Use of Sexual and Reproductive Health Services and Associated Factors Among University Students in South Kivu, Democratic Republic of the Congo

Abstract

Background University students in the Democratic Republic of the Congo face barriers to sexual and reproductive health (SRH) services. This study examined SRH knowledge, service use and associated factors in Bukavu, South Kivu. Methods A cross-sectional structured questionnaire survey was conducted in January–February 2025 among 430 students. Previous SRH service use was defined by the direct question asking whether the respondent had ever consulted an SRH service. Categorical comparisons used chi-square or exact tests. Multivariable logistic regression estimated adjusted odds ratios (AORs). Results The mean age was 22.00 ± 3.03 years. Of 430 students, 325 (75.6%) met the study-specific threshold for good SRH knowledge and 175 (40.7%) reported previous service use. In the adjusted model (n = 413), service use was associated with healthcare professionals as an information source (AOR 1.58, 95% CI 1.01–2.46), reporting cost as a barrier (AOR 1.62, 95% CI 1.05–2.52), and sexual intercourse in the previous three months (AOR 2.04, 95% CI 1.33–3.11). Good SRH knowledge was inversely associated with use (AOR 0.50, 95% CI 0.30–0.82). Conclusion Reported SRH service use was limited despite a high proportion meeting the study’s knowledge threshold. The associations suggest considering practical access, engagement with healthcare professionals and students’ needs alongside education. They do not establish causal effects.