Background Although sexuality remains a taboo in Nepali society, the prevalence of premarital sexual activities is increasing. Youth who begin early premarital sexual activity are more likely to be engaged in unsafe sex. This study aims to determine the prevalence and associated factors of premarital sex among college-going youths of Dhangadhi Sub-Metropolitan City, Kailali (DSMC). Methodology This descriptive cross-sectional study was conducted in management colleges with Bachelor of Business Studies (BBS) programs in DSMC. The sample size for the study was 374. The probability proportionate to size sampling technique was adopted for sample estimation for the selected colleges. The data was entered, cleaned, and analyzed in SPSS26. Bivariate analysis was done using Pearson's chi-square test was used to determine differences between groups. A simple logistic regression model was conducted to assess the association between several characteristics of the respondents and the outcome variable- premarital sex, followed by multiple logistic regression to evaluate the combined impacts of various predictors on premarital sex. Results The prevalence of premarital sex among undergraduate college youths was 35.3%, of which 52.3% were males. Among those undergraduate youths, more than half (51.5%) had experienced their first intercourse before 18 years of age. At least 1 out of 10 respondents reported that their intercourse led to pregnancy.  In model I, in simple logistic regression, predictors such as age, gender, relationship status, dating experience (p-value < 0.001), communication with parents (p-value = 0.002), family type (p-value = 0.020), and family income (p-value = 0.002) were significantly associated with premarital sex. Furthermore, not living with parents, parent’s education level, friends with sex partners, friends having dating experience, and awareness that friends have sex were also among the factors significantly associated with premarital sex. In the multiple logistic regression, in Model II, relationship status (aOR, 44.47; 95% CI: 7.88, 251.08), dating experience (aOR, 24.00; 95% CI: 5.36, 107.58), discussion about sexual health with parents (aOR, 8.16; 95% CI: 2.25, 29.62), and knowing friends who had premarital sex (aOR, 15.82; 95% CI: 2.92, 85.61) were significantly associated with premarital sex after controlling for potential confounding predictors. Conclusion Sex education interventions within and beyond educational institutions are crucial to increase the level of awareness and protect the physical, mental, and social health of young unmarried partners in Nepal.

The authors have declared no competing interest.

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