Factors Associated with Risky Sexual Behavior Among Reproductive-Age Men in Ethiopia: Evidence from Ethiopian Demography and Health Survey 2016

Background: Risky sexual behavior is defined as engaging in sexual activities that increase the risk of contracting sexually transmitted infections (STIs) and unintended pregnancies, both of which are global public health issues, particularly in low and middle-income countries like Ethiopia. Hence, this study aimed to identify factors associated with risky sexual behaviors among sexually active men in Ethiopia. Methods: We analyzed data on 8, 103 men aged 15-59 years obtained from the 2016 Ethiopian Demographic and Health Survey. Bivariable and multivariable logistic regression analyses were performed to identify the factors associated with risky sexual behavior. Statistical significance was defined at a 95% confidence interval (CI) with a p-value less than 0.05. Results: Overall, 13.6% (95% CI: 12.8-14.3) of men were engaged in risky sexual behavior. Men who were married (adjusted odds ratio [AOR]=0.02, 95% CI: 0.01-0.03) and residing in agrarian-dominated regions (AOR=0.58, 95% CI: 0.44-0.76) were less likely to engage in risky sexual behavior. On the other hand, men who had alcohol-drinking habits (AOR=1.50, 95% CI: 1.13, 1.99), and initiated sexual activity before the age of 18 (AOR=1.58, 95% CI: 1.26-1.99), those with primary education (AOR=1.32, 95% CI: 1.01-1.72) or secondary education (AOR=1.65, 95% CI: 1.20-2.26), and those who were Muslim (AOR=1.84, 95% CI: 1.32-2.60) or other religion followers (AOR=2.00, 95% CI: 1.44-2.76) were more likely to engage in risky sexual behavior. Conclusion: Risky sexual behavior was significantly associated with marital status, geographic location, alcohol consumption, age of first sexual experience, religion, and educational level, which highlights the importance of encouraging men to avoid early sexual activities and to abstain from consuming alcohol. Moreover, a greater emphasis should be placed on initiatives that promote safer sexual behaviors, particularly targeting men living in pastoral regions, unmarried individuals, and Muslim religious followers.