Sexual and reproductive health remains a priority global challenge, especially in young populations from low- and middle-income countries. This study aimed to evaluate sexual and reproductive health practices among university students on the Ecuadorian coast. We assessed sociodemographic characteristics, contraceptive behaviors, service access, and abortion experiences in a cross-sectional observational study. A total of 4,156 participants, comprising 59.2% aged 18–23 years, 79.9% male, and 79.6% rural residents. Nearly half (47.5%) had never attended sexual health checkups, and 38.7% had never accessed spe-cialized services. Abortion was reported by 8.3% of women, with younger women (18–23 years) showing a higher likelihood compared to those aged 24–29 (aRRR = 0.449; p < 0.001). Contraceptive use in the past year was reported by 58.8% of participants, predom-inantly condoms (44.1%), while 41.2% reported non-use, mainly due to personal prefer-ence (52.3%). Only 20.3% felt very informed about HIV and STI prevention, while 28.1% reported poor or no knowledge. Older youth (24–29 years) demonstrated greater aware-ness of free contraceptives (p = 0.000) but paradoxically reported lower engagement with services (aRRR = 2.917; p < 0.001). These findings highlight younger students as the most vulnerable group, underscoring the need for targeted strategies to expand preventive care, especially in countries with scarce resources.
Mercedes Navarro Cejas, Miguel Angel Arteaga Quiroz, ,Evelyn Lisbeth Morales-Rodríguez, Johanna Magdalena Mieles Alcivar, Lesly Elizabeth Navas Jiménez, Carla Párraga Lino, Karime Montes-Escobar, Aline Siteneski (2026) studied this question.