Nearly Four in Five Ghanaian Students Report Risky Sexual Behaviour, Survey Finds

A sweeping survey of nearly 11,000 undergraduate students at a public university in Ghana has revealed a striking pattern of sexual risk-taking that public health researchers say could undermine decades of progress against HIV and unintended pregnancy. The study, published in BMC Public Health by a team from the University of Cape Coast, found that while just over a third of students were sexually active, nearly four in five of those who were sexually experienced reported at least one behaviour that markedly increases their exposure to sexually transmitted infections or unplanned pregnancies. The findings arrive at a moment when universities across sub-Saharan Africa are being urged to treat student sexual health not as a private matter but as a core pillar of campus public health infrastructure.

The research team, led by Mary Aku Ogum and including Thomas Hormenu and Edward Wilson Ansah, set out to quantify both the prevalence of risky sexual behaviours and the social and demographic factors that predict them among unmarried, regular undergraduate students. Their motivation was straightforward: university students in Ghana, as in many countries, represent a large, mobile, and socially transitional population. They are typically living away from parental oversight for the first time, navigating new peer environments, and encountering the freedoms and pressures of early adulthood. Studies from universities in multiple countries have shown that this group is more likely to be sexually active and to engage in behaviours with negative consequences for health and academic achievement, making them a priority population for prevention efforts.

Methodologically, the study was ambitious in scale. The researchers conducted a quantitative cross-sectional survey using a multistage sampling procedure to recruit 10,896 undergraduate students, split evenly between 5,448 males and 5,448 females. Data were collected with an adapted questionnaire drawn from the Core Expanded Questions of the Global School-based Student Health Survey, a standardized instrument designed to allow comparison across settings and countries. The team then analyzed responses using frequencies, percentages, and binary logistic regression, a statistical technique that estimates how strongly each candidate factor predicts a binary outcome, in this case whether a student engaged in risky sexual behaviour. The study received ethical approval from the Institutional Review Board of the University of Cape Coast, and every participating student signed an informed consent form before taking part.

The headline numbers are sobering. Of the 10,896 students surveyed, 38.3 percent, or 4,176 individuals, reported being sexually active. Within that sexually active group, the researchers documented a cluster of behaviours that epidemiologists consider high-risk. The most common was condom non-use: 63.7 percent of sexually active students, amounting to 2,661 individuals, reported not using condoms. Nearly half, 45.7 percent or 1,654 students, reported having multiple sexual partners, a pattern that multiplies the number of potential transmission pathways for HIV and other sexually transmitted infections. A substantial 37.2 percent, or 1,552 students, reported using alcohol or drugs in connection with sex, a behaviour known to impair judgment, reduce condom negotiation, and increase the likelihood of unprotected encounters.

Two further findings rounded out the risk profile. Some 16.3 percent of sexually active students, or 682 individuals, reported engaging in anal sex, a practice associated with a heightened biological risk of HIV transmission compared with vaginal intercourse because of the fragility of rectal mucosal tissue. Meanwhile, 12.4 percent, or 520 students, reported an early onset of sexual activity, defined in the study context as first intercourse at a young age. Taken together, these behaviours produced an overall magnitude of risky sexual behaviour of 78.8 percent among sexually active students, meaning 3,291 of the 4,176 sexually experienced respondents reported at least one behaviour placing them at elevated risk. The authors frame this figure as a clear signal that the burden of sexual risk in this population is not confined to a small minority but is a mainstream campus health issue.

Beyond the raw prevalence figures, the study’s regression analysis identified which characteristics predicted risky behaviour. Chronological age emerged as a significant factor, with risk profiles shifting as students moved through their undergraduate years. Religious affiliation also played a measurable role, consistent with a body of literature suggesting that religious identity can shape sexual norms, expectations, and disclosure behaviour among young adults in Ghana. Perhaps most tellingly, the age at first sexual intercourse and the circumstances influencing that first experience predicted later risk-taking, suggesting that early sexual trajectories cast a long shadow over subsequent behaviour during university years.

Living arrangements and family communication completed the predictive picture. The researchers found that who students lived with during their studies influenced their likelihood of engaging in risky behaviour, an intuitive but important result given that residence type shapes supervision, privacy, and peer exposure. Equally significant was the difficulty students reported in discussing sexual issues with their parents. Where parent-child communication about sexuality was strained or absent, students were more likely to engage in risky practices. This finding resonates with a broader public health consensus that open, accurate family communication about sexuality acts as a protective factor, delaying sexual debut and increasing protective behaviours such as condom use when sexual activity does begin.

The implications for intervention are spelled out clearly in the study’s conclusion. The authors argue that public health programmes should incorporate campus-based counselling and peer education, with a particular focus on students who are already sexually experienced. Peer education, in which trained students deliver health information and norm-change messages within their own social networks, has a long track record in HIV prevention because it leverages trust and shared language in ways that top-down messaging often cannot. Counselling services, meanwhile, can address the individual-level drivers of risk, including alcohol use, relationship pressures, and gaps in knowledge about transmission and contraception. The finding that parental communication difficulties predict risk suggests that interventions may also need to reach beyond the campus gates, supporting families in sustaining conversations about sexual health into late adolescence and early adulthood.

The study also situates itself within global health frameworks. The rising prevalence of HIV/AIDS and unintended pregnancies is widely attributed to exactly the behaviours this survey measured: non-use of condoms, alcohol intake before sex, multiple sexual partnerships, early sexual debut, and survival sex. Because university students represent an educated cohort whose health behaviours today shape the health of families and communities tomorrow, the authors argue that securing their well-being is crucial for the overall health and development of society, in line with the United Nations Sustainable Development Goals. In Ghana, where young people constitute a large share of the population, the stakes of translating these findings into policy are considerable.

Caveats are worth noting, as with any cross-sectional survey. The design captures behaviour at a single point in time and cannot establish cause and effect; it shows that age, religious affiliation, early sexual debut, living situation, and parental communication are associated with risky behaviour, not that one directly produces the other. Self-reported data on sexual behaviour are also vulnerable to social desirability bias, particularly on sensitive topics, although the large sample size and use of a validated international instrument strengthen confidence in the overall patterns. The study was conducted at a single public university, so generalization to other institutions or countries should be made cautiously. The authors received no specific funding for the research and declare no competing interests. Even with these limitations, the sheer scale of the survey, nearly eleven thousand respondents balanced by sex, makes it one of the most detailed portraits to date of sexual risk among Ghanaian undergraduates, and its central message is hard to ignore: condom use, partner reduction, and substance-related risk remain stubbornly high on campus, and the levers of change run through families, faith communities, and student peer networks as much as through clinics and lecture halls.

Subject of Research: Prevalence and predictors of risky sexual behaviours among undergraduate university students in Ghana

Article Title: Prevalence and factors influencing risky sexual behaviours among university students in Ghana

Article References: Ogum, M. A., Mintah, J. K., Ogum, P. N., Hormenu, T., & Ansah, E. W. (2026). Prevalence and factors influencing risky sexual behaviours among university students in Ghana. BMC Public Health. https://doi.org/10.1186/s12889-026-29715-w

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29715-w

Keywords: risky sexual behaviour, university students, Ghana, HIV/AIDS, condom non-use, multiple sexual partners, sexually transmitted infections, unintended pregnancy, cross-sectional survey, peer education, parental communication, public health