Tabriz University of Medical Sciences Depiction of Health 2008-9058 16 1 2025 03 26 Familial Aggregation of Sexual Risky Behaviors in the Northwestern Iran: A Cross Sectional Study 68 78 10.34172/doh.2025.07 EN Elham Davtalab Esmaeili https://orcid.org/0000-0002-6811-6881 Leila Ranandeh Kalankesh https://orcid.org/0000-0002-0868-5521 Ali Hossein Zeinalzadeh https://orcid.org/0000-0003-2527-6276 Alireza Ghaffari https://orcid.org/0000-0003-0784-9974 Saeed Dastgiri https://orcid.org/0000-0002-8129-9125 Journal Article 10.34172/doh.2025.07 2025 01 19 2025 03 16 Background. Much evidence indicates that familial aggregation plays an important role in determining and developing the control and prevention methods of diseases and high-risk behaviors. The present study aimed to estimate the prevalence of high-risk sexual behaviors and assess their familial aggregation among mother-offspring, father-offspring, between spouses, and among children. Methods. The current cross-sectional study involved 822 participants in Tabriz in 2022. The heads of households were regarded as probands and were selected using the convenience sampling method from the list of daily clients of the family medicine clinic at Asadabadi Hospital. Data was collected using two standard questionnaires: the behavioral risk factor tool and socioeconomic status, which were completed by the self-report method. The generalized estimating equations type 2 (GEE2) was employed to assess family aggregation. The significance level in all statistical tests was considered 0.05. Data was analyzed using STATA version 17 software. Results. The response rate was 95.47%. The prevalence of high-risk sexual behavior among the participants was reported to be 18.61%. There was statistically significant familial aggregation in risky sexual behavior between fathers and offspring (OR = 2.34, 95% CI: (1.4-4.45)). Furthermore, significant familial aggregation was found between mothers and offspring (OR = 1.88, 95% CI: (1.3-3.9)). Conclusion. The current study revealed a notable familial aggregation in risky sexual behavior, particularly between fathers and their offspring. Moreover, family members uniquely influence each other's participation in risky sexual behavior, irrespective of environmental or genetic factors.