BACKGROUND:
Even though evidence from across the globe and in Ghana highlights STIs as a public health concern for adolescents and young adults, limited studies have focused on the differences in STI rates and risk factors between adolescent boys and girls. The purpose of this research is to explain the variation in STIs among male and female sexually active adolescents and young adults (AYA) in Ghana using non-linear decomposition analysis based on logit estimates.

METHODS:
The study's data were extracted from the 2022 Ghana Demographic and Health Survey. The study included male and female sexually active adolescents and young adults aged 15-24 years. A cross-sectional analysis of the data was conducted, using a non-linear decomposition model to examine gender differences in STIs.

RESULTS:
The prevalence of STIs in the study was 10.9%. STI was highest among males (18.1%) than among females (8.4%). STI prevalence was highest among those with multiple sexual partners (28.7%), high media exposure (17.3%), high comprehensive HIV knowledge (12.1%), no children (12.4%), early age (8-17 years) at first sex (12.0%), and those not married (12.4%). Approximately 55% of the gender differences in STIs were attributable to the differences in socio-demographic and sexual and reproductive health characteristics. The number of sexual partners (37.4%), media exposure (17.3%), and age at first sex (-10.2%) explained approximately 47% of the gender differences in STIs.

CONCLUSIONS:
The prevalence of STIs among adolescents and young adults is increasing and skewed towards men. Multiple sexual partners contributed mainly to the gender differences in STIs among AYA in Ghana. Thus, interventions aimed at reducing STIs among AYA could be targeted at lowering multiple sexual partners through promoting behaviour change communication, particularly among men.