Sexual And Reproductive Health Issues Research Articles

Adolescent utilization of sexual and reproductive health services in Gamo Zone, Southern Ethiopia. Insights from multilevel and latent class analysis.

Adolescents face unique challenges related to their sexual and reproductive health (SRH), with access to timely services being critical for positive outcomes. However, SRH service utilization among adolescents remains low. This study aimed to identify factors influencing SRH service use among adolescents in Gamo Zone, Ethiopia. A community-based cross-sectional study involved 1172 adolescents selected through stratified sampling. Structured face-to-face interviews were employed for data collection. Multilevel mixed logistic regression was fitted to identify factors and latent class analysis was conducted to understand population heterogeneity. The findings of this study reveal that 198 (16.89%) adolescents (95% CI: 14.8%-19.2%) utilized SRH services within the past 12 months. Factors significantly associated with SRH service utilization included good knowledge about SRH rights (AOR = 4.65; 95% CI: 2.68, 8.07), belonging to one-parent families (AOR = 4.13; 95% CI: 2.39, 7.12), engaging in parental discussions regarding SRH issues (AOR = 3.17; 95% CI: 1.89, 5.29), high family support (AOR = 1.96; 95% CI: 1.09, 3.51), and enrolling in school (AOR = 0.19; 95% CI: 0.11, 0.33). Additionally, access to social media was associated with increased SRH service utilization among adolescents (AOR = 1.98; 95% CI: 1.25, 3.15). Latent class analysis identified four groups: rural school-enrolled adolescents living with parents, urban school-enrolled adolescents with both parents, urban disadvantaged female adolescents, and early adolescents with limited social media access. In conclusion, our study sheds light on the utilization of SRH services among adolescents, revealing that 16.89% of the participants accessed these services within the past year. Significant factors associated with SRH service utilization included good knowledge about SRH rights, belonging to one-parent families, engaging in parental discussions regarding SRH issues, high family support, and enrollment in school. Interestingly, access to social media was also linked to increased utilization of SRH services among adolescents. Furthermore, our latent class analysis identified four distinct classes of adolescents based on socio-demographic indicators, highlighting the heterogeneity within this population. These findings underscore the importance of tailored interventions and targeted approaches to address the diverse needs of adolescents in accessing and utilizing SRH services.

What sexual and reproductive health issues do young people want to discuss with a doctor, and why haven’t they done so? Findings from an online survey

ObjectiveYoung people are a priority group for sexual and reproductive health (SRH) care. We considered which SRH topics young Australians want to discuss with a general practitioner (GP) and explored barriers they encounter to discussing these issues. MethodsWe conducted an online survey (2nd May – 21st June 2022) of Australians aged 16–29 years. Participants were asked to identify from a list of SRH topics which they wanted to discuss, but never had, with a GP. Those who selected any topic/s (with ‘undiscussed SRH issues’) were asked a free-text follow-up question about what prevented them from discussing issues. We explored characteristics associated with having undiscussed issues using multivariate logistic regression. Free-text comments were analysed using content analysis. ResultsA total of 1887 people completed relevant survey questions. Most (67.1 %) were women and 48.5 % were heterosexual. Two-thirds (67.0 %) had a usual GP. Nearly half (45.6 %) had undiscussed issues. Most commonly, women wanted to discuss cervical screening and sexual problems, and men wanted to discuss sexual problems and STIs. Participants who were male, older, heterosexual, and with a usual GP were least likely to have undiscussed issues. Barriers to accessing care for SRH were identified from free-text comments, including discomfort, lack of opportunity, fear of negative outcomes, low priority of SRH issues, and perceptions about the role and expertise of GPs. ConclusionsMany young people would welcome more preventative SRH care. Young people may be reassured that all issues, including sexual difficulties and dysfunction, are appropriate to discuss with a GP.

Exploring Barriers to Accessing Adolescents Sexual and Reproductive Health Services in South Ethiopia Regional State: A Phenomenological Study Using Levesque's Framework.

