The Relationship Between Decisional Balance and Self-Efficacy for Sexual Abstinence Among University Students

Purpose: This research was conducted to determine the relationship between university students’ decision-making regarding sexual abstinence and their self-efficacy.Methods: In this analytical cross-sectional study, data were collected from 450 students proportionally selected from three faculty groups (Health Sciences, Engineering and Natural Sciences, Social/Humanities) at a private university in Istanbul between October 2024 and February 2025. Data were evaluated using the Decisional Balance Scale for Sexual Abstinence (DBSSA) and the Self-Efficacy Scale for Sexual Abstinence (SESSA). Analyses included Pearson correlation, paired and independent-samples t-tests, one-way ANOVA with Tukey post-hoc comparisons, and multiple linear regression.Results: The mean age of the participants was 21.26 ± 2.51 years, and 31.3% reported being sexually active. The mean scores for internal pros, external pros, and cons were 16.25 ± 3.67, 13.01 ± 4.01, and 20.24 ± 6.16, respectively, while the mean self-efficacy score was 23.38 ± 5.25. The mean-item scores for internal and external pros were nearly identical (3.25 ± 0.73 vs. 3.25 ± 1.00; t(449) = −0.073, p = 0.942). Self-efficacy was positively correlated with internal pros (r = 0.464) and external pros (r = 0.401) and negatively correlated with cons (r = −0.393; all p < 0.001). In the multiple regression model (R² = 0.380), internal pros (β = 0.173, p = 0.001), external pros (β = 0.176, p < 0.001), cons (β = −0.141, p = 0.003), and female gender (β = 0.316, p < 0.001) were independently associated with selfefficacy.Conclusion:Students with higher abstinence self-efficacy scored higher on the pros of abstinence and lower on the cons, and self-efficacy was higher among female students. Abstinence-related programs may be more effective when they address the internal pros, external pros, and cons together, taking students’ gender into account.