Association between sexual and reproductive health knowledge and protective sexual behaviors among young women in Nigeria

BackgroundWhile the literature is replete with studies on young peoples risky sexual behaviors and their effects on HIV and STI acquisition, unintended pregnancy, and unsafe abortion, few studies have explored the practice of protective sexual behaviors and its association with sexual and reproductive health knowledge. We examined the association between sexual and reproductive health knowledge and protective sexual behaviors using data of young women in Nigeria. MethodsData of 8,995 young women (aged 15-24) who were neither married nor living with a partner were obtained from the 2018 Nigeria Demographic and Health Survey (NDHS) and analyzed in this study. Protective sexual behaviors were measured using questions exploring sexual fidelity, condom use, having multiple partners, and abstinence, while sexual and reproductive health knowledge was measured with questions on fertility, fecundity, contraceptives, and HIV prevention. We fitted multinomial logistic regression to examine the association between sexual and reproductive health knowledge and protective sexual behaviors. ResultsThe median score on sexual and reproductive health knowledge was five. The majority of the sample (71.5%) had no sexual experience, 6.6% abstained from sex in the past year, 7.2% used condoms and practiced sexual fidelity, 1.0% used condoms but did not practice sexual fidelity, 12.7% did not practice sexual fidelity but used condoms while 0.8% neither used condom nor practiced sexual fidelity. After controlling for important covariates, sexual and reproductive health knowledge was positively associated with "condom use and sexual fidelity" (uRRR = 1.28; CI = 1.04-1.60) relative to "not using condoms nor practicing sexual fidelity." However, the association between sexual and reproductive health knowledge and other categories of protective sexual behaviors, such as no sexual experience, abstinence in the past year, and sexual fidelity but no condom use, did not reach a significant level. ConclusionWe found a high prevalence of protective sexual behavior among young women in Nigeria. Our study provides evidence in support of the association between sexual and reproductive health knowledge and a higher likelihood of practicing protective sexual behaviors. Intervention efforts can focus on providing sexual and reproductive health education to young people to equip them with information to safeguard their sexual health.