Abstract

Abstract Background Sexual risk behaviour (SRB), including the subtypes sex without contraception, sexualized substance use, sex work, and intimate partner violence, leads to health-related consequences for one-self or intimate partners. Especially young adults comprise a vulnerable group for SRB as they tend to use risk behaviour as maladaptive coping strategies to face developmental challenges. We aim to identify SRB patterns by analysing the relation between SRB-subtypes and to previous found risk factors, and to derive adequate treatment and prevention strategies. Methods A cross-sectional study was conducted via an online-questionnaire. SRB was measured via nine items. Latent class analysis was used to identify patterns of SRB, multinomial logistic regression to capture related risk factors. Included risk factors were gender, sexual orientation, younger age of first intercourse, higher number of sexual partners, and hypersexual behaviour (HB; measured via HB-inventory). Results Within the sample (n = 609) three classes of SRB patterns were identified: unremarkable (67%; low values in all SRB facets), and the therapeutic-relevant classes shame-ridden (17%; esp. high values in sexual feelings of shame/ guilt), and risky (16%; high values in all SRB facets, esp. sexualized use of illegal drugs, inadequate contraception use, and impairments in important relationships). Both pathological patterns are strongly associated to higher HB-values. Male and queer participants tend to demonstrate pathological SRB-patterns more often than females and heterosexuals. Conclusions To implement adequate gender- and diversity sensitive prevention and treatment addressing SRB it is necessary to understand the complexity of its expression. Based on the results, shame-ridden clients could be addressed by focusing on their feelings of shame/ guilt, while it seems helpful to address substance use and compulsive sexual behaviour of clients belonging to the risky group primarily. Key messages • Three patterns of sexual risk behaviour could be identified, two of them are theraptuic-relevant. • To implement adequate SRB prevention and treatment it is necessary to understand its complexity, thus respective differentiated strategies should address specific needs of young adults.

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