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.