Social media as sources of sexual health knowledge: A compensatory or complementary form of education?

BackgroundThere are many social and cultural factors affecting the sexual knowledge of adolescents. This study measured the sexual health knowledge level of adolescents and identified its association with role of parents, friends and school environment in adolescent girls in Riyadh, Saudi Arabia.MethodsFour hundred and nineteen Saudi female students belonging to intermediate and secondary grades were randomly selected from four public and private girl schools. 255 (69.8%) students were ≤15 years and 164 (39.2%) were >15 years. A self-administered structured questionnaire comprising of socio-demographic information, role of parents and teachers, availability of school curriculum on sexual health was used. Sexual health knowledge was assessed through questions on identification of physical changes during puberty for ≤15 years and separate questions on sexually transmitted infections for >15 years.Results54% of ≤15years and 70.7% of >15 years had poor sexual health knowledge. Multivariate analysis found determinants for poor sexual health education in ≤15years are: lower education level of both parents (OR 10.87; 95% CI 2.44–48.38), second birth order or more (OR 2.32; 95% CI 1.24–4.33) and absence of school curriculum on sexual health (OR 0.56; 95% CI 0.33–0.95). Determinants for >15 years of age are : mothers with low literacy (OR 3.08, 95% CI 1.42–6.71), as for sources of poor sexual knowledge : parents (OR 10.10; 95% CI 2.70–37.74), schools (OR 6.95; 95% CI 1.95–24.78) maids (OR 4.57; 95% CI 1.26–16.59) and media (OR 5.12; 95% CI 1.29–20.07) were statistically significant factors.ConclusionGovernment agencies with collaboration of all stake holders should develop policies and programs for implementing and evaluating integrated and comprehensive sexual educational programs for adolescents in Saudi Arabia.

Background:There is a lack of sexual health knowledge and resource access among youth in Latin America, along with rising rates of teenage pregnancy and STD transmission.Objectives:To determine baseline sexual health knowledge and the acceptance of a technology based sexual health risk-reduction program among Ecuadorean adolescents.Methods:We used mixed methods to determine the sexual health knowledge and practices, and technology use among 204 adolescents from two schools in Cumbayá and Lumbisí, Ecuador. Quantitative data was collected through surveys and qualitative through single-gender focus groups.Findings:Nearly every participant (96.6%) expressed interest in a sexual health education program using technology and social media. A majority of participants indicated that they consulted parents (58.3%) regarding sexual health questions. Only a few participants had access to physicians outside of appointments (3.9%), and most desired more sexual health information (87.3%). Although approximately one-quarter of participants were sexually active (27%), most lacked baseline knowledge regarding contraceptives and STDs. Facebook (91%) and WhatsApp (53%) were the most frequently used and requested social media for an educational program. Students indicated a strong desire to be involved in the design stages of a sexual health risk-reduction program, rather than use a pre-established program.Conclusions:There is strong interest in a technology based sexual health risk-reduction program through Facebook and WhatsApp, which could establish communication between health providers and Ecuadorian youth to disseminate health information and answer private inquiries. Findings from this study, the first of its kind among South American adolescents, introduces a novel idea: involving participants from initial design stages of a text-messaging health education program. Future studies should focus on engaging families as well as physicians’ willingness to participate.Implications and Contributions:This paper is the first acceptability study of a technology based sexual health risk-reduction program among low-income South American adolescents. Findings enhance understanding of pregnancy and STD prevention interventions by demonstrating participants’ desire for self-design and implementation, and highlight their importance through a lack of baseline adolescent sexual health knowledge.

