BackgroundRisky sexual behaviors (RSB) are becoming an important problem all over the world. RSB are defined as behaviors leading to sexually transmitted diseases and unintended pregnancies. The objective of this study was to determine the prevalence and associated factors of RSB among undergraduate students in state universities of Western Province in Sri Lanka.MethodsA descriptive cross sectional study was conducted on1575 second and third year undergraduates using stratified cluster sampling of the selected universities. A pretested self-administered questionnaire was used to assess socio-demographic, knowledge attitudes and behavior on reproductive health. RSB was defined as reporting of one or more following behavior/s; having more than one sexual partner, use of alcohol or inability to use condom or other contraceptive methods in sexual activities. The results were expressed as prevalence and its 95% confidence interval (CI) of RSB. Multiple logistic regression was performed ascertain the association between RSB and possible associated factors. The results were expressed as adjusted odds ratios (AOR).ResultsPrevalence of RSB in last 1 year and 3 months periods were 12.4%, (95% CI: 11.8–13.1) and 12.1% (95% CI: 11.5–12.7) respectively. The significantly associated risk factors for RSB were, attended night clubs in last month (AOR = 3.58, 95% CI: 1.29–9.88), alcohol consumption within last 3 months (AOR = 2.67, 95% CI: 1.87–3.80) and good knowledge on condoms (AOR = 2.82, 95% CI: 1.94–4.10). Those who thought religion was very important to their lives (AOR = 0.68, 95% CI: 0.48–0.95) was a protective factor.ConclusionsAlcohol consumption and attending night clubs were associated with RSB. Necessary measures should be taken to reduce risk behaviors within university to reduce RSB.

Background Postnatal care (PNC) is important for preventing morbidity and mortality in mothers and newborns. Even though its importance is highlighted, PNC received less attention than antenatal care. This study determines the level of PNC coverage and its determinants in Srilanka. Methods This is a secondary analysis of the 2016 Demographic and Health Survey. Receiving full postnatal care (FPNC) was defined with a set of indicators to detect adequate care for mother and newborn. Demographic and socio-economic associated factors for receiving FPNC were identified using binary and multiple logistic regression. Variables that had marginal relationship with receiving FPNC which p-value less than or equal to 0.2 at binary analysis were selected and included in the multiple logistic regression models. We used manual backward stepwise regression to identify variables which had independent association with receiving FPNC on the basis of adjusted odds ratios (AOR), with 95% confidence interval (CI) and p-value less than 0.05. All analyses were performed in SPSS 25. Results Of the 8313 women with a live birth in the last 5 years, more than 98% had received postnatal care at facility at least 24 h. More than three-fourth of mothers (n = 5104) received the FPNC according to WHO guideline. Four factors were positively associated with receiving FPNC: mothers received antenatal home visits by Public health midwife (AOR = 1.98, 95% CI 1.65–2.39), mothers who got information about antenatal complications and places to go at antenatal clinics (AOR = 1.56, 95% CI 1.27–1.92), been Sinhala (AOR = 1.89, 95% CI 1.35–2.66) and having own mobile phone (AOR = 1.19, 95% CI 1.02–1.38). Mothers who are residing in rural area (AOR = 0.697 95% CI = 0.52–0.93] compared to those who reside in urban areas and maternal age between 20 and 34 years [AOR = 0.72, 95% CI 0.54–0.97] compared to maternal age less than 20 years were detected as negatively associated. Conclusion Receiving FPNC in Srilanka is high. However, inequity remains to be a challenge. Socio-demographic factors are associated with FPNC coverage. Strategies that aim to improve postnatal care should target improvement of non-health factors as well.

