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

Abstract

Objective: 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. Design: A case-control methodology was used. Sample: The sample consisted of 500 students (375 HIV negative students and 125 students living with HIV). Measurement: Adjusted logistic regression modeling was performed to assess the association of predictors with RSBs and HIV seropositivity. Results: 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]. Conclusion: 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.