Evidence suggests that adolescents face multiple barriers to accessing Sexual and Reproductive Health (SRH) services. However, there remains a notable gap in the literature regarding the nuanced interplay between supply-side and demand-side barriers. Therefore, this study aimed to examine barriers to accessing SRH services in the Gamo Zone of South Ethiopia Regional State. A descriptive phenomenology study was conducted from September 04 to October 15, 2023. A total of seven Focus Group Discussions (FGDs), four with girls and three with boys, with a total of 75 adolescents, and ten Key informant interviews (KIIs)with healthcare providers participated in the study. A semi-structured interview guide was used to explore their lived experiences. All interviews and discussions were audio-recorded. To analyze and manage data framework analysis approach was applied using ATLAS Ti version 7 software. The major barriers preventing adolescents from accessing SRH services are related to the interplay between supply and demand-side barriers across all five domains of the Levesque framework. Despite the high need for access to health care, lack of SRH literacy, lack of outreach activities, and integration of SRH information in health facilities often hampered adolescents' healthcare need. Additionally, fear of stigma from family and community, social norms, and lack of discussion of SRH issues hindered their ability to seek health care. Shortage of supplies and healthcare providers' behaviors further hindering adolescents' ability to access health care services. Furthermore, the limited involvement of adolescents in decision-making and the lack of effective coordination further complicate the appropriateness of services for adolescents. The finding of this study reveals that adolescents face multifaceted barriers. Therefore, there is a need for high-impact complex interventions, program and policy that address both supply and demand side barriers needs to give due intention to improve access to SRH services for adolescents.

Sexual and reproductive health (SRH) of women with mental illness (WMI) - An integrative mixed-method study.

Women with mental illness (WMI) are more likely to experience unreported sexual and reproductive health (SRH) problems. Mixed-method research studies with the strengths of quantitative and qualitative approaches provide deeper insight into SRH issues of WMI. A sequential explanatory mixed-method design was used to understand better the SRH problems of WMI attending tertiary care psychiatry hospital. In phase 1, a survey was conducted to identify if they have SRH problems. Women who were identified to have SRH problems were part of Phase II. In this phase, in-depth interview was conducted to explore their lived-in experiences. Integration at the method level was adopted by connection through sampling. Using a narrative approach, integration was accomplished at the level of interpretation and reporting. Among the users, 261 (64.6%) female sterilization, 244 (93%) was the most common, and the other methods like coitus interruptus, male condoms, and intrauterine devices were reported less. Of the non-users, 137 (33.9%) WMI 100 (73%) were unaware of the best family planning approach. Most of them, 377 (93.3%), were ignorant about sexually transmitted infection (STI) symptoms. WMI reported 62 (15.3%) unusual foul-smelling vaginal discharge and 58 (14.4%) genital ulcers, with poor treatment-seeking behavior. Sexual dysfunction in desire, arousal, lubrication, orgasm, satisfaction, and pain were also reported. The findings were described in a single report based on the quantitative data followed by themes obtained from qualitative interviews using weaving techniques under the headings of contraceptive use and its awareness, prevalence of STI symptoms and its treatment, and sexual health experiences. Data integration demonstrated that one-fourth of WMI had inadequate awareness of contraceptive use, were ignorant of STI symptoms, and experienced sexual dysfunction.

“It Means Being Safe, Having Power over One's Body”: Black Female Adolescent Experiences with Reproductive Health Counseling in Primary Care

Study ObjectiveThere is limited research examining the sexual and reproductive health (SRH) care needs and experiences of Black adolescents who are assigned female at birth (AFAB). This study aimed to understand the perspectives of Black AFAB adolescents in their receipt of SRH counseling in primary care and elicit preferences for SRH-related communication with clinicians. MethodsWe interviewed English-speaking Black AFAB adolescents, ages 13-17, living in North Carolina between February and June 2022 about their SRH care experiences. The interviews were conducted via video conferencing, audio-recorded, professionally transcribed, and analyzed using a thematic approach. ResultsWe interviewed 23 adolescents (mean age 15.8 years) across 10 geographically diverse counties in North Carolina. Most conveyed positive perceptions of clinicians regarding trust and comfort. However, many expressed concerns about clinicians not doing enough to ensure patient confidentiality, provide them with enough information to make informed and autonomous decisions, and destigmatize discussing SRH issues during the clinical encounter. Suggested improvements include sociodemographic congruence between patients and clinicians (eg, younger Black women), ensuring time alone with clinicians across adolescence, and proactively sharing information to promote respect and autonomy. ConclusionAlthough Black AFAB adolescents had positive perceptions of their health care providers regarding relational components of care, many participants shared significant gaps and areas for improvement in the quality of care received to better align services with their preferences for SRH care. These findings can inform the development of SRH counseling best practices and clinician education to support respect and autonomy, which are routinely denied to Black AFAB adolescents.