Advancing Sexual and Reproductive Health Education—Pursuing the Long Arc of Justice

This paper reports on a study to examine the effects of a theory-based interactive postpartum sexual health education programme on postpartum women's sexual health knowledge, attitudes towards sexual health, contraceptive self-efficacy and sexual self-efficacy. Childbearing can challenge marital satisfaction and the sexual life of women, making the childbearing years a vulnerable stage in the sexual life of a woman. Although sexual education used to be a routine aspect of local postpartum teaching, this teaching was inadequate to satisfy women's informational needs related to sexual health. For this two-group, randomized controlled trial, 166 participants were recruited at a medical centre in northern Taiwan. The experimental group (n = 84) received the intervention. The control group (n = 82) received routine postpartum teaching. Participants in the experimental group were separated according to their learning preparedness, as determined by the transtheoretical model. Their level of preparedness was then matched to different sexual health education strategies used in the intervention. Data were collected in 2003 at baseline and at 3 days and 8 weeks following the intervention. Descriptive and repeated-measures anova were used to analyse data. Sexual health knowledge, attitudes and sexual self-efficacy were significantly greater for women in the experimental group at 3 days and 8 weeks after the intervention programme than for those in the control group. However, contraceptive self-efficacy was not significantly different in the two groups. The longer-term effectiveness of our theory-based interactive postpartum sexual health education programme will be enhanced by matching teaching strategies to participants' stage of learning preparedness.

Research has shown the role of identity on future health professionals' confidence and competence in addressing the sexual and reproductive health (SRH) needs of their patients. While there has been some work in increasing the sexual health literacy of future providers via various curricular approaches and comprehensive clinical-based training, there are research gaps on how social differences around identity impact future healthcare professionals' knowledge and practices around SRH. This article presents research findings on the experiences of US undergraduate students attending a campus that provides training in the health sciences and health professions. Our study aims to understand the perspectives of these students as they pertain to their future career choices in healthcare, with a focus on how their past experiences learning about sex, sexuality, and reproduction impact their current and future professional trajectories. We present a qualitative analysis from 40 in-depth interviews with U.S. undergraduates. The interview questions were designed in collaboration with undergraduate researchers interested in sexual health education. These student researchers collected all the interview data and worked with senior researchers to analyze some of these data. The themes that emerged from the interviews were around experiences with what students perceived as "fractured" sexual and reproductive health (SRH) knowledge they received as children and adolescents. This knowledge shaped essential aspects of their identity as young adults and future healers. Data indicated unique processes implicated in how past as well as present socialization experiences learning about sex, sexuality, and reproduction positions undergraduates in health professions to see young adulthood as a journey of "catching up" on sexual knowledge but also as an ongoing experience of anticipation and planning influencing their career-building journey. The importance of sexual health literacy among healthcare professionals cannot be overstated, as it is vital in providing patient-centered and non-judgmental sexual and reproductive health (SRH) care and services. To date, there is a shortage of studies looking at the impact of sexual health knowledge on healthcare professionals. More research is needed on educational strategies that could be implemented at the intra-personal level to assist college-aged young adults in healthcare career tracks to "catch up" or "fill in the gaps" in their sexual education journey.

BackgroundSouth Africa has one of the highest burdens of adolescents with perinatally-acquired HIV (APHIV) in the world. APHIV in South Africa have limited access to sexual and reproductive health (SRH) education and services specific to their HIV status. When lacking comprehensive SRH education, APHIV are prone to sexual risk behaviors that can lead to unintended pregnancy, sexually transmitted infections, and HIV transmission. The use of mHealth interventions has been shown to deliver information, foster social support, and improve decision-making skills. In this study, we evaluate how an mHealth intervention influences sexual health knowledge and behaviors in APHIV.MethodsWe purposively enrolled adolescents from the intervention arm of a randomized clinical trial assessing a multi-module, moderated WhatsApp-based intervention—Interactive Transition Support for Adolescents Living with HIV (InTSHA)—within a government supported clinic in KwaMashu, an urban township of KwaZulu-Natal, South Africa. We conducted in-depth interviews based on World Health Organization guidelines for asking adolescents about SRH. We thematically analyzed data through an iterative, team-based coding approach combining deductive and inductive elements to contextualize SRH attitudes, knowledge, and behaviors before and after receiving the InTSHA intervention.ResultsOf the 21 participants, 13 (61.9%) were female and the mean age was 16.6 years. Most participants reported first learning about SRH as young teenagers in school through non-targeted and negative ways, seeking clarification through peers and the internet rather than clinicians or caregivers. Participants reported that InTSHA provided a holistic perspective on relationships, gender, and sexuality specific to growing up with HIV in South Africa. They praised the ability to give and receive information from peers in a moderated setting through the mHealth intervention, building their confidence, decision-making skills, and communication with partners and caregivers throughout their everyday lives. Despite reporting some technological challenges, adolescents agreed that InTSHA was convenient, confidential, and user-friendly.ConclusionsSouth African APHIV receive incomplete and conflicting sexual education from peers, caregivers, teachers, and technology that can be supplemented by mHealth curricula targeted for the unique needs of APHIV. Future, scaled-up mHealth interventions can lower SRH stigma by expanding access to sexual education and peer support, supplementing adolescents’ existing SRH education.

