Sexual Behavior, Substance Use, and Psychosocial Factors Among Mongolian University Students

While Mongolian university students have been exposed to rapid sociocultural changes, also shifting their sexual norms and substance use behaviors, there is limited empirical evidence on them. Therefore, we examined associations between substance use (smoking, drinking, illicit drug use), sexual behaviors (sexual intercourse, casual and unprotected sex), sexual beliefs, social support, and psychological factors (self-efficacy, optimism, and general well-being). Using a cross-sectional design, we employed self-administered online questionnaires in a sample of Mongolian undergraduate students (N = 396; aged 18–24 years; 49.2% males). More than 62% reported ever drinking, 40.4% ever smoking, 23.0% illicit drug use; 64.9% was the lifetime prevalence of sexual intercourse, 41.2% reported engagement in casual sex, and 29.5% had engaged in unprotected sex. Differences by sex were significant with a higher prevalence among males, except for current illicit drug use and unprotected sex. Substance use was significantly associated with an increased likelihood of having sexual intercourse and participating in casual sex. While higher levels of well-being, self-efficacy, optimism, and social support from family and friends were significantly linked to ever being engaged in sexual intercourse, these positive constructs did not prevent them from risky sexual behaviors. Sex differences in substance use, sexual behaviors, and beliefs support the influence of the prevailing social expectations and traditional gender role perceptions in Mongolia. These findings emphasize the importance of comprehensive health education and supportive psychosocial environments.