Sexual activity among school-going adolescents in Himachal Pradesh, India : what are the risky and protective factors?
(2026) In Discover Public Health 23(1).- Abstract
Introduction: Early and risky sexual behaviours among adolescents contribute to adverse health outcomes, yet evidence from school-based settings in India, particularly from methodologically robust samples, remains limited. Previous research in India has documented sexual attitudes and behaviours in specific contexts; however, to our knowledge, no study has examined both risk and protective factors using a large, systematically sampled cohort at the state level. This study investigated sexual activity among school-going adolescents and examined associated risk and protective factors to inform targeted interventions. Methods: A school-based cross-sectional survey was conducted during December 2023 in 204 government schools across Himachal... (More)
Introduction: Early and risky sexual behaviours among adolescents contribute to adverse health outcomes, yet evidence from school-based settings in India, particularly from methodologically robust samples, remains limited. Previous research in India has documented sexual attitudes and behaviours in specific contexts; however, to our knowledge, no study has examined both risk and protective factors using a large, systematically sampled cohort at the state level. This study investigated sexual activity among school-going adolescents and examined associated risk and protective factors to inform targeted interventions. Methods: A school-based cross-sectional survey was conducted during December 2023 in 204 government schools across Himachal Pradesh, India among 7,563 adolescents aged 13–17 years using a self-administered questionnaire adapted from the Global School-based Student Health Survey in India. Descriptive statistics and multivariate logistic regression were performed to assess predictors of ever having sex, early sexual debut, and non-use of contraception. Results: Overall, 6% of adolescents reported ever having sexual intercourse; of these, 62.4% initiated intercourse before age 14. Fewer than half used contraception. Being a boy, parental employment in unskilled/semi-skilled jobs, substance use, poor mental health, and experiencing bullying were significantly associated with sexual activity. Younger adolescents from larger families had higher odds of early sexual debut. Non-use of contraception was associated with being boy, older age, larger families, experiencing bullying, and mental health problems. Conclusions: The findings underscore the need to strengthen comprehensive, age-appropriate sexual and reproductive health interventions in schools to address early and risky sexual behaviours. Although elements of comprehensive sexuality education are delivered through existing platforms, a structured and systematic approach is lacking. Leveraging ongoing initiatives such as Rashtriya Kishor Swasthya Karyakram and the Ayushman Bharat School Health Programme provides a practical opportunity to institutionalize and scale up integrated delivery within the school system.
(Less)
- author
- Mohanty, Saroj ; Mehra, Devika LU ; Das, Subha Sankar ; Patel, Nikita ; Sethi, Gaurav ; Garg, Rishi ; Gupta, Anmol ; Chauhan, Anjali and Mehra, Sunil LU
- organization
- publishing date
- 2026-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adolescents, India, Protective factors, Risk factors, School-based survey, Sexual behaviour
- in
- Discover Public Health
- volume
- 23
- issue
- 1
- article number
- 913
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:105041824473
- ISSN
- 3005-0774
- DOI
- 10.1186/s12982-026-02296-0
- language
- English
- LU publication?
- yes
- id
- 0cdfc12b-12a5-4083-8f0c-907e0c12c805
- date added to LUP
- 2026-09-02 11:53:27
- date last changed
- 2026-09-02 11:54:19
@article{0cdfc12b-12a5-4083-8f0c-907e0c12c805,
abstract = {{<p>Introduction: Early and risky sexual behaviours among adolescents contribute to adverse health outcomes, yet evidence from school-based settings in India, particularly from methodologically robust samples, remains limited. Previous research in India has documented sexual attitudes and behaviours in specific contexts; however, to our knowledge, no study has examined both risk and protective factors using a large, systematically sampled cohort at the state level. This study investigated sexual activity among school-going adolescents and examined associated risk and protective factors to inform targeted interventions. Methods: A school-based cross-sectional survey was conducted during December 2023 in 204 government schools across Himachal Pradesh, India among 7,563 adolescents aged 13–17 years using a self-administered questionnaire adapted from the Global School-based Student Health Survey in India. Descriptive statistics and multivariate logistic regression were performed to assess predictors of ever having sex, early sexual debut, and non-use of contraception. Results: Overall, 6% of adolescents reported ever having sexual intercourse; of these, 62.4% initiated intercourse before age 14. Fewer than half used contraception. Being a boy, parental employment in unskilled/semi-skilled jobs, substance use, poor mental health, and experiencing bullying were significantly associated with sexual activity. Younger adolescents from larger families had higher odds of early sexual debut. Non-use of contraception was associated with being boy, older age, larger families, experiencing bullying, and mental health problems. Conclusions: The findings underscore the need to strengthen comprehensive, age-appropriate sexual and reproductive health interventions in schools to address early and risky sexual behaviours. Although elements of comprehensive sexuality education are delivered through existing platforms, a structured and systematic approach is lacking. Leveraging ongoing initiatives such as Rashtriya Kishor Swasthya Karyakram and the Ayushman Bharat School Health Programme provides a practical opportunity to institutionalize and scale up integrated delivery within the school system.</p>}},
author = {{Mohanty, Saroj and Mehra, Devika and Das, Subha Sankar and Patel, Nikita and Sethi, Gaurav and Garg, Rishi and Gupta, Anmol and Chauhan, Anjali and Mehra, Sunil}},
issn = {{3005-0774}},
keywords = {{Adolescents; India; Protective factors; Risk factors; School-based survey; Sexual behaviour}},
language = {{eng}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{Discover Public Health}},
title = {{Sexual activity among school-going adolescents in Himachal Pradesh, India : what are the risky and protective factors?}},
url = {{http://dx.doi.org/10.1186/s12982-026-02296-0}},
doi = {{10.1186/s12982-026-02296-0}},
volume = {{23}},
year = {{2026}},
}