Unmarried Sri Lankan youth: sexual behaviour and contraceptive use

BACKGROUND: Youth are at high risk for casual and unprotected sexual activities even before marriage. The objective of the study is to describe the sexual behavior, and contraceptive use among unmarried youth of Sri Lanka and to assess the factors associated with sexual behaviour. METHODS: An observational descriptive cross-sectional study was conducted in three selected districts in Sri Lanka from 1st March 2019 to 31st January 2020 among 1057 never-married youth using a self-administered questionnaire. Both stratified cluster sampling and snowball sampling were used to select the eligible never-married youth. Factors associated with sexual intercourse were assessed using logistic regression. RESULTS: Compared to boys (26%), more girls (35%) were engaged in unprotected sexual intercourse. Among sexually active unmarried youth aged less than 20 years, 10% had sexual intercourse with an unknown person. Unmarried Tamil and estate sector youth displayed significantly lower chances of sexual intercourse compared to Sinhala and urban counterparts (OR = 0.390, CI = 0.213-0.715, p = 0.002 and OR = 0.807, CI = 0.709-0.978, p = 0.020 respectively). Youth in the rural (69.5%) and urban sectors (87.3%) tend to use contraceptives during intercourse compared to the youth in the Estate sector (51.1%). CONCLUSIONS: A significant portion of youth are exposed to sexual risk behavior including unprotected sexual intercourse even before marriage which can contribute to many social and health consequences. Focus interventions are needed to address the issue. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40834-022-00185-w.