Unsafe Sex

Unsafe Sex is one of the modifiable risk factors tracked by the IHME Global Burden of Disease Study. The attributable deaths shown here represent the estimated number of deaths that could be prevented if exposure to this risk factor were eliminated or reduced to optimal levels. Understanding risk factor contributions helps prioritize public health interventions and policy decisions.

Risk factor attribution uses comparative risk assessment methodology. A single death may be partially attributed to multiple risk factors, so attributable death counts should not be summed across risk factors. Data covers 204 countries from 1990 to the latest available year.

Unsafe sex is a major behavioural risk factor for mortality, contributing to deaths from HIV/AIDS, cervical cancer, other sexually transmitted infections, and maternal conditions associated with unintended pregnancy. HIV/AIDS alone accounts for the majority of deaths attributable to unsafe sex, with sub-Saharan Africa bearing the overwhelming burden. Cervical cancer caused by sexually transmitted HPV claims approximately 342,000 lives annually. Other STIs — syphilis, gonorrhoea, chlamydia — cause direct mortality (congenital syphilis, pelvic inflammatory disease complications) and facilitate HIV transmission. Unintended pregnancy resulting from lack of contraception access contributes to unsafe abortion deaths. Globally, an estimated 374 million new STIs occur each year. Young people, women and girls, sex workers, men who have sex with men, and people who inject drugs face the highest risk. Gender inequality, lack of comprehensive sexuality education, and stigma around sexual health services are structural barriers.

Unsafe Sex contributes to mortality from HIV/AIDS, cervical cancer, syphilis, gonorrhoea, and 1 other conditions. The magnitude of impact varies by country depending on exposure levels, population demographics, and the availability of preventive and treatment services.

Comprehensive sexuality education, condom promotion and distribution, HPV vaccination, and access to HIV pre-exposure prophylaxis (PrEP) are evidence-based prevention strategies. STI screening and treatment — particularly for syphilis in pregnancy — prevents transmission and complications. Access to contraception and safe abortion services prevents maternal deaths from unintended pregnancy. Treatment as prevention for HIV (U=U) and voluntary male circumcision reduce transmission. Addressing gender inequality and removing legal barriers to sexual health services for key populations are essential structural interventions.