Prevalence of Cohabitation and Emergency Contraceptive Use among Female Undergraduates in Obafemi Awolowo University, Ile-Ife, Osun State

Aims: This study examined cohabitation practices and emergency contraceptive (EC) use among female undergraduates at Obafemi Awolowo University, Ile-Ife. Background: Cohabitation and premarital sexual relationships among undergraduates are increasing in African universities. These trends have significant reproductive health implications, including unintended pregnancies and unsafe abortions. Emergency contraception (EC) provides an important preventive measure, yet its use among cohabiting female undergraduates remains underexplored. Objectives: The study assessed the prevalence of cohabitation and EC use, explored female students' perception of cohabitation and EC use, identified cohabitation outcomes, and examined associated factors among female undergraduates at Obafemi Awolowo University, Ile-Ife. Materials and Methods: A descriptive cross-sectional survey was conducted among 308 female undergraduates. Data were collected with a structured questionnaire and analyzed using descriptive statistics, Chi-square test, and multivariate logistic regression with SPSS version 25 (IBM Corp., Armonk, NY, USA). Results: 5.8% were currently cohabiting and 9.7% had previously cohabited. EC use prevalence was 56%, with 51% reporting positive perceptions of cohabitation and EC utilization. Most participants were single (98.1%), while 1.9% were married, which may influence the interpretation of results. Reproductive/sexual history was significantly associated with cohabitation (X²=46.687; p=0.001), and perception of cohabitation & EC use was significantly associated with actual usage (X²=16.009; p=0.001). Multiple logistic regression identified abandonment of valued African culture as the only significant predictor of cohabitation (p=0.000). Conclusion: The prevalence of cohabitation was low, while EC use was relatively high. Strengthening sexual health education, counseling, and access to EC services within universities could reduce unintended pregnancies and unsafe abortions among students.