Young women remain disproportionately vulnerable to sexually transmitted infections, partly due to gaps in access to structure and evidence-based sexual health education. Although comprehensive sexual health education is widely advocated, evidence regarding its effectiveness in improving sexually transmitted infection prevention and sexual health knowledge among young women in low- and middle-income settings remains limited. To evaluate the impact of health education on knowledge and sexually transmitted infections prevention in young married women. A quasi-experimental study was conducted among 160 young married women aged 18-25years attending a primary healthcare center, Port Said City, Egypt. Participants received a structured sexual health education program focusing on safe sexual practices, contraception, and sexually transmitted infection prevention. Sexual health knowledge, attitudes, behaviors, and infection-related outcomes were assessed before and after the intervention using validated assessment tools. Following the educational intervention, participants demonstrated statistically significant improvements in sexual health-related knowledge and attitudes. Positive changes were also observed in reported health practices, including a reduction in risk-related behaviors and an increase in preventive practices after the intervention (p<0.001). Additionally, overall sexual health outcome scores showed a significant improvement, indicating the effectiveness of the educational program. Comprehensive sexual health education contributes to improved knowledge related to the prevention of sexually transmitted infections and supports the adoption of healthier personal health practices among young women. These findings underscore the value of structured educational interventions as an important public health nursing strategy for promoting reproductive health and preventing infection. It is recommended that structured reproductive and sexual health education be integrated into community-based and educational health programs, with ongoing evaluation to ensure responsiveness to young women's sexual and reproductive health needs.

Introductionthere is little or no progress towards the attainment of sexual and reproductive health (SRH) targets of the Sustainable Development Goals (SDGs) in many developing country settings. Key SRH gap in these settings includes suboptimal knowledge-based safe sexual practices, especially among adolescent girls as a vulnerable subpopulation. Unique features of school environmental settings including gender segregation have not been harnessed for cost-effective sexual health education, perhaps due to the current paucity of literature. This study was aimed at comparing sexual health knowledge and practices, between sexually active adolescent girls in co-educational and girl-only secondary schools in Calabar, Nigeria.Methodscross-sectional comparative study design was used. Sexually active adolescent girls were randomly recruited from co-educational and girl-only secondary schools in Calabar, Nigeria. Validated questionnaire developed by the United Nations Educational Scientific and Cultural Organization (UNESCO), was used to assess sexual health knowledge and behavioral practice. Factors associated with a satisfactory level of knowledge were assessed using the Chi-square test. Data analysis was done using SPSS version 24.0, with the p-value set at 0.05. Ethical approval was obtained before data collection.Resultsone hundred and twenty respondents were studied, comprising an equal proportion of sixty (60) in co-educational and girl-only schools. Mean age and age at sexual debut were 16.4 ± 1.8 and 14.3 ± 2.2 years, respectively. Compared with group 1 (co-education), respondents in group 2 (girl-only) had significantly higher mean knowledge scores (26.1 vs. 30.4, p<0.05). Fifty respondents (41.7%) had a satisfactory level of knowledge of sexual health. There was no significant difference in mean practice scores comparing groups 1 and 2 (20.4 vs. 21.5, p>0.05). Internet use, unmarried parental status, and not living with both parents, were associated with unsatisfactory levels of knowledge on sexual health.Conclusioncompared with co-educational schools, girl-only schools have better sexual health knowledge, but a similar level of behavioral practices. There is a need for improvement in sexual health education efforts among adolescent girls, perhaps with more focus on coed schools, within the context of potential inherent disadvantage in the school environmental setting.

