Risky sexual behavior and associated factors among secondary and above-education-level students in Ethiopia: A systematic review and meta-analysis

Background: Risky sexual behavior is defined as the behavior that increases the susceptibility of an individual to problems related to sexuality and reproductive health. The main aim of this study was to determine the pooled prevalence of risky sexual behavior and its associated factors in Ethiopia. Methods: Systematic review and meta-analysis (PRISMA) rules were used. During the searching period, MEDLINE, PUBMED, Cochrane Library, EMBASE, Google Scholar, and CINAHL were used with search terms. The STATA form 14 program was utilized to perform the meta-analysis. I-2 statistics was used to test heterogeneity, and publication bias was assessed using Begg's and Egger's tests. Odds ratio (OR) with a 95% confidence interval (CI) was presented using forest plots. Results: There were 24 studies, and 13,440 study participants were included in this meta-analysis. The pooled prevalence of risky sexual behavior in Ethiopia was 40% (95% CI: 32%, 48%). The associated factors for risky sexual behavior were substance use [OR: 2.41 (95% CI: 1.49, 3.89)], watching pornography [OR: 2.59 (95% CI: 1.01, 6.69)], and night club visit, [OR: 2.53 (95% CI: 1.64, 3.90)]. Conclusion: Risky sexual behavior among secondary school and above-education-level Ethiopian students was high.