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.

Background Youth are at high risk for casual and unprotected sexual activities even before the marriage. The objective of the study is to describe the sexual behavior, contraceptive use among unmarried youth of Sri Lanka and to assess the factors associated with sexual behaviour. Methods Observational descriptive cross-sectional study was conducted in three selected districts in Sri Lanka from 1st of March 2019 to 31st of January 2020 among 1057 never-married youth using a self-administered questionnaire. Both stratified cluster sampling and snow-ball sampling was used to select the eligible never-married youth. Factors associated with the sexual intercourse was 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 rural (69.5%) and urban sector (87.3%) tend to use contraceptives during the intercourse compared to the youth in the Estate sector (51.1%). Conclusions A significant portion of youth expose to sexual risk behavior including unprotected sexual intercourse even before the marriage which can contribute to many social and health consequences. Focus interventions are needed to address the issue.

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Background Youth are at high risk for casual and unprotected sexual activities even before the marriage. The objective of the study is to describe the sexual behavior, contraceptive use among unmarried youth of Sri Lanka and to assess the factors associated with sexual behaviour. Methods Observational descriptive cross-sectional study was conducted in three selected districts in Sri Lanka from 1st of March 2019 to 31st of January 2020 among 1057 never-married youth using a self-administered questionnaire. Both stratified cluster sampling and snow-ball sampling was used to select the eligible never-married youth. Factors associated with the sexual intercourse was 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 rural (69.5%) and urban sector (87.3%) tend to use contraceptives during the intercourse compared to the youth in the Estate sector (51.1%). Conclusions A significant portion of youth expose to sexual risk behavior including unprotected sexual intercourse even before the marriage which can contribute to many social and health consequences. Focus interventions are needed to address the issue.