A qualitative assessment of the impact of a community-embedded intervention on beneficiaries' attitudes and beliefs about adolescent sexual reproductive health in Ebonyi State, Southeast, Nigeria

BackgroundAdolescents and their communities in Ebonyi State, Nigeria have poor attitudes and beliefs towards adolescent sexual and reproductive health (SRH). This paper reports on the effects of a community-embedded intervention that focused on creating positive changes in the attitudes and beliefs of adolescents and community members to enhance adolescents’ access to SRH information and services. MethodsThis study adopted the Qualitative Impact Assessment approach to evaluate the changes in attitudes and beliefs about the SRH of adolescents from the perspectives of the beneficiaries of a community-embedded intervention namely, adolescents, parents, school teachers, and community leaders. The intervention was implemented in six local government areas in Ebonyi State, southeast Nigeria and the evaluation was undertaken four months after the implementation of the interventions commenced. Eighteen (18) interviews were conducted with 82 intervention beneficiaries including: (i) six in-depth interviews with school teachers; (ii) two sex-disaggregated FGDs with parents; (iii) two sex-disaggregated FGDs with community leaders; and (iv) eight sex-disaggregated FGDs with in school and out of school adolescents. A thematic analysis of data was performed with the aid of NVivo software, version 12.ResultsThe community-embedded intervention led to changes in individual attitudes and beliefs, as well as changes in community norms and values concerning adolescent SRH. Adolescents reported that following the community-embedded SRH intervention, they have become more comfortable discussing openly SRH issues with their peers, and they could more easily approach their parents and initiate SRH discussions. The parents of adolescents reported that following the intervention, they have become more willing to discuss sensitive SRH issues with adolescents, and frequently make out time to do so. It was also reported that parents no longer use euphemisms to describe sexual body parts, and community leaders now believe that it is all right to discuss SRH with adolescents. Hence, initiating or having SRH discussions with adolescents is no longer misconceived as encouraging sex, and menstruation in unmarried adolescents is no longer viewed as a sign of promiscuity. Respondents also highlighted changes in community norms of, (i) gendered parental communication of SRH matters, as both mothers and fathers have started discussing SRH issues with their adolescent boys and girls; and (ii) public shaming and discipline of pregnant teenage girls are on the decline.ConclusionThe community-based intervention had a positive impact on individual attitudes and beliefs, as well as community and societal values and norms about adolescent SRH. Interventions that take into account community norms and values regarding adolescent SRH should be prioritized to enable the achievement of the SRH-related target of SDG 3.

Sexual and reproductive health issues of women attending psychiatric clinic in India-A qualitative study.

Women with mental illness (WMI) experience considerable disparities in sexual and reproductive health (SRH) when compared to the general population. Due to their restricted access to SRH services, they have unmet contraceptive needs, a greater prevalence of sexually transmitted infections (STIs), and sexual dysfunction. The study aimed to explore the SRH issues of WMI in a tertiary care psychiatric outpatient clinic in Bengaluru, India. A qualitative hermeneutic phenomenological approach was used. A reproductive age group (18-49 years) WMI (n = 32) was selected by purposive sampling technique. The period of data collection was from January 2021 to September 2021. An in-depth face-to-face interview was conducted using a validated interview schedule. Hycner's explicitation process was used to investigate the constituents of a phenomenon. The codes revealed potential themes and subthemes. SRH issues faced by WMI were organized under three main themes, namely, (1) factors responsible for sexual dysfunction, (2) symptoms of STI and treatment adherence, and (3) use of contraception and its barrier. Sexual dysfunction among WMI is contributed by numerous factors. Women were exhibited limited knowledge of STI symptoms and treatment compliance. Such women experience issues with current method of contraception and are unaware of the alternatives. The findings of this study may be helpful for clinical nurses in drawing attention to and increasing knowledge of the reproductive health issues that women with psychiatric disorders face, taking the required precautions, and devising strategies for minimizing harm.

