Exploring prevalence of risky sexual behaviour among adolescents in high schools: A systematic review

Background: Adolescents’ engagement in risky sexual behaviours poses a significant risk to their sexual and reproductive health, particularly in low- and middle-income nations. Risky sexual behaviour includes actions that heighten the risk of sexually transmitted infections and unintended pregnancies. This study aims to identify strategies for managing risky sexual behaviours among adolescents, focusing on understanding their prevalence, risk factors, consequences and effective interventions. Methods: A systematic review was performed following the PRISMA 2020 guidelines. We searched electronic databases (PubMed, Cochrane Library, Web of Science, Science Direct, Google Scholar) for English-language studies published between January 2012 and May 2024, using keywords and MeSH terms related to ‘risky sexual behaviour’, ‘adolescents’, ‘high school students’, ‘prevalence’, ‘factors’, ‘consequences’ and ‘interventions’. The review involved identification, screening, eligibility assessment and data extraction, with methodological quality assessed using Joanna Briggs Institute checklists, guided by inclusion and exclusion criteria. Results: A total of 26 studies showed global risky sexual behaviour prevalence ranging from 7.6% in Uganda to 85.1% in Indonesia. Key risky behaviours included multiple partners and inconsistent condom use. Influencing factors were socioeconomic status, substance use, peer/media influence, family dynamics and individual traits. Consequences included sexually transmitted infections, unintended pregnancies and school dropouts. Peer pressure and inadequate parental involvement were identified as major drivers of high-risk activities. Conclusion: Effective strategies identified include sexual education, healthcare, family support and policy changes. A multifaceted approach involving education, parental involvement and peer engagement is essential for reducing adolescent risky sexual behaviour and promoting healthier outcomes for youth.