Lesbian, gay, and bisexual (LGB) adults often experience cissexism, heterosexism, and other forms of discrimination, which, as a result, leaves LGB adults vulnerable to identity-related victimization such as sexual orientation microaggressions (SOMs). These derogatory, hostile, and homophobic insults can lead to adverse mental and physical health outcomes for this minoritized group. While research has established taxonomies related to SOMs and their impact on the mental health and identity development of LGB people, little research has addressed the systemic influence SOMs have on sexual health knowledge and risk-related sexual behavior. The present study conducted four focus groups with LGB emerging adults (N = 17; M = 20.4 ± 2.4) to understand how their experiences with microaggressions might affect their knowledge and attitudes about sex and sexual risk behavior. Reflexive thematic analysis resulted in four themes as critical aspects of (a) early familial moments, (b) religious persecution about their sexuality, (c) coping and resilience strategies and sexual health, and (d) sexual education and miseducation. Results suggest that SOMs greatly influence how LGB individuals view their identity, sexual health, and attitudes toward sexual behavior. Additionally, addressing these microaggressions in the education, family, and healthcare systems may enhance healthcare access and quality and create inclusive environments that encourage equitable experiences early on in one's identity development. Given that sexual health education begins during the stage of adolescence, future research can utilize these findings to design a study that understands LGB youth experiences of SOMs and how it impacts their identity development, well-being, and sexual health behaviors and attitudes.

The purpose of this quantitative retrospective study was to understand the impact of prior exposure to sexual health education on middle and high school students' sexual health knowledge, self-efficacy, and intentions. The study analyzed a secondary dataset that included pre- and posttest results collected for program evaluation purposes by a leading provider of sexual health education in California from approximately 8,500 middle school and high school students. Of those participants, pretest and posttest results for 1,626 middle school students and 1,103 high school students were matched using self-generated identification codes. Middle school and high school cohorts were analyzed separately based on self-report of prior doses of sexual health education (0, 1, 2, and 3 or more prior doses) using one-way analysis of variance, paired t-tests, and chi-square tests for association. Results of this study suggest promising, though quite modest, impacts from prior exposure to sexual health education. There were minimal statistically significant differences between dosage groups in sexual health knowledge. There were statistically significant differences between dosage groups on self-efficacy-aligned survey items and on the single intention-related survey item. This study also exposed some counterintuitive dynamics with regard to self-efficacy and prior exposure, such that students without prior sexual health instruction may exhibit greater confidence in their ability to execute sexual health-promoting behaviors than participants who report one or two prior doses. Taken together, the results suggest that it may be important to look beyond the outcomes of a single intervention and understand how interventions may provide compound outcomes over time. There are important limitations to this study, including the use of self-reported prior exposure and the lack of validated survey items to measure the theorized constructs. Nonetheless, the results provide support for the integration of multiple doses of comprehensive, inclusive, age-appropriate sexual health education programming to more effectively incorporate sexual health education across the K-12 educational life cycle. This study also prompts important questions and potential opportunities to understand the nuances and intricacies of how dosage over time functions in sexual health education.

