Factors Associated With Risky Sexual Behaviour Amongst Students at a Training College in Limpopo Province, South Africa

Background: Globally students who attend colleges indulge in risky sexual practices which in turn expose them to sexually transmitted infections. Risky sexual practices such as multiple sexual partners, unprotected sex, and transactional sex continue to pose risks of sexual transmitted infections, unwanted pregnancy as well as increased termination of pregnancy amongst young people. Engaging in risky sexual behaviour is associated with various factors. Therefore, the reported study was aimed at describing the factors associated with risky sexual behaviour amongst students at a training college in South Africa. Methods: The study adopted a quantitative, cross-sectional descriptive design to describe factors associated with risky sexual behaviour amongst students. Data was collected through a self-administered questionnaire among 307 students who were random sampled. The Statistical Package for Social Sciences version 23.0 was used to analyse data. Results: Among the respondents, 70,7% were females and 29.3% were males. Majority of the respondents 51.2% were staying at a rental place and about 49% were depending on the National Financial Aids Scheme (NSFAS). Staying at alone at a rental place and depending on the NSFAS is associated to engaging in risky sexual behaviours. Conclusions: Environmental factors and socio-economic factors contribute to risky sexual behaviours among students at a training college in Limpopo. Intervention to address the contributing factors should be implemented to curb the burden of engaging in risky sexual behaviours.


Introduction
The population of youth and young adults constitute the largest number of the total population. Various global population reports shown that the population of youth and young adults is signi cantly increasing overtime, furthermore this group of population accounts for 90% in the developing countries and over 20% in the sub Saharan Africa, with the 15-24 years accounting for 16% of the global population [1][2][3].
Sexual eminence amongst youth is an increased behaviour and is often associated with various risky behaviours such as engaging in unprotected sex, multiple sexual relationships and unwanted pregnancy [4]. Several studies have found that sexually active youth engage in tendencies which expose to certain risky due to various reasons and tendencies of developing increased interest in same or opposite sex [4][5][6].
Risky sexual behaviour involves different activities that may expose an individual to be infected with sexually transmitted infections including Human Immune de ciency virus (HIV) [7]. The ndings of a study conducted in China revealed that students especially male students were found to have knowledge on risky sexual behaviour, however, they have shown underutilisation of HIV prevention measures [8].
Many studies conducted in various universities and colleges including South African colleges and universities indicated that both male and female students have multiple sexual partners with inconsistent use of condoms. [6,8,9].
Risky sexual behaviours among students have been investigated by many researchers and they have found out that there are factors associated with the risky sexual behaviour [10,11,15]. In the mentioned studies, risky sexual behaviours have been observed as a behaviour which is claiming lives of the future leaders of many countries. Although sexual transmitted infections including HIV affects all age groups, statistics shows that HIV is more prevalent to adolescents, youth and young adults including students [1].
Public Training Colleges in South Africa do not have student accommodation as compared to the universities. Most of the students who are registered in colleges come from disadvantages communities or poor parental background and are living in rented places around the colleges.
Despite the "First thing rst" programme which was initiated by HEAIDS through Universities South Africa and colleges, many students were seen in PHC facilities seeking pregnancy testing and antiretroviral therapy. According to the HEAIDS report, 56% of students in colleges are females. Forty one percent of the South African college students engage in multiple sexual partnerships, which increases their risk of HIV infection. Furthermore, students engage in transactional or intergenerational sex. The report further indicates that more than 1200 females including female students in South Africa become HIV positive every week [13]. This paper basically discussed the ndings of a study which described the factors associated with risky sexual behaviour amongst students at a training college in Limpopo Province, South Africa.

Setting
The study was conducted at Vhembe Technical Vocational Education and Training (TVET) college.

Population and sampling
The study population was comprised of all students who were registered at the selected college. Purposive sampling was used to select the college because of its location, which is in a village and further away from town. The sample size was determined using Slovin's formula. Given the population size of 1204 and an assumption of level of con dence set at 95% and a 5% marginal error. We added a 10% allowance for non-response rate. Therefore, the nal sample size calculated was 330. The respondents were selected from the target population through random sampling. We used shbowl technique wherein pieces of small comprising the total population were cut and only 330 papers were written yes to indicate inclusion to the study. The papers were placed in a container, mixed well and then each respondent were asked to pick one piece at a time. All students registered in each eld of study had a chance to pick one piece of paper. The students who picked pieces which were written a yes for inclusion could participate in the study. The researcher managed to distribute 330 questionnaires as targeted, however, 307 questionnaires were completed correctly, and 23 questionnaires were destroyed due to errors found during data capturing. Therefore, the response rate was 93% and which is acceptable.