Situational context of home-based sexual education in urban slums of Ibadan, Nigeria

Abstract Background Little is known about how events in slum settings interfere with informal sexual education in Nigeria. This study explores the influence of situational context on parent-adolescent communication about sexual and reproductive health (SRH) issues in the urban slums of Ibadan, Nigeria. Methods A qualitative exploratory study was conducted in the Southeast and Northeast local government areas of Ibadan. Eight (8) vignette-based focus group discussions (FGDs) with parents and adolescents of both sexes were conducted in addition to four (4) key informant interviews (KIIs) with community and women's leaders. Interviews were audio-recorded, transcribed, and translated into English. Descriptive and interpretative analyses were conducted with the aid of ATLAS Ti 9 software. Results Findings portray SRH meanings and experiences, intergenerational cultural norms, and expectations for SRH, gender double standards in SRH discussion, streetwise SRH knowledge, and social media exposure to SRH as contexts that interfere with parent-adolescent communication on SRH issues. The findings show that although parents and teenagers understood SRH issues and their consequences, there was no effective communication about them. Also, the conversation between parents and adolescents promotes gender inequalities as different SRH information is passed to adolescent girls and boys. Streetwise SRH knowledge was identified to impede effective parent-adolescent conversation on SRH issues. Social media exposure had a significant impact on where teenagers got their unfiltered SRH knowledge, interfering with and distorting SRH discussion between parents and adolescents. Conclusions Interventions that enable parents to give and allow their children early access to appropriate SRH knowledge, considering their context, are urgently needed. Key messages • The study emphasizes the need for tailored sexual education programs that are culturally sensitive, age-appropriate, and accessible to parents and children in urban slums. • The study highlights the absence of formal sexual education in schools and communities in urban slums of Ibadan, Nigeria.

ADOLESCENT-PARENT COMMUNICATION ON SEXUAL AND REPRODUCTIVE HEALTH AND ITS ASSOCIATED FACTORS AMONG HIGHER SECONDARY SCHOOL STUDENTS OF TOKHA MUNICIPALITY, NEPAL : A CROSS-SECTIONAL STUDY

Background: As compared to other age groups, adolescents are more vulnerable to sexual and reproductive health issues. Parents can become protective and influencing factors for their children to prevent risky sexual behavior. Purpose: This study aimed to assess adolescent-parent communication on sexual and reproductive health and its associated factors. Methods: A descriptive cross-sectional study among 212 adolescents aged 15–19 in higher secondary schools of Tokha Municipality. A self-administered structured modified questionnaire to assess the communication used the Weighted Topics Measure of Family Sexual Communication tool with a simple random sampling technique. Descriptive statistical analysis and chi-square tests were used to analyze data and assess the association between variables. Data quality was assured through careful questionnaire design, pretesting, and training. Results: The study found that 75.9% of adolescents had communicated on sexual and reproductive health (SRH) topics with their parents, 24.1% never communicated, 47.2% seldom communicated on SRH topics, followed by sometimes (23.6%) and often (5.2%), respectively. Adolescent-parent communication on SRH was significantly associated with the level of knowledge regarding sexual and reproductive health (ꭓ2 = 5.809, p-value = 0.01, df = 1). Similarly, there was a significant association with the perceived parenting style (ꭓ2 =3.932, p-value =0.04, df =1), living arrangements (ꭓ2 =6.376, p-value=0.01, df =1), and adolescent-parent communication. Conclusion: It concluded that adolescent-parent communication on SRH issues is not satisfactory. Creating an adolescent-friendly environment at home and conducting awareness programs with the help of the local government of the respective schools would help to increase adolescent-parent communication.

Displaced Women and Sexual and Reproductive Health Services: Exploring Challenges Women With Sexual and Reproductive Health Face in Displaced Camps of Nigeria

Background: Displaced women are affected by sexual and reproductive health (SRH) challenges, often exacerbated by poor living conditions, limited access to healthcare, and cultural norms. The aim of this study was to explore SRH issues, the effects of displacement into camps on women’s SRH, and challenges with accessing and utilizing SRH services among women in camps for the displaced in Benue State, Nigeria. Methods: A qualitative phenomenological approach was employed to gain an in-depth understanding of the women’s SRH challenges, based on 12 focus group discussions between women of different age groups and eight in-depth interviews. The data were collected using tape recorders and notes. Data analysis followed a thematic approach. Ethical approval and appropriate consent were obtained for the study. Results: The majority of research participants stated that sexually transmitted disease/human immunodeficiency virus was the most serious SRH issue in the camp. Their stay in camp enhanced the women’s vulnerability and exposed them to sex in exchange for basic needs/palliatives, increasing their SRH challenges. Access to and use of SRH services were impacted by their migratory lifestyle, cultural and religious views, lack of SRH knowledge, and other difficulties. Short-term approaches to intervention, health providers’ poor communication, and attitudes were reported to affect SRH service use. Conclusion: There is an urgent need for comprehensive interventions to address SRH challenges among women in displaced settings, including proper coordination of humanitarian services, education on transactional sex, encouragement of men to participate in SRH initiatives, and expansion of access to services, as well as the training and hiring of culturally competent healthcare providers.

