94 (62.7) 52 (76.5) 41 (51.2)
Females might have limited power to negotiate condom use. Difficulty Frequent
in using a female condom might be another reason as indicated in Total 150 (100.0) 68 (100.0) 80 (100.0)
Brazil [34]. Besides, females might have less intention to use condom-
as shown in Madagascar [31]. In South Africa: a study indicated a *Analyzed among substance users
significant association of condom use efficacy with an intention to use
it and a history of condom use [29]. Table 7: Substance use among respondents.
Older students (≥ 26 years) were three times more likely to start sex
and six times more likely to have multiple sex partners in the last 12 Knowledge, risk perception, and attitude to HIV infection
months. This finding is consistent with a similar study in Ethiopia [5].
According to Table 8, near two-thirds of participants were aware of
Substance users were more likely to begin sex than non-users. They university students’ vulnerability to HIV. They were also aware of the
were also more likely to have multiple sex partners than non-users possible presence of HIV in a healthy looking individual. Most
(Table 7). Students with a history of substance use were less likely to students (95.1%) knew transmission of HIV by unprotected sex. They
always use a condom during casual sex. These might be explained by also mentioned condom use and abstinence to prevent HIV infection.
the risk-taking behavior associated with the effects of substances used. Eighty percent of study participants considered HIV test for safe sex.
These findings are consistent with similar studies in Ethiopia [5,9]. We Above fifty percent (to be exact, 54.7%) of participants were tested for
did not see any significant predicting association of the year of study HIV. These findings are consistent with the results of the health survey
with sexual behavior. This might indicate that education level might among Addis Ababa’s youth [2]. The statistical analysis results also
not affect students’ sexual behavior. showed no significant difference between male and female students (in
relation to knowledge, risk perception, and attitude).
Variables All responses Sex Chi-Square
(n=425) No. Test (p-value) Variables All Sex Chi-Square
(%) Responses Test (p-value)
Female Male (n=425) No. Female Male (n=141,
(n=272; (n=141; (%) (n=272, 34.1%) No.
65.9%) No. 34.1%) No. 65.9%) No. (%)
(%) (%) (%)

Substance use 0 University students are at risk of HIV infection

Yes 156 (37.5) 73 (27.4) 82 (59.4) Yes 266 (65.4) 174 (67.2) 83 (61.0) 0.268

No 260 (62.5) 193 (72.6) 56 (40.6) No 141 (34.6) 85 (32.8) 53 (39.0)

Total 416 (100.0) 266 (100.0) 138 (100.0) Total 407 (100.0) 259 (100.0) 136 (100.0)

Substances used* (Multiple responses) Sources of HIV infection among students (Multiple responses)

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Citation: Sendekie DB, Worku N (2019) A Case Study on Risky Sexual Behaviour of Undergraduate Students in Ethiopia. J Trop Dis 7: 306. doi:
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Students 199 (54.8) 121 (52.2) 68 (57.1) 0.439 Total 399 (100.0) 256 (100.0) 131 (100.0)

Lecturers 111 (30.6) 78 (33.6) 27 (22.7) 0.046 The healthy looking student can have an HIV infection 0.824

Business 234 (64.5) 156 (67.2) 69 (58.0) 0.111 Yes 302 (75.9) 195 (76.8) 100 (75.8)
man/woman
No 96 (24.1) 59 (23.2) 32 (24.2)
Commercial 134 (36.9) 81 (34.9) 46 (38.7) 0.566
Sex workers Total 398 (100.0) 254 (100.0) 132 (100.0)

Street boy/girl 128 (35.3) 75 (32.3) 46 (38.7) 0.288 HIV prevention methods (Multiple responses)

Ways of HIV transmission (Multiple responses) Condom use 273 (70.0) 170 (68.5) 96 (73.8) 0.341

Sharing sharp 122 (31.3) 88 (35.6) 31 (23.7) 0.023 Being 93 (23.8) 52 (21.0) 37 (28.5) 0.133
materials mutually
faithful
Sex without 371 (95.1) 236 (95.5) 124 (94.7) 0.894
Condom Abstaining till 262 (67.2) 172 (69.4) 81 (62.3) 0.205
marriage
Blood 34 (8.7) 24 (9.7) 10 (7.6) 0.628
transfusion Not sharing 138 (35.4) 86 (34.7) 47 (36.2) 0.863
sharp stuff
Mosquito bite 19 (4.9) 13 (5.3) 6 (4.6) 0.967
Male 16 (4.1) 5 (2.0) 11 (8.5) 0.007
Sharing food 8 (2.1) 6 (2.4) 2 (1.5) circumcision