Ethical considerations
Ethical clearance (no. SHS/16/PH/27/2811) was obtained from the ethical review committee of University of Venda. A written permission to conduct the study was obtained from the Limpopo Province Department of Education. Letter of approval to conduct the study was obtained from Vhembe Training College and the selected campus. The con dentiality of information was maintained by using codes on the questionnaire, furthermore data was collected after obtaining informed consent from the respondents.
Data collection Data was collected using a self-administered structured questionnaire. The questionnaire was selfdeveloped and comprised of three sections: Section A included demographic characteristics of respondents, Section B focused on environmental factors associated with risky sexual behaviour and Section C on socio-economic factors. The questionnaire was written in English. The instrument was pretested using 33 students which is 10% of the sample size and comprised of students who did not select the yes paper during sampling. Therefore, the results of the pre-test were not included in the study instead pre-testing assisted the researchers to modify the questions which were not clear. Content validity was ensured by presenting the instrument to experts in reproductive health to check if the instrument has covered important aspects related to sexual health. A test-retest technique was used to check the reliability of the instrument. We compared the results obtained on the rst occasion with the results obtained on the second occasion and the Cronbach's Alpha correlation coe cient was 0,895 which showed high reliability.
Students were gathered in hall at the selected college to complete the questionnaire. The process of data collection took 10 days. Students who volunteered to participate in the study were requested to read the information sheet which had the details of the study and the rights of the respondents clearly written. Thereafter students who were willing to participate in the study were requested to sign a consent form before participating in the study. Questionnaires were distributed to respondents by the researchers and collected on the same day.
The completed questionnaires were collected, coded and analysed using descriptive statistics. An SPSS software version 23.0 was used to analyse data. Results from the analysis were presented in frequency tables, percentages and bar graphs. Cross tabulations were used to compare variables.

Results
This section provides the synthesis of the results obtained, grouped according to the subsections of the topic of interest, demographic factors, environmental factors and socio-economic factors associated with risky sexual behaviour among students at a training college

Demographic analysis
Out of 307 respondents, 217 were females and 90 were males. Respondents were spread according to age, sexual orientation and marital status.
The respondents' age was categorised into four age categories as shown in Fig. 1. Age category 21-24 years showed the highest response as compared to the other three age categories. The distribution of respondents according to marital status shows that were fewer married respondents with 33(9.1%), and more respondents 155(60.1%) were single whilst 119(30.3%) of respondents who were not married. Figure 2 shows that of those respondents who reported they were single 124 (57.8%) were females whilst (47.5%) were males. Sixty-ve (30%) female respondents and (42.2%) male respondents reported that they were not married. Twenty-six (12.2%) female respondents indicated they were married whilst 9(10.1%) indicated that they were not married. (33.3%) respondents who were staying with parents reported that they were not using condoms whilst 30(66.6%) reported that they were using them as shown in Table 2.

Socio-economic factors
Given that respondents in this study were depending on either the parents, National Respondents Aid Funds(NSFAS) or other, the researcher found that majority of respondents ,267(87.0%) depend on NSFAS for study fees and 40 (13.0%) depend on their parents. Pertaining to who buys food for the respondents 158(51.5%) reported that their parents bought them food whilst 149(48.5%) reported that their partners did so. In relation to the nancial status of the respondent's parents, majority of the respondents 163 (63.2%) had parents who were not working, 59(22.9%) had one parent working whilst 36 (13.9%) had both parents working. Table 3 indicate that most of the respondents who declared that they depend on NSFAS for study fees, hundred and thirty-one (49%) would have sex for money whilst 136(51%) would not have sex for money. With respondents who reported depending on parents for study fees, 18(45%) reported that they would have sex for money whilst 22(55%) would not.

