Sexual knowledge as a predictor of intention in sexual activity in university women

Sexual health knowledge is a key determinant of adolescents' and young adults' sexual and reproductive behaviors. However, limited evidence exists on how sexual knowledge influences behavioral intentions among university women who have not yet initiated sexual activity. Understanding these relationships is essential for designing evidence-based educational and public health strategies that promote safer sexual decision-making and reproductive autonomy.

To evaluate whether the level of sexual health knowledge predicts intentions regarding sexual activity, sexual protection, and sexual risk among university women with no history of sexual intercourse.

A cross-sectional, analytical study was conducted among female university students aged 18-35 years enrolled in a private university in East Lima during the 2025-I academic semester. A total of 493 participants met eligibility criteria, which included absence of prior sexual intercourse and capacity to complete questionnaires independently. Sexual health knowledge was measured using the validated knowledge dimension of the CAPSEX questionnaire, and sexual intentions were assessed with the female version of the Intention Scale in Sexual Activity. Descriptive statistics, Spearman correlation analyses, and multiple linear regression models were used to examine associations between knowledge scores and intentions. Multivariate models were adjusted for age, relationship status, place of origin, school of enrollment, year of study, family income, and employment status. Significance was set at P<.05.

Overall, 51.3% of participants demonstrated adequate sexual knowledge. Knowledge was not significantly correlated with intention of sexual activity (ρ=-0.063; P=.165). In multivariate analyses, higher sexual knowledge predicted lower intention of sexual risk (B=-0.302; 95% CI: -0.462 to -0.141; P<.001) and higher intention of sexual protection (B=0.127; 95% CI: 0.019 to 0.235; P=.021). Age was positively associated with sexual risk intention (B=0.181; 95% CI: 0.018 to 0.344; P=.029). Low family income was associated with higher intention of sexual protection (B=0.572; 95% CI: 0.145 to 0.999; P=.009) and reduced intention of sexual risk (B=-0.744; 95% CI: -1.382 to -0.105; P=.023). Not working showed lower scores with sexual protection intention (B=-0.513; 95% CI: -0.988 to -0.039; P=.034).

Sexual health knowledge independently predicts both decreased sexual risk intention and increased protective intention among university women without prior sexual activity. Socioeconomic disadvantage remains an important modifying factor. Strengthening comprehensive sexuality education within higher education institutions may enhance reproductive autonomy and reduce future sexual health risks.