Others¥ 15 (3.8) 9 (3.6) 5 (3.8) ¥Supernatural natural means like witchcraft, God’s curse, *among students who
had HIV test
Tested for HIV 0.573

Yes 220 (54.7) 138 (53.9) 77 (57.5) Table 8: Knowledge and Attitude to HIV/AIDS among respondents.

No 182 (45.3) 118 (46.1) 57 (42.5) Despite good knowledge of safe sexual practices, we observed a
statistically significant presence of risky sexual behavior. This finding is
Total 402 (100.0) 256 (100.0) 134 (100.0)
consistent with similar studies in Uganda [13] and Malawi [32], where
Time of HIV test* 0.37 high knowledge of STI prevention methods was not followed by the
proper behavior. In Addis Ababa: a study indicated a significant
≤ 12 129 (62.3) 86 (64.7) 40 (57.1) presence of HIV infection among well-educated individuals [48]. This
month=Recen
t study shows the need to have a proper behavioral modification. The
university has only one nurse to do first aid. Since more than half of
>12 78 (37.7) 47 (35.3) 30 (42.9) participants did not start sex, availing youth-friendly HIV testing
months=Late
service might help to practice safe sexual behavior. It has already been
Total 207 (100.0) 133 (100.0) 70 (100.0) stated less than 10% of students with sexual experience, considered
they at risk of HIV. The low self-risk perception might also be the
HIV test for safe sex explanation for the observed risky sexual behaviors. Hence, there is an
urgent need for HIV risk awareness programs in a similar setting.
Yes 280 (70.9) 184 (73.0) 91 (69.5) 0.54

No 115 (29.1) 68 (27.0) 40 (30.5) Study Limitations

Total 395 (100.0) 252 (100.0) 131 (100.0) The survey was cross-sectional; we could not tell any cause and
Allow HIV infected Student to continue the friendship 0.363
effect relationship. But, it has been tried to determine observed
significant associations between socio-demographic characteristics
Yes 249 (63.5) 163 (65.5) 78 (59.5) and sexual behavior. The responses might also be affected by recall
bias. We tried to minimize such effect-by including questions related to
No 46 (11.7) 25 (10.0) 19 (14.5)
“one event/recent event”. Though this might make it easy to remember
Not sure 97 (24.8) 61 (24.5) 34 (26.0) an event, there might still be possible effects of recall bias. Some
questions related to substance use and sexual behavior might also be
Total 392 (100.0) 249 (100.0) 131 (100.0) quite sensitive. This might result misreporting, under- or over-
Keep it secret the fact that your classmate is infected 0.24
reporting of similar other variable responses.
with HIV
Conclusion
Yes 338 (84.7) 222 (86.7) 105 (80.1)
Even though it is not easy to infer these results into the general
No 14 (3.5) 8 (3.1) 6 (4.6)
population, our study revealed the presence of risky sexual behaviors
Not sure 47 (11.8) 26 (10.2) 20 (15.3) among the study groups. Though these students were considered more
privileged than those in public universities, the findings showed

