Risky sexual behaviours and associated factors among high school students in Lomé, Togo: A cross-sectional study

BACKGROUND: Adolescent sexual and reproductive health remains a major public health concern in sub-Saharan Africa. In Togo, evidence on risky sexual behaviours (RSBs) among in-school adolescents is limited. This study examined patterns of RSB and associated sociodemographic, relational, and digital factors among high school students in Lomé. METHODS: A cross-sectional study was conducted from December 2023 to March 2024 among 461 high school students aged 15-23 years. Participants were selected through multistage sampling and completed a structured, self-administered questionnaire. RSB was defined as reporting at least one of the following: inconsistent condom use, overlapping sexual partnerships, substance-influenced sex, or casual sexual encounters. Descriptive statistics and logistic regression analyses were used to examine patterns and associated factors. RESULTS: Nearly half of respondents (47.3%) reported sexual intercourse during the past 12 months. Among sexually active students, 58.7% reported sexual debut before age 18, 56.4% inconsistent condom use, 40.8% overlapping sexual relationships, and 27.5% coerced first sex. Gendered patterns were observed, with females more likely to report coerced first sex, older partners, and transactional sex. In adjusted analyses, higher odds of RSB were associated with personal mobile phone ownership (AOR = 11.35, 95% CI: 3.11-41.34), sexual debut at age 18 or older (AOR = 5.54, 95% CI: 1.55-19.82), and coerced first sex (AOR = 5.84, 95% CI: 1.15-29.49). Lower odds were observed among students with one to two agemates in the household (AOR = 0.23, 95% CI: 0.05-0.98), those identifying with other religions (AOR = 0.07, 95% CI: 0.01-0.37), and those living alone (AOR = 0.04, 95% CI: 0.00-0.39). CONCLUSIONS: RSBs among high school students in Lomé highlight gaps in sexual health literacy, consent negotiation, condom-use skills, and online safety. Strengthening comprehensive sexuality education, integrating digital literacy into school curricula, and expanding gender-responsive, youth-friendly SRH interventions are essential to promote safer, informed, and equitable adolescent sexual practices in Togo.