Introduction: Contraceptives help prevent unplanned pregnancies and have the desired number of children with adequate space. Most undergraduates are living outside their home environment. Despite being more vulnerable to risk behaviour, their knowledge and attitude towards contraceptives are poor. Objectives: To describe the knowledge and attitudes towards contraceptives among undergraduates in state universities of Western Province Methods: A descriptive cross-sectional study was conducted among 1575 second-and third-year undergraduates using stratified cluster sampling of the selected universities. A pre-tested self-administered questionnaire collected data on knowledge and attitudes on contraceptives. Based on a scoring system, the level of knowledge and attitudes was assesed. Their associations with selected variables were determined. Results: Of the 1575 respondents, 926 (58.8%) were females. Over 90% were aware of at least one contraceptive method. More than 50% knew that condoms are protective against HIV/AIDS. The knowledge on contraception was 'good' in 28.4%. The knowledge on condom use was good in 21%. In multivariate analysis, the only factor associated with good knowledge on contraceptives was studying in Bioscience stream (adj. OR=9.5; 95% CI=7.0, 12.9), whereas the factors associated with good knowledge on male condoms were: being male (adj. OR=13.2; 95% CI=10.3, 16.9), studying in Bioscience stream (adj. OR=1.8; 95% CI=1.1, 1.9) and secondary education in nonmixed type schools (adj. OR=1.4; 95% CI=1.1, 2.0). Overall, 30.3% (n=477) and 38.6% (n=608) of the respondents had desirable attitudes towards contraception and male condoms, respectively. In multivariate analysis, factors associated with desirable attitudes on contraception were: being male (adj. OR=1.7; 95% CI=1.4, 2.2), studying in Bioscience stream (adj. OR=1.5; 95% CI=1.1, 2.0) and secondary education in non-mixed type schools (adj. OR=1.3; 95% CI=1.1, 1.7), whereas the only factor associated with desirable attitudes on condom use was being male (adj. OR=3.4; 95% CI=2.8, 4.2). Conclusions: Knowledge and desirable attitudes towards contraceptives and condoms were relatively low among the undergraduates. Being female and studying in non-Bioscience stream were major determinants.

Introduction: Oral cancer is the commonest cancer among Sri Lankan males for decades.Objectives: To describe the sex difference in site specific cancers in oral cavity and to analyse the incidence trends according to sex, sites and age category of oral cancer in Sri Lanka between 2005 and 2019 Methods: Data on oral cancers were obtained from National Cancer Registry, Sri Lanka (NCR-SL) from 2005 to 2019. Sex difference for lip, tongue and mouth cancers were analysed. Analysis was performed with Joinpoint Trend Analysis Software on age standardized incidence rate (ASR) to examine the trends in sites, sex and age group categories over a 15-year period.Results: Data ofa total of31 919 oral cancer patients (males: 24 982; 78.3%; females: 6937; 21.7%) were analysed.All three site specific sub types showed a higher incidence in males than females. ASR has increased over the 15-year period in both sexes. The proportional increase in incidence was higher for males (1.9-fold increase with ASR; 9.8 to 18.9, average annual percentage change (AAPC) of5.4; 95% CI: 4.1, 6.7) than females (1.55-fold increase with ASR; 2.9 to 4.5,AAPC of3.l; 95% CI: 1.8, 4.5; p<0.001 fortrend). A statistically significant increasing trend was detected in all three types according to anatomical sites and in both sexes with a higher proportional increase in lip cancers (AAPC ofl0.5; 95%CI: 5.9, 15.3 in males;AAPC of6.9; 95%CI: 1.5, 12.6 in females;p<0.05 fortrend).An increasing trend in ASR was detected for all age categories. The rate was higher in less than 40 years age groups in both sexes (AAPC of 6.5; 95%CI: 3.3, 9.8 in males;AAPC of7.8; 95%CI: 3.4, 12.4 infemales;p<0.05 for trend). Conclusions & Recommendations:The incidence of oral cancer in Sri Lanka has shown an increasing trend with a greater propor t ional rise in males. It showed a higher incidence in males than females in all three subtypes. Structured prevention, screening and early detection programmes have to be planned to reduce the burden of oral cancer in Sri Lanka.