Sexuality and Sexual and Reproductive Health Depiction in Social Media: Content Analysis of Kinyarwanda YouTube Channels.

Social media platforms such as YouTube can be used to educate people of reproductive age about healthy and nonrisky sexual and reproductive health (SRH) practices and behaviors. However, there is a paucity of evidence to ascertain the authenticity of sexuality and SRH content on Kinyarwanda YouTube, making it difficult to determine the extent to which these topics are covered, the characteristics of available videos, and the themes covered by these videos. The aims of this study were (1) to determine the extent to which YouTube channels in Kinyarwanda-language videos address sexuality and SRH issues, identify the general characteristics of the available videos (type of video, when published, intention for the audience, and content focus), and the aspects of sexuality and SRH covered; and (2) to identify the themes covered by retrieved Kinyarwanda videos, and the extent to which the channels have been used to communicate issues of sexuality and SRH during the COVID-19 pandemic. Using a content analysis approach, we searched Kinyarwanda YouTube channels to analyze videos about sexuality and SRH. The adopted framework for data collection from social media platforms builds on three key steps: (1) development, (2) application, and (3) assessment of search filters. To be included, an audio and/or visual video had to be in Kinyarwanda and the video had to be directed to the general public. Descriptive statistics (frequency and percentages) were computed to characterize the basic characteristics of retrieved channels, portrayal of the videos, and presentation of sexuality and SRH themes that emerged from retrieved videos. Further analysis involved cross-tabulations to explore associations between the focus of the channel and the date when the channel was opened and the focus of the channel and who was involved in the video. The YouTube search retrieved 21,506 videos that tackled sexuality and SRH topics. During the COVID-19 pandemic, there was a 4-fold increase (from 7.2% to 30.6%) in channels that solely focused on sexually explicit content. The majority of the 1369 retrieved channels (n=1150, 84.0%) tackled the topic of sexuality, with sexually explicit content predominantly found in the majority of these videos (n=1082, 79%), and only 16% (n=287) of the videos covered SRH topics. This is the first study to analyze the use of YouTube in communicating about sexuality and SRH in the Kinyarwanda language. This study relied on videos that appeared online. Further research should gather information about who accesses the videos, and how channel owners and individuals involved in the videos perceive the impact of their videos on the Rwandan community's sexuality and SRH.

Young Queer Community Members Faced Higher Discrimination in Albania During the COVID-19 Pandemic.

The COVID-19 pandemic has hit vulnerable populations harder.In this context, the aim of this study was to assess the negative personal impacts and discrimination experienced by the LGBTQ+ community in Albania during the COVID-19 pandemic. This cross-sectional study was carried out in Albania in 2021, as a part of a larger multicenter study conducted by the International Planned Parenthood FederationEuropean Network (IPPF EN). Binary logistic regression was used to assess the likelihood of feeling discriminated, ashamed, or afraid due to sexual orientation, adjusting for main confounding factors. In total, 279 youngsters aged 14-30 years were included in this study. Of these, 55 participants or 19.7% self-declared as LGBTQ+. Significantly higher proportions of LGBTQ+ were older and of Albanian ethnicity, whereas lower proportions were not married/cohabiting compared to non-LGBTQ+ participants. Significantly higher proportions of LGBTQ+ members have felt discriminated (32.7%), ashamed to discuss about sexual and reproductive health(SRH) issues of concern (32.7%), afraid to express their sexual orientation (45.5%), and lacked privacy to discuss SRH issues with people of trust (36.4%) compared to non-LGBTQ+ participants (5.4%, 15.2%, 4%, and 17.4%, respectively). LGBTQ+ participants were 19.57 times more likely to feel discriminated because of their sexual orientation and 25.05 times more likely to be afraid to express their sexual orientation compared to non-LGBTQ+ participants. The LGBTQ+ community in Albania was more negatively impacted by the COVID-19 pandemic compared to non-LGBTQ+ participants. The findings should guide future interventions for addressing the needs of the LGBTQ+ community in emergency situations.