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similar patterns of sexual behavior. Besides, there were similar 6. Belachew TJC, Mamo Y (2002) Knowledge, attitude and practice about
predisposing factors to risky sexual behavior. Despite the high HIV/AIDS and VCT among students of Jimma University. Ethiop J
knowledge of HIV, there was low HIV risk perception and testing. Low Health Scie 14: 43-53.
health/treatment-seeking behavior was also observed among STI 7. Dingeta T, Oljira L, Assefa N (2012) Patterns of sexual risk behavior
among undergraduate university students in Ethiopia: A cross-sectional
exposed or at-risk individuals. The study findings may be used to
study. Pan Afr Med J 12: 33.
strengthen STI/HIV risk perception, prevention, testing, and
treatment-seeking behaviors. It can be suggested that the university 8. Dingeta T OL, Alemayehu T, Akililu A (2011) First sexual intercourse and
risky sexual behaviors among undergraduate students at Haramaya
would benefit from collaborating with health organizations working on University, Ethiopia. Ethiop J Repro Health 5: 22-30.
HIV/AIDS prevention programs. The student council may also be used
9. Regassa N, Kedir S (2011) Attitudes and practices on HIV preventions
as entry point-to deliver peer education, strengthen negotiation skills, among students of higher education institutions in Ethiopia: The case of
and demonstrate correct use of condom/other proper behavioral Addis Ababa University. East Afr J Public Health 8: 141-154.
modifications. In conclusion, in order to help policymakers and bring 10. Wasie B, Belyhun Y, Moges B, Amare B (2012). Effect of emergency oral
significant progress to the general population, it is highly suggested contraceptive use on condom utilization and sexual risk taking
that larger studies including other departments/universities using a behaviours among university students, Northwest Ethiopia: A cross-
combination of additional qualitative and quantitative methods be sectional study. BMC Res Notes 5: 501.
done. 11. Organization WHO (2008) 10 facts on adolescent health.
12. Odu OO, Asekun-Olarinmoye EO, Bamidele JO, Egbewale BE, Amusan
OA, et al. (2008) Knowledge, attitudes to HIV/AIDS and sexual behavior
Data Availability of students in a tertiary institution in south-western Nigeria. Europ J
All the necessary data used to support the findings of this study are Contracep Repro Health Care 13: 90-96.
included in the article. 13. Sekirime WK, Tamale J, Lule JC, Wabwire-Mangen F (2001) Knowledge,
attitude and practice about sexually transmitted diseases among
university students in Kampala. Afr Health Scie 1: 16-22.
Funding Statement 14. Okafor II, Obi SN (2005) Sexual risk behavior among undergraduate
There was no funding available to perform this study. students in Enugu, Nigeria. J Obstet Gynaecol 25: 592-595.
15. Peltzer K ( 2010) Early sexual debut and associated factors among in-
school adolescents in eight African countries. Acta paediat 99: 1242-1247.
Competing Interests 16. Deressa W, Azazh A (2011) Substance use and its predictors among
The authors declare no competing interests. undergraduate medical students of Addis Ababa University in Ethiopia.
BMC Public Health 11:660.
17. Imaledo JA, Peter-Kio OB, Asuquo EO (2012) Pattern of risky sexual
Authors’ Contributions behavior and associated factors among undergraduate students of the
University of Port Harcourt, Rivers State, Nigeria. The Pan Afr Med J 12:
The author DS conceived the study topic, formulated and designed
97.
the study, collected the research data, conducted the statistical analysis,
18. Addis Ababa University (2013) HIV, STI, and TB prevention and control
and wrote the manuscript. The author NW participated in the revision project.
of the study topic and study design, supervised statistical analysis, and
19. Dahlgren GWM (2007) Policies and strategies to promote social equity in
approved the final version of the manuscript to be published. health. Background document to WHO-Strategy paper for Europe.
WHO: Institute for Future Studies.
Acknowledgment 20. Group TMET (2012) Unity University.
21. Wikipedia TFE (2012) Unity University.
A special thanks to Carina Källestål (Associate professor) who
contributed to the development of the research protocol in the 22. HIV/AIDS Behavioral Surveillance Survey (BSS) Round two (2005).
Addis Ababa, Ethiopia.
Department of Women's and Children's Health, Uppsala University,
Sweden. Great acknowledgments go back to all the study participants 23. WMA (2008) Declaration of Helsinki-ethical principles for research
involving human subjects.
and staff members of Unity University, Addis Ababa, Ethiopia. Thanks
24. Sun X, Liu X, Shi Y, Wang Y, Wang P, et al. (2013) Determinants of risky
to Zelalem Berihun for his unwavering support, Samuel Tilahun for sexual behavior and condom use among college students in China. AIDS
printing questionnaires. care 25: 775-783.
25. Sujay R (2009) Premarital sexual behaviour among unmarried college
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Citation: Sendekie DB, Worku N (2019) A Case Study on Risky Sexual Behaviour of Undergraduate Students in Ethiopia. J Trop Dis 7: 306. doi:
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