Discussion
Demographic factors Figure 1 indicates the highest number of females which was 217(70.7%) compared to 90(29. 3%) males. A majority of students in this study were aged 25-29 years which constituted 54.1%. This age category is still at a stage of exploring ways of life [14]. Both male and female students are still searching for lifetime partners, however searching for lifetime partners can mean engaging in risky sexual behaviour such as having multiple sexual partners and having unprotected sex [14]. Given that being a student in South Africa is de ned as an individual who is under parental guidance, it was not surprising that only 33(9.1%) of the students were married. Majority of students were single 155(60.1%) and 119(30.3%) were not married. The results of this study revealed that majority of the college students were females as compared to the female to the male students. Furthermore, the female students were married as compared to the male students. The higher number of female students con rmed the higher pregnancy rate which is being reported in nearby health facilities. It can also be expected that the more the students are single or not married, the more they are likely to engage in risky sexual behaviour particularly not using condom. The results of this study suggest that female students who were single or not married were most likely staying with sexual partners in their residences around while at college. The results of this study concur with the results of various studies [6,15,16]. Furthermore, in their studies [6,15,16] it is stipulated that women who stay with their partners or who were married were engaging in risky sexual behaviour.

Environmental factors
In this study, it was revealed that students were either staying in a rental place, own house or living with parents. The majority 189(61.6%) were staying in a rental place. When students are staying in a rental place, they lack parental guidance in taking important life decisions. Being far from parental guidance can make students engage in risky sexual behaviour as they are experiencing more freedom. Most students were staying in cluster rental places, where rooms were closer to each other, which mean they were free to visit each other as often as possible. This kind of environment is ripe for risky sexual behaviour to happen. Peer in uence is also rife in this kind of living conditions. Through peer in uence, some students could start negative social activities like indulging in alcohol consumption and having multiple sexual partners. Perera et al [17] found similar results where it was revealed that students who were staying in places close to alcohol outlets may consume alcohol three times higher than the students staying with their parents. Students who were staying at rental places reported not sharing a room. Not sharing a room could also have contributed to having different sexual partners as there is no older person such as parents or siblings to moderate student's behaviour. For students who reported staying with parents it could mean that they were prevented by their living condition to engage in such behaviour. Similar results were revealed in a study conducted by [18]. The results indicated that students who were not staying with parents were engaging in risky sexual behaviour as compared to the students who were staying with their parents The results from this study shows that students who were staying in a rental place were not using condoms as compared to -those who were staying with their parents. An assumption can be made that the students who were staying with parents were receiving guidance from their parents on condom use dissimilar to students who were on their own in a rental place. Another study revealed similar results which indicated that environmental factors such as place of stay were associated with risky sexual behaviour [19].

Socio-economic factors
The results of this study showed that majority 267(87%) of students depended on NSFAS for study fees. Some of the students who depended on NSFAS for study fees also d depended on their partners for rent and food costs. Furthermore, it was revealed in this study that the students who were depending on NSFAS had either one parent or no parents. The nancial position of students can be another factor which could have led to students engaging in risky sexual behaviour, as NSFAS does not cover all the necessities. The results support the study by [7] which indicates that students do engage in risky sexual behaviour or transactional sex in return for getting basic needs such as food and rent.
One of the criteria for students to qualify for NSFAS is parents not working or having an income of less than R100 000 per year [13,20]. The criteria set by NSFAS might be contributing to students who do not meet the criteria to seek assistance from older people who are working. Engaging in risky sexual behaviour might be a source of income in some students to maintain college life and to curb poverty related factors.
The results in this study revealed that majority 131(49%) of students who indicated that they would have sex for money were students who were depending on NSFAS for study fees as compared to the students who depended on parents for study fees. The study results also reveal that both male and female students engaged in transactional sex, however, female students were dominating the behaviour. This might be related to the fact that females have more basic needs than males. For instance, a female experience monthly menstruation and needs to buy sanitary towels, so engaging in this risky sexual behaviour may be a solution. Furthermore, students who reported drinking alcohol were more likely to report having sex for money. This means that after having sex the students will get money to buy more alcohol. Similar results were reported by Murudi et al [6] which indicated that students who came from poor backgrounds -were the ones faced with a challenge of engaging in transactional sex.

Study limitations
The self-administered questionnaire used to collect data can be biased for true risky sexual behaviours and may not re ect all the factors associated with risky sexual behaviours. However, the use of various closed ended questions provided a detailed analysis for students. In addition, the researchers were trained to ensure that consistency and accuracy of data collection processes. Establishment of student support section with a quali ed Psychologist and Social Workers to assist students who are not having parents or who are having one parent. A need for extensive research is needed to further develop the results involving students in different training colleges. In this way, a more representative study could be developed towards the risky sexual behaviour amongst students.