Background: Risk taking is inherent in young people (aged 10 to 24 years old) as they grow to adulthood; the choices they make during this phase of life could enhance or diminish their future health and well-being. Culture, economic disparities, political decisions and social support or lack of it contribute to sexual risk taking. Changing social structure, migration patterns, disasters, globalisation, developments in computerised communication media among others place young people at risk sexually. Adverse health outcomes such as sexually transmitted infections, including Human Immunodeficiency virus/acquired immune deficiency syndrome and unintended pregnancies are among the consequences of sexual risk taking. Public health sexual risk reduction programmes target groups of young people by providing age and context-appropriate interventions to reduce risk taking, prevent the outcomes and complications of such risks.

Objectives: The objective of this review is to synthesise the best-available evidence on the effectiveness of population-based risk-reduction programmes and services on sexual risk taking among young people in low- and middle-income countries.

Methods: Publications will be assessed using a 3-step search strategy. Randomised-controlled trials and in their absence, quasi-experimental studies will be considered. Two independent reviewers will assess for methodological validity, extract and synthesise data using standardised critical-appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI).

Results: Anticipated outcomes would include measures related to reduction in risky sexual behaviour among young people such as time to sexual initiation, number of sexual partners, condom use generally and at first sex, consistent and correct contraceptive (condom) use during sexual encounters [condom use skills] and self-efficacy in negotiating safer sex.

Conclusions: Recommendations will be made for further primary studies, reviews or policy and programme guidelines aimed at reducing sexual risk taking, its outcomes and complications in low- and middle-income countries.