Factors associated with sexual risk behaviours and sexually transmissible infection testing among university students by enrolment type in Queensland, Australia: a cross-sectional study

BACKGROUND: Young people are disproportionately affected by sexually transmissible infections (STIs). University student populations comprise a large proportion of diverse young people with varied experiences and identities. This study aimed to analyse factors associated with increased risk of sexual risk behaviours and testing among domestic Australian-born students (DABS), domestic overseas-born students (DOBS), and international students (IS); and to investigate the use of a sexual risk behaviour score to examine whether sexual behaviours differ between DABS, DOBS, and IS. METHODS: Results from a cross-sectional survey of 4291, conducted among Australian university-enrolled students aged 18 years and older analysed associations between participant demographics, sexual behaviours, and STI testing. A 15-item sexual risk behaviour score (lowest risk, 0; highest risk, 23) was developed and analysed descriptively. Associations with other participant factors were investigated using linear regression. RESULTS: Most students (72%) (mean age, 23 years) reported being sexually active, although there were significant differences between enrolment categories (DABS, 74.8%; DOBS, 68.6%; IS, 61.5%. Sexual risk behaviour scores ranged from 1 to 23. IS had lower sexual risk behaviour scores (adjusted coefficient -1.20, P < 0.001). Compared with those aged 18-19 years, individuals aged 20-24 years (aOR = 1.91, P < 0.01) and 25-29 years (aOR = 4.11, P < 0.01) were more likely to report STI testing. Men who reported being attracted to men, those engaging in drug- or alcohol-influenced sex, having five or more sexual partners, and previous HIV testing were all positively associated with STI testing. CONCLUSIONS: Despite lower sexual risk behaviours, international students were less likely to access STI testing, suggesting a greater understanding of IS health-seeking behaviour and health literacy is needed to inform suitable responses.