Prevalence and factors associated with sexual and reproductive health literacy among youth living with HIV in Uganda: a cross-sectional study

BackgroundAdequate sexual and reproductive health literacy (SRHL) among young people has been linked to informed sexual behaviours. Studies on SRHL have largely been conducted among the general adolescent population. Little is known about youth aged 15-24 years living with human immunodeficiency virus (YLHIV). There is a possible lack of SRHL in this population, considering the high rate of teenage pregnancies and unprotected sex reported by YLHIV. This study aimed to assess the prevalence and associated personal and environmental factors for SRHL among YLHIV at a high-volume urban HIV Clinic in Uganda.MethodsThrough a cross-sectional survey, YLHIV receiving routine HIV care services at Baylor-Uganda HIV Clinic were interviewed using an adapted European Health Literacy Survey (HLS-EU). Using simple random sampling, eligible youth who received HIV care services between August and November 2019 were enrolled in the study. SRHL scores were computed using the HLS-EU index method; and individuals whose scores ranged from 34 to 50 were considered health literate. We used descriptive statistics to determine the prevalence. Potential associated personal and environmental factors (p<0.05) were identified by performing two-step inferential statistics, bivariate analysis and binary logistic regression. Odds ratios were calculated to estimate the likelihood of youth being health literate on sexual and reproductive health (SRH) issues in comparison with the reference categories, and 95% confidence intervals were determined to establish whether the relationships were statistically significant.ResultsOf the 267 YLHIV interviewed at Baylor-Uganda HIV Clinic, 167 (62.5%) were female with a mean age of 18.9 years (SD± 2.8), and the majority (242; 90.6%) were vertically infected with HIV. Only 52 (19.5%) were health literate on SRH issues. At the multivariate level, YLHIV who never had difficulty accessing SRH information were 0.391 times less likely to be health literate on SRH issues than their counterparts with challenges in accessing SRH information (Adjusted Odds Ratio [AOR] = 0.391, 95% CI =0.178 to 0.860; p= 0.019). YLHIV who did not find it easy to access SRH care service points were 2.929 times more likely to be literate in SRH than those who found it easy to access such services (Adjusted Odds Ratio [AOR] = 2.929, 95% CI =1.241 to 6.917; p=0.014). Additionally, YLHIV who did not listen to radio health talks were 2.406 times more likely to be health literate on SRH issues than those who did (AOR = 2.406, 95% CI =1.133 to 5.112; p=0.022).ConclusionsSRHL is an unmet need among YLHIV; only 19.5% were health literate on SRH issues. This could complicate the achievement of the UNAIDS sustainable development goal (SDG) of an HIV/AIDS-free generation by 2030 because low health literacy (HL) skills can affect the efficacy of almost all HIV disease prevention and health promotion efforts. Inaccessible SRH care service points and not listening to radio health talks were positively associated with SRHL, while having access to SRH information was negatively associated with SRHL.

A Brief Overview of the Sexual and Reproductive Health Awareness of Adolescents in Kerala

Background: Adolescence is a critical and challenging period of life. Many adolescents today have patchy knowledge on SRH issues, which may lead to risky decision making concerning their health. Kerala, though one of the most literate states in India, is yet to implement comprehensive sex education. Objectives: To list the sources of information and to study the awareness of adolescents on Sexual and Reproductive Health (SRH) issues among high school students in Kerala. Materials &amp; Method: A cross sectional study was conducted among 8th, 9th, 10th class students. Multistage random sampling was conducted and a sample size of 338 was achieved. Data was collected via a self-administered questionnaire and analyzed using SPSS Version-23. Results were explained in terms of frequency, percentage, mean and standard deviation. Results: Mean age of the study population was 14.2 ±0.88 years; most of them were females (58%) and followed Christian religion (49%); belonged to urban areas. The major sources of information for adolescents regarding SRH matters like private parts, type of touch, response to sexual assault and menstruation was their mother. When it comes to puberty changes, both mother and teachers were the major sources. Media was the most common source of information regarding Masturbation, sexual contact, pregnancy, contraception, STDs, and sexual abuse. There is wide disparity in the awareness of adolescents on major SRH issues. Conclusions: India has the largest adolescent population, and it is a country known to have strict traditional values and age-old cultures and customs. Adequate information through parents may improve the knowledge on these issues. Age-appropriate comprehensive sexuality education must be incorporated into their curriculum effectively to improve their SRH.

