Low Levels of Sexual and Reproductive Health Knowledge Found Among Students in Sri Lanka

Abstract

A survey conducted in Sri Lanka reveals low levels of sexual and reproductive health knowledge among students aged 16-19. (1) For example, only one in 10 could correctly identify a method of contraception, and fewer than 1% correctly answered all four of the survey's primary sexual knowledge questions. The survey also examined sexual attitudes and behaviors, and found that males were more likely than females to consider sexual relationships acceptable among youth their own age (21% vs. 8%). Just 2% of the adolescents had had sexual intercourse; 57% of these youth had used contraceptives at first sex, and 63% had ever used contraceptives. The lack of information on the reproductive and sexual health needs of adolescents in Sri Lanka has been highlighted as an area of national concern. To help identify these needs and to inform reproductive health policy, in 2010 researchers conducted the first survey in 10 years to assess the sexual and reproductive health knowledge, attitudes and behaviors of in-school teenagers. Students from randomly selected government schools in Badulla District (an area socioeconomically similar to the rest of the country) were eligible for inclusion if they were aged 16-19, were attending grades 11-13 and had been registered in a state school between July 2007 and June 2009. The self-administered survey, which was completed by 2,020 students (response rate, 90%), included questions on social and demographic characteristics, socioeconomic status, sexual and reproductive knowledge, attitudes toward premarital sex, and sexual behaviors. The researchers computed descriptive statistics and used chi-square testing to identify statistical differences between males and females in sexual knowledge, attitudes and behaviors. Overall, 26% of the respondents were male and 74% were female, reflecting the sex ratio in state schools. The majority of students were aged 16-17; almost all of the students were Sinhalese (97%) and Buddhist (96%). Nine percent characterized their home environment as poor, most often because of financial difficulties or paternal alcoholism. Levels of parental closeness were high: Nine-tenths of participants reported being very close to their mother, and two-thirds reported being very close to their father. Although 57% of females and 34% of males identified their parents as their most important source of general support, only 45% of females and 3% of males identified them as their most likely source of support and information concerning sex. About one-third of males and one-fifth of females said they had no one with whom to discuss sexual matters; their most preferred sources of information on sexual issues were health personnel (midwives and public health inspectors; 20%) and doctors (18%). The four questions that served as indicators of reproductive health knowledge revealed substantial deficits. Fewer than 25% of respondents were aware that it is possible to acquire an STI at first sex, and a similarly small proportion knew that it is possible to become pregnant at first sex. Just one in 10 correctly identified a contraceptive method, and even fewer (6%) could identify a way to prevent STI transmission. Only 0.4% of respondents answered all four questions correctly. …