This study is on effects of student’s centred method of learning (cooperative learning method) on sexual health knowledge and attitudes of adolescents in Anambra State secondary schools. The inability of adolescents to acquire adequate knowledge regarding sexual health could be due to the method of teaching used which are mainly techer-centred methods such as lecture, discussion, Socratic, demonstration teaching methods among others. Therefore, students’ centered method is recommended in today’s teaching and learning and cooperative learning method is one of them. The main purpose of the study was to determine the mean scores of adolescents in Anambra State secondary schools exposed to cooperative learning method on sexual health knowledge and attitudes and by comparing the scores with that of control group. The study was guided by six research questions and eight hypotheses. Quasi experimental research design was used and the population consisted of 20,342 senior secondary two (SS2) students in Anambra State. One hundred and fourty SS2 students comprised sample for the study using simple random sampling technique without replacement. Four secondary schools in Anambra state were sampled. Then one intact class was sampled from each of the sampled schools using simple random sampling technique without replacement. Two schools were exposed with cooperative learning method and the other two schools were used as control group for six weeks. The instruments for data collection were Sexual Health knowledge Test (SHKT) and Sexual Health Attitudes Questionnaire (SHAQ). Analyses of data were carried out using Mean, Standard Deviation and Analysis of Covariance (ANCOVA). The findings of the study among others revealed that cooperative learning method improved sexual health knowledge and attitudes of the subjects as depicted by the positive gained mean scores recorded more than the control group. Male adolescents exposed to cooperative learning method had better sexual health knowledge gained mean score (X = 37.27) than their female counterparts (X = 32.46) exposed to the same method. But the female adolescents’ standard deviation showed better homogeneity of responses than their male counterparts. Female adolescents exposed to cooperative learning method had better sexual health attitude gained mean score (X = 11.38) and their standard deviation showed better homogeneity of responses than their male counterparts exposed to the same method (X = 9.37). The effect of cooperative learning method on the mean sexual health knowledge and attitudes scores of adolescents in Anambra state secondary schools differ significantly using their post-test mean scores P &lt; 0.05. On the contrary, the effect of cooperative learning method on the mean sexual health knowledge and attitudes scores of male and female adolescents in Anambra state secondary schools did not differ significantly using their post-test mean scores P &gt; 0.05. It was recommended among other things that there is need to include cooperative learning method in handling sexual health education in the school curriculum at all levels of education in Nigeria.

Introduction Sexuality education varies considerably from abstinence-only to comprehensive sex education and can influence knowledge, attitudes, and behaviors about sexuality. We examined the relations among types of sex education, sex-positive and purity culture attitudes, and sexual and reproductive health knowledge among a group of diverse high school graduates. Methods This study captured the sexuality knowledge and attitudes pursuant to the type of sex education received among a sample of 1005 high school graduates. Data were collected in the summer of 2023. We used ANOVAs, MANOVA, and linear regressions to examine relations among sex education type, sexual and reproductive health knowledge, sex-positive and purity culture beliefs, and participants’ self-reported readiness for their sexual lives. Results Participants who reported receiving abstinence-only sex education endorsed more purity culture beliefs and fewer sex-positive beliefs than those who experienced comprehensive sex education. Sexual and reproductive health knowledge was poor. Participants who experienced comprehensive sex education rated that education as better preparing them for a healthy sexual life compared to those who had abstinence-only education. Conclusions Findings reveal the relation of sex education type on attitudes toward sexuality and self-reported readiness for adults’ sexual lives. Policy Implications Policymakers, educators, and others who work with young people should champion sex-positive, comprehensive sex education. More work is needed to ensure sex education yields an informed public who can navigate their sexual lives effectively.

Few measures explicitly assess general youth sexual knowledge in the United States, The Acquired Sexual Knowledge Questionnaire (ASKQ) was designed to be a practical and useful measure of sexual health knowledge for youth (Grades 7-12) participating in sexuality education courses in schools. This article outlines the construction, development, and evaluation of the ASKQ on a sample of 244 middle and high school students who participated in a United Way approved eight-week sexual health education program. The questionnaire was found to have good internal consistency (α = .80) and will be a useful tool in measuring sexual health knowledge.

