Abstract
BACKGROUND: Sexually transmitted infections (STIs) remain a global public health issue and are highly prevalent in sub-Saharan Africa, with current literature indicating that risky sexual behaviors are major risk factors. Studies have shown that STIs are more common among young people engaging in risky sexual behaviors. We examined the associations between sexual behaviors and self-reported STIs, including the role of marital status, among male and female Nigerian youths (aged 15-29). METHODS: We pooled and analyzed data from the 2008, 2013, and 2018 Nigeria Demographic and Health Surveys (NDHS). The secondary data were collected using a stratified two-stage cluster sampling technique across the states in Nigeria. We categorized sexual behaviors (in the last twelve months) into six groups ranging from abstinence to non-condom use and sexual infidelity, and measured STI status through self-reporting. We performed chi-square tests of associations and multivariable logistic regressions to examine the relationships between sexual behaviors and self-reported STIs among married and never-married youths. RESULTS: The findings of this study revealed that the associations between sexual behaviors and self-reported STI depended on sex and marital status. Among never-married women, those who did not use condoms and who were engaged in sexual infidelity were four times more likely to report having a STI (OR = 4.88; 95% CI = 2.84-8.37) compared to those who practiced abstinence. Among married women, the odds of self-reporting of a STI were seven times higher for those who used condoms but engaged in sexual infidelity (OR = 7.60; 95% CI = 2.06-28.09). For never-married men, those who used condoms but engaged in sexual infidelity were five times more likely to report STIs (OR = 5.54; 95% CI = 2.87-10.68) than those who practiced abstinence. For married men, sexual behaviors were not significantly associated with self-report of STI. CONCLUSION: This study showed that sexual behaviors were associated with self-reported STIs among never-married and married female youths and never-married male youths in Nigeria. These findings can inform programs aimed at reducing STI transmission among youths in Nigeria. Specifically, they can guide the development of educational programs to increase youth awareness of the risks associated with their sexual behaviors.