Psychosocial and behavioral correlates of STI-related sexual risk among college students: A multivariable analysis across racial and ethnic groups

Objective: To examine psychological, behavioral, and knowledge-based predictors of STI-related sexual risk among college students, with attention to racial and ethnic differences. Participants: A total of 1,826 undergraduate students from three U.S. universities. Methods: Students completed validated measures of STI-related sexual behavior, HIV knowledge, substance use, depressive symptoms, and sexual regulation. Analyses included ANOVAs, t tests, and race- and ethnicity-stratified logistic regression models. Results: Overall, 15.6% of sexually active students demonstrated elevated STI-related sexual risk. External sexual regulation and substance use were associated with greater risk among Black and White students, while depressive symptoms and HIV knowledge showed inconsistent associations. Black students reported both higher STI testing rates and higher sexual risk, suggesting greater screening among those at increased risk. Conclusions: Mental health, substance use, and sexual risk behaviors frequently co-occur, highlighting the importance of culturally responsive STI prevention and screening strategies on college campuses.