# A Case‐Control Investigation of Factors Associated With Risky Sexual Behaviors Among South African University Students

## TL;DR

This study identifies factors like heavy drinking and drug use before sex that increase risky sexual behaviors and HIV risk among South African university students.

## Contribution

The study provides new insights into specific behavioral predictors of risky sexual behaviors and HIV seropositivity among university students in South Africa.

## Key findings

- Heavy episodic drinking increases the likelihood of multiple concurrent sex partners.
- Drug use before sex significantly raises the risk of risky sexual behaviors.
- More lifetime sex partners are strongly associated with increased risky sexual behaviors.

## Abstract

This study aimed to investigate risk factors associated with risky sexual behaviors (RSBs) and HIV seropositivity among students from four universities in KwaZulu‐Natal, South Africa.

A case‐control methodology was used.

The sample consisted of 500 students (375 HIV negative students and 125 students living with HIV).

Adjusted logistic regression modeling was performed to assess the association of predictors with RSBs and HIV seropositivity.

Data showed that heavy episodic drinking [aOR: 2.73, (95% CI: 1.38; 5.44), p = 0.004], drugs before sex [aOR: 7.46, (95% CI: 2.11; 27.88), p = 0.003], and a higher number of lifetime sex partners increased students’ likelihood of having multiple concurrent sex partners (2–5 lifetime partners) [aOR: 4.22, (95% CI: 1.69; 10.54), p = 0.002] and ≥ 6 lifetime partners [aOR: 16.36, (95% CI: 6.18; 43.28), p < 0.001].

These findings indicate a need for South African universities to offer HIV prevention programs that inform students of how participation in particular risky activities can result in engagement in specific RSBs, contributing to a heightened HIV infection risk. Re‐evaluation and strengthening of these prevention programs can ensure optimal efficiency in the battle against HIV infection.