Ohttps://orcid.org/0000-0002-0246-4031Introduction: Breast cancer is the commonest cancer among females globally as well as in Sri Lanka. There were 2.3 million women diagnosed with breast cancer and 684 996 deaths due to breast cancer globally in 2020. Objective:To analyse the trends and patterns ofincidence ofbreast cancer in Sri Lanka between 2005 and 2019. Methods:Cancer incidence data published in National Cancer Registry, Sri Lanka (NCR-SL) from 2005 to 2019 was analyzed. Age standardized rates (ASR), and age specific incidence rates were used to determine the trends of the breast cancer. Trend analysis of these two rates were performed using j oinpoint regression program and p

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Background: Abortion is legally permitted in Sri Lanka only to save mother's life. A great majority of undergraduates reside away from home and are vulnerable to risky behaviour. However, their knowledge and attitudes on abortion are scarce in Sri Lanka. Objective: To describe the knowledge and attitudes on unsafe abortions among undergraduates in the state universities of Western Province, Sri Lanka Methods: A descriptive cross-sectional study was conducted among 1575 second and third year undergraduates using stratified cluster sampling of the selected universities. Pre-tested self-administered questionnaire was administered to assess socio-demographic factors, knowledge and attitudes on unsafe abortion. Responses to the knowledge and attitude questions were scored and graded. Percentage of knowledge categories and attitudes were calculated. The associations of knowledge categories with selected variables were assessed and reported as odds ratio (OR). Results: Of the respondents, the majority (n=839, 53.3%) had good knowledge on unsafe abortion while 30.5% (n=480) had satisfactory knowledge and the minority (16.3%) had poor knowledge. Females (n=509, 55%) had more good knowledge than males (n=329, 51%; p>0.05). Also, those who studied in Bio-Science stream (n=174, 70.2%; p<0.001) and had their secondary education at mixed schools (n=351, 54.4%; p>0.05) had more good knowledge than the other categories. The majority (n=1074, 68.5%) agreed that legal restrictions would drive people to unsafe abortion while making abortion services through the government health facilities could increase inappropriate sexual behaviour (n=998, 63.7%). Only a very few (n=111, 7.1%) of the undergraduates agreed that abortion was a convenient form of contraception while 47.7% (n=747) agreed abortion to be restricted to save mother's life. The majority (n=833, 53.2%) agreed that it should be a right of a pregnant woman to decide whether she wants an abortion or not. Conclusion: A majority of undergraduates had good knowledge on unsafe abortion. Most of the undergraduates did not prefer to fully liberalize abortion policies due to inappropriate usage, yet acknowledged it is a right of a pregnant mother.

Introduction: Sexual and Reproductive Health Rights (SRHR) are universal. The objective was to describe the knowledge and attitudes and explore the perceptions regarding SRHR among undergraduates. Methods: A cross sectional study was conducted among 1575 undergraduates using stratified cluster sampling of the selected universities. A pre-tested self-administered questionnaire was administered to assess knowledge and attitudes on SRHR. In addition, focus group discussions were conducted to explore perceptions and attitudes regarding SRHR. Three hundred and eighty-five (24.4%, n = 385) undergraduates had good knowledge, 604 (38.3%) had satisfactory knowledge and 586 (37.2%) had poor knowledge on SRHR. Males and undergraduates who had studied in bioscience stream had better knowledge than the other categories (p < 0.001). Majority of undergraduates (93.4%, n = 1463) agreed with the statement aimed at equal say among both men and women in sexual relationships, 1234 (78.8%) agreed that a woman has a right to refuse sex with her male partner anytime she wants and 511(32.7%) said women should be submissive to men. Only a very few (3.1%, n = 48) thought that the child-care would-be women’s sole response. School education, law, media and culture were identified as being related to the protection and violations of rights. Suggestions were made for the improvement of SRRs including strengthening of education and proper implementation of law. Conclusion: Undergraduates’ knowledge on SRHR was not in an acceptable level, however their attitudes were positive. Effective educational program should be implemented.