Correlates and effects of information, motivation and behavioral skills on primary sexual abstinence among female university students in Ethiopia: a cross-sectional study

Abstract

Abstract Background The burden of sexually transmitted infections (STIs) and unintended pregnancies continue to pose significant public health challenges, disproportionately affecting young women. The information-motivation-behavioral (IMB) skills model is useful for understanding risky and safe sexual behavior. However, while the IMB models have been used primarly to understand and promote HIV prevention with condom use behavior, there is limtted research using the IMB model to understand and promote safer sexual dual-protection behaviors, such as abstinence, to address the risk of both STI/HIV and unwanted pregnancy among youth in Ethiopia. This study aimed to fill this gap by applying the IMB model to assess the correlates and effects of information, motivation, and behavioral skills on primary sexual abstinence among female university students in Ethiopia. Methods A cross-sectional study was conducted with a sample of 1,020 female university students at Mattu University between May and June 2023. Data were collected using a self-administered questionnaire and analyzed using SPSS version 23. Descriptive statistics were used to summarize the percentage distribution of participants by their sociodemographic characteristics and levels of HIV risk reduction/dual protection information, motivation, behavioral skills, and risky and safer sexual behaviors. Bivariate and multivariate analyses were conducted using structural equation modeling (SEM) with AMOS 23 to examine the correlations and effects of information, motivation, and behavioral skills on primary sexual abstinence. Results Of 1,020 participants, 624 (61.2%) reported having practiced primary sexual abstinence.Multivariate analyses showed that primary sexual abstinence was significantly predicted by motivation (β = 0.34, P < 0.001), behavioral skills (β = 0.24, P < 0.001) and information (β = 0.11, P < 0.001) after controlling for the effects of other confounding variables. Overall, approximately 28% of the variance in primary sexual abstinence was explained by the IMB model constructs. Conclusions The findings indicate that the IMB model is a useful tool for identifying powerful determinants of sexual abstinence, which has potential implications for interventions aimed at enhancing specific information, motivation, and behavioral skills to promote sexual abstinence and reduce the risk of HIV/STI and unintended pregnancy among youth in settings with high HIV burdens.

Keywords

• IMB model
• HIV risk reduction
• Safer sexual dual protection
• Primary sexual abstinence
• Female university students