# Prevalence of risky sexual behaviors and associated factors among students at a private university in Lebanon

## TL;DR

This study finds that risky sexual behaviors are common among university students in Lebanon, with substance use and new sexual partners being key factors.

## Contribution

The study provides new insights into risky sexual behaviors in the Middle East, a region with limited prior research on this topic.

## Key findings

- 233 out of 588 participants were sexually active, with 96.6% engaging in at least one risky sexual behavior.
- Substance use was significantly associated with a higher number of risky sexual behaviors.
- Unprotected oral sex was the most common risky behavior reported.

## Abstract

Engaging in unsafe sexual practices remains a major public health concern among young adults worldwide. Despite extensive global research, there is limited evidence from the Middle East, where sexuality is often a taboo subject and sexual education is minimal. This study aimed to examine the prevalence of risky sexual behaviors among university students in Lebanon and to identify factors associated with these behaviors, including substance use and engagement with social and digital media.

A cross-sectional online survey was conducted among undergraduate and graduate students at the Lebanese American University between May and November 2022. Participants completed an anonymous, self-administered questionnaire assessing sociodemographic characteristics, sexual history, and multimedia use. Data were analyzed using IBM SPSS Statistics version 29. For the count outcome, poisson regression was applied to identify factors associated with a higher number of risky sexual behaviors, defined as unprotected sex, multiple simultaneous partners, sexual activity under the influence of substances, or transactional sex.

Among 588 participants, 233 (39.6%) were sexually active, of whom 225 (96.6%) reported at least one risky sexual behavior, with a mean of 2.24 risky behaviors per participant. Unprotected oral sex was the most common unsafe practice. Students who reported drug use were significantly more likely to engage in a higher number of risky sexual behaviors (rate ratio = 1.73), as were those who reported sexual activity with someone they had just met (rate ratio = 1.39). Social media and dating application use were not significantly associated after adjustment.

Risky sexual behaviors are highly prevalent among university students in Lebanon. These findings highlight the urgent need for culturally adapted educational interventions addressing substance use and promoting safer sexual behaviors among young adults in the Middle East.