Sexual and reproductive health issues and associated factors among female night school students in Amhara Region, Ethiopia: an institution-based cross-sectional study

ObjectiveThis study aimed to assess the prevalence of sexual and reproductive health (SRH) issues and associated factors among female night school students in the Amhara Region, Ethiopia.DesignInstitution-based cross-sectional study.Setting16 night...

Adolescent–Parent Relationships and Communication: Consequences for Pregnancy Knowledge and Family Planning Service Awareness

PurposeWe explore three dimensions of parent–adolescent relationships (sexual and reproductive health (SRH) communications, connectedness, and parental monitoring) from the perspective of young adolescents as they relate to pregnancy knowledge and family planning service awareness in four diverse geographic areas ranging from low to high income settings and stratified by sex. MethodsAnalyses utilized baseline data from four Global Early Adolescent Study sites (Shanghai, China; Kinshasa, Democratic Republic of the Congo; Denpasar and Semarang, Indonesia; and New Orleans, United States). Multiple linear regressions were conducted to assess the relationships between key characteristics of parent–adolescent relationships and pregnancy knowledge. Multiple logistic regressions were also conducted to assess relationships between key characteristics of parent–adolescent relationships and family planning service awareness. ResultsAcross all four sites, communication with a parent about SRH matters was significantly associated with increased pregnancy knowledge among female respondents. Further, girls in Shanghai and New Orleans and boys in Kinshasa who had ever communicated with a parent about SRH matters were significantly more likely to know where to get condoms. Finally, girls who communicated with a parent about any SRH matter were significantly more likely to know where to get other forms of contraception across all four study sites. DiscussionFindings strongly support the importance of SRH communications between young adolescents and their parents. Our findings also suggest that while parental connectedness and monitoring are beneficial they are not replacements for quality parent–adolescent communications about SRH issues that begin early in adolescence before sexual intercourse is initiated.

Evaluating the History-Taking Process of Sexual Reproductive Health Problems in Tanzania: Lessons from a Study of Health Students and Practitioners.

Building trust and therapeutic relationships between healthcare providers and patients are crucial for delivering high-quality, comprehensive sexual and reproductive health (SRH) services. Yet, while patients face substantial SRH disparities in Tanzania, little is known about health care professionals' [HCPs] SRH history-taking practices and experiences. This paper describes HCPs' interdisciplinary practices, experience in conducting SRH taking, and the critical lessons learned to optimize quality SRH care. We conducted 18 focus group discussions in June 2019 in Dar es Salaam, Tanzania, with 60 healthcare practitioners and 61 students in midwifery, nursing, and medicine. We implemented a purposive, stratified sampling design to explore the experiences and perspectives of HCPs regarding providing sexual health services. We employed a grounded theory approach to perform the analysis. We provided seven scenarios to participants to discuss how they would manage SRH health problems. The scenarios helped us evaluate the practice and experience of SRH in Tanzania. Four broad themes and sub-themes emerged during the discussion; 1) SRH history-taking practices and experiences in the health care facilities; 2) the perceived benefit of effective SRH history-taking; 3) Factors hindering the SRH history-taking process; 4) The power of confidence. These findings have implications for strengthening a sexual health curriculum for medical students and continuing education programs for practicing health professionals designed to address the observed health disparities in Tanzania. These findings affirm that proper SRH history-taking requires a conducive environment, knowledge of relevant SRH-related laws and regulations; application of evidence-based techniques; and giving patients autonomy to make decisions for their health while making recommendations regarding standard care. Comprehensive SRH history-taking identifies critical data for illness diagnosis, provides foundational information for risk-reduction behavioural change counselling, and reduces medical costs. Therefore, the primary goal is to optimize health professional training on SRH issues and history-taking skills within the medical interview.

Narratives of most significant change to explore experiences of caregivers in a caregiver-young adolescent sexual and reproductive health communication intervention in rural south-western Uganda.

This paper presents findings from a qualitative effectiveness evaluation of an intervention aimed at improving caregiver-young adolescent sexual and reproductive health (SRH) