Sexual health literacy and risky sexual behaviour among female university students in Tanzania: a social-ecological analysis of levels, differences, and determinants

Unintended pregnancy (UIP) remains a persistent public health concern among young women in sub-Saharan Africa, including Tanzania. This study examined Sexual Health Literacy for Pregnancy Prevention (SHLPP) and engagement in Sexual Behaviours potentially leading to UIP (referred to in this study as Risky Sexual Behaviours [RSB]) among female university students using a Social Ecological Model (SEM). Specifically, it assessed (i) levels of SHLPP and RSB, (ii) differences across individual, interpersonal, and contextual factors, and (iii) the predictive effects of these factors on SHLPP and RSB, including the influence of SHLPP on RSB. A cross-sectional study was conducted involving 255 female university students at Sokoine University of Agriculture, Tanzania. Data were collected using a structured questionnaire and analysed using descriptive statistics, factorial ANOVA, and hierarchical multiple regression. Most participants (75.6%) exhibited low-to-moderate SHLPP, while 63.7% reported moderate-to-high RSB. Upbringing environment significantly influenced both RSB (F(1,165) = 17.817, p < .001, η 2 = .097) and SHLPP (F(1,218) = 4.124, p < .05, η 2 = .019), with urban students reporting higher levels of both. Year of study showed a small, albeit significant effect on RSB (F(2,165) = 3.246, p < .05, η 2 = .038) only. Parental education and accommodation type did not have significant independent effects on SHLPP and RSB. However, they exerted significant interaction effects between: (i) parental education and upbringing environment, and between parental education and accommodation type on RSB and (ii) upbringing environment and accommodation on SHLPP. Parent–daughter communication emerged as the strongest predictor of both SHLPP (β = .318, p < .001) and RSB (β = .402, p < .001). Notably, SHLPP did not significantly predict RSB (β = .088, p = .221), indicating a disconnect between knowledge and behavior. Sexual behaviour among FUS is more strongly shaped by interpersonal and contextual factors than by individual knowledge alone. These findings underscore universities’ need to enhance parent–child communication, deliver targeted sexual health education, and consider student backgrounds when allocating housing.