Background Numerous studies have been documented in Nigeria to assess the magnitude of sexual coercion there is limited literature that linked sexual coercion with sexual exchanges, and vulnerability among students. This study therefore examines the relationship between sexual exchanges and coercion with its implication on Sexually Transmitted Infections (STI) among undergraduate students in the study area.

Methods A multi-stage random sampling procedure was employed in administration of 1458 questionnaires. Three levels of analysis were used for this study.

Results From the survey, half of the respondents had their first sexual experiences before age 16 years while 40% of the respondents had sexual intercourse with two or more partners in the last six months preceding the survey. Two-thirds of the respondents did not use condom in their last sexual intercourse. The study established a significant relationship between sexual coercion and ever had STIs, period of relationship, use of condom, having multiple partners and STI treatment behaviour. While the logistic regression shows that respondents aged 15–19 years are 2.568 times more likely to be coerced (P value X² = 0.00 CI 1.717–3.839) when compared with the reference category aged 20–24 years. There is a positive relationship between sexual coercion and sexual gratification; those who received gifts (both materials and money) are 1.947 times more likely to experience sexual coercion when compared with those who receive nothing.

Conclusion and recommendation Violence limits women’s ability to manage their reproductive health and exposes them to sexually transmitted diseases. There is need for holistic approach to the issue of sexual coercion especially among young females based on the health consequences and the psychological trauma for the experience they did not prepare for. There is need for policy action and health education against sexual coercion in the study area.