Adolescents frequently experience perceived and actual barriers to sexual and reproductive healthcare related to confidentiality, access, and their relationship with healthcare providers. Advanced Practice Registered Nurses (APRNs) are well positioned to work with adolescents in a variety of non-acute care settings to provide preventative sexual healthcare services. No studies have recorded Nurse Practitioners' (NPs) and Certified Nurse Midwives'/Certified Midwives' (CNMs/CMs) adolescent sexual health knowledge, attitudes, and beliefs. The purpose of this study was to determine whether there were any differences between Women's Health Nurse Practitioners (WHNPs) and CNMs/CMs whose educational programs have a concentration in sexuality, and APRNs from other specialties (ANPs, FNPs, PNPs, and PMHNPs) regarding knowledge, attitudes, and beliefs toward adolescents' sexual health. The study used a cross-sectional, descriptive comparative design. A convenience sample was recruited through the National Association of Nurse Practitioners in Women's Health (NPWH) and the Nurse Practitioner Association- New York State (NPA) e-newsletters and surveyed online with The Sex Knowledge Attitude Test (SKAT), the Sexuality Attitudes and Beliefs Survey (SABS), and the National Violence Against Women Survey (NVAWS) to assess sexual health knowledge, sexuality attitudes, beliefs about addressing adolescent's sexual health, and personal experience of sexual violence. One open ended question elicited responses of qualitative data. Demographic data of participants (n = 204) were analysed and 171 participants finished the online survey. Multiple logistic regression analysis shows that the WHNP/CNM/CM group have significantly more positive beliefs about addressing adolescents' sexual health than the Other NPs group, [beta] = -3.36, p = .003. Chi-square of attitude scores by region of the U.S. show that positive attitudes toward adolescent sexuality vary significantly with the South showing the least positive attitude scores (p &lt; .01). Religion (not being Christian), [beta] = 1.69, p = .04, and religiosity (frequency of attending religious services), [beta] = -6.05, p &lt; .0001, were significant predictors of adolescent sexuality attitudes. In addition, results of logistic regression of sexual health knowledge, and adolescent sexuality attitudes between the WHNP/CNM/CM group and the Other NPs group trends towards significance. The open ended question was analyzed using content analysis. Categories and constructs derived from respondents (n = 29, 17%) further support the quantitative findings, such as adolescents' lack of access to comprehensive sexual health education and sexual health care services led by APRNs, discomfort in addressing adolescent's sexual health, and the need for further adolescent sexual health education. Further research needs to be done with a larger sample size and more advanced knowledge questions for APRNs. Competency-based curriculum in the area of adolescent sexual health that promotes professional values and compassionate care in educational programs for APRNs is essential to improve adolescent's access to sexual healthcare services and outcomes.

ABSTRACTSexually active college students in the United States have alarming rates of unplanned pregnancy and sexually transmitted infections. Varying degrees of sexual health knowledge and attitudes among college students are an outcome of sexuality education in the K-12 school systems with abstinence-only or comprehensive focus. Community college students (n = 737) aged 18–24 years, 57% from a college in an abstinence-only sex education state and 43% from a college in a comprehensive sex education state, both in the Mid-Atlantic region, took the Sexual Health Survey in October 2016, which measures sexual health knowledge and attitudes. Gender and ethnicity differences, as well as other sources of sexuality information were evaluated. Students from the comprehensive sex education state, New Jersey had higher sexual health knowledge and attitude scores than the students from the abstinence-only sex education state, Pennsylvania. Male students in New Jersey scored significantly higher in sexual health knowledge compared to male students in Pennsylvania, while female students in New Jersey had higher sexual health knowledge scores compared to the male students. Analysis of ethnicity revealed the New Jersey college sample had healthier sexual attitudes as compared to the Pennsylvania college sample, with notable distinction among Black students. The Internet, friends, and personal experiences were chosen by 75% of all students across both colleges as the top reported sources of sexuality information. In addition to advocating for comprehensive sex education, recommendations are made for sexual health initiatives in community colleges to provide sexual health instruction and support.