O4 Views of key stakeholders in saudi arabia on protective sexual health strategies

Abstract

Background Approaches to sexual health education diverge between promoting abstinence-until-marriage and supporting harm reduction (HR). The latter acknowledges that adolescence is a period of risk taking and aims to reduce the harms of STIs and unplanned pregnancies. In Saudi Arabia, there is no sexual health education and the sensitivities surrounding sex-related issues in a country that rules exclusively by Islamic laws, creates challenges for the provision of sexual and reproductive health information. This study aimed to explore the views of key stakeholders in Saudi Arabia on the relative merits of adopting an abstinence-only approach or HR strategies within a proposed sexual health education program and to examine which approaches are likely to be feasible in Saudi Arabia, and by extension in other Muslim communities around the world. Methods In this qualitative study, semi-structured interviews with 28 participants were conducted. Four different groups were targeted, policymakers (n=6); healthcare providers (n=10); teachers (n=9); and religious scholars (n=2). Results The need for sexual health education for adolescents was universally acknowledged by participants. Stakeholders’ views spanned a spectrum rather than fitting in clear cut categories of adopting abstinence vs HR strategies. The concept of harm was conceptualized, contrary to the conventional public health discourse, as strictly health-related but focused on social and religious harm. Those who opposed HR strategies believed that these messages can encourage premarital sexual activity and hence damage traditional family norms. While those who leaned towards adopting HR strategies viewed it as a necessary step in preventing infectious harm from pervading the rest of society. Opinions varied on who should formulate the program and in what context it should be delivered. Conclusion The results showed that understanding the local interpretations of harm and HR strategies is vital to formulating a culturally sensitive sexual health education program that can expand beyond international public health definitions and messaging.