Published in PLOS One on 2026-08-14, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Essi Edjodjinam Kpegba-Fiaboe
Source: PLOS One • DOI 10.1371/journal.pone.0335879
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Adolescent sexual and reproductive health remains a major public health concern in sub-Saharan Africa. In Togo, evidence on risky sexual behaviours (RSBs) among in-school adolescents is limited. This study examined patterns of RSB and associated sociodemographic, relational, and digital factors among high school students in Lomé.
A cross-sectional study was conducted from December 2023 to March 2024 among 461 high school students aged 15–23 years. Participants were selected through multistage sampling and completed a structured, self-administered questionnaire. RSB was defined as reporting at least one of the following: inconsistent condom use, overlapping sexual partnerships, substance-influenced sex, or casual sexual encounters. Descriptive statistics and logistic regression analyses were used to examine patterns and associated factors.
Nearly half of respondents (47.3%) reported sexual intercourse during the past 12 months. Among sexually active students, 58.7% reported sexual debut before age 18, 56.4% inconsistent condom use, 40.8% overlapping sexual relationships, and 27.5% coerced first sex. Gendered patterns were observed, with females more likely to report coerced first sex, older partners, and transactional sex. In adjusted analyses, higher odds of RSB were associated with personal mobile phone ownership (AOR = 11.35, 95% CI: 3.11–41.34), sexual debut at age 18 or older (AOR = 5.54, 95% CI: 1.55–19.82), and coerced first sex (AOR = 5.84, 95% CI: 1.15–29.49). Lower odds were observed among students with one to two agemates in the household (AOR = 0.23, 95% CI: 0.05–0.98), those identifying with other religions (AOR = 0.07, 95% CI: 0.01–0.37), and those living alone (AOR = 0.04, 95% CI: 0.00–0.39).
RSBs among high school students in Lomé highlight gaps in sexual health literacy, consent negotiation, condom-use skills, and online safety. Strengthening comprehensive sexuality education, integrating digital literacy into school curricula, and expanding gender-responsive, youth-friendly SRH interventions are essential to promote safer, informed, and equitable adolescent sexual practices in Togo.
Introduction
Adolescence represents a pivotal developmental stage characterized by rapid biological maturation, evolving cognitive capacities, and expanding social autonomy. It is during this period that individuals begin to consolidate their identity, assert independence, and navigate increasingly complex interpersonal and sexual relationships [1–3]. As adolescents strive for autonomy, they also experience a profound need for social belonging, rendering them highly responsive to peer norms and social expectations [4]. This dynamic tension between individuation and conformity heightens vulnerability to external pressures, such as misinformation, social coercion, and unequal gender or power relations that can manifest in risky sexual behaviour (RSB) [3,5].
Globally, adolescent sexual and reproductive health (SRH) remains a major public health concern. At regional and national levels, several policy commitments recognize the need to protect adolescents’ health and rights, including the African Charter on the Rights and Welfare of the Child [6] and Togo’s Code de l’Enfant (Law No. 2007–017), which promotes the protection of children’s rights and defines a child as any person under 18 years. Despite these commitments, adverse SRH outcomes, including early sexual debut, unintended pregnancy, sexually transmitted infections (STIs), and unsafe abortions, remain high, particularly in low- and middle-income countries (LMICs) [7,8]. The World Health Organization [9] estimates that approximately 21 million girls aged 15–19 years become pregnant annually, with nearly half of these pregnancies unintended. In sub-Saharan Africa (SSA), one in four adolescent girls gives birth before the age of 18 [10], often resulting in early school dropout, limited socioeconomic mobility, and intergenerational cycles of poverty and gender inequality [11–13].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Essi Edjodjinam Kpegba-Fiaboe. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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