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Sexual Activity and High-Risk Sexual Behavior Among Youth Aged 15–24 Years: Sociodemographic, Health, and Behavioral Correlates
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Jovana Radovanović Selaković, Viktor Selaković, Snežana Radovanović, Mirjana Tošić, Aleksandra Dimitrijević, Darija Šapić, Marija Šorak, Tamara Leković, Stefan Jovanović, Miloš N. Milosavljević, Šćepan Sinanović, Nevena Folić, Maja Vulovic, Milos Stepovic and Jovana Milosavljević
Youth 2026, 6(4), 139; https://doi.org/10.3390/youth6040139 (registering DOI) - 22 Sep 2026
Abstract
Adolescence and young adulthood are critical periods for sexual initiation with implications for lifelong sexual and reproductive health. This study assessed the prevalence of sexual activity and risky sexual behavior among individuals aged 15–24 years in Serbia and examined their sociodemographic, health-related, and
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Adolescence and young adulthood are critical periods for sexual initiation with implications for lifelong sexual and reproductive health. This study assessed the prevalence of sexual activity and risky sexual behavior among individuals aged 15–24 years in Serbia and examined their sociodemographic, health-related, and behavioral correlates. A nationwide cross-sectional study used data from the 2019 Serbian National Health Survey (EHIS-wave 3). The final analytical sample included 777 participants aged 15–24 years. Sexual intercourse experience was analyzed as the primary outcome, while risky sexual behavior, defined as the presence of at least one prespecified high-risk sexual practice, was assessed as a composite outcome among sexually active respondents. Associations were examined using chi-square tests and multivariable logistic regression. Overall, 51.6% of participants reported sexual intercourse experience, and 20.9% were classified as having risky sexual behavior. Sexual activity was significantly associated with age, marital status, employment, smoking, and alcohol consumption (
p < 0.05). In multivariable analysis, age group and marital status remained significant independent correlates of risky sexual behavior. Among sexually active participants, risky sexual behavior was significantly associated with age group and marital status in the adjusted model, whereas sex, smoking, alcohol consumption, education level, and employment status were not statistically significant predictors. HIV-related knowledge was high (84.2%) but was not associated with risky sexual behavior. Conclusions: Sexual activity and risky sexual behavior are common among young people in Serbia and are significantly associated with sociodemographic characteristics, particularly age and marital status. The findings highlight the need for targeted, age-appropriate, and behaviorally oriented sexual and reproductive health interventions that address broader sociodemographic and lifestyle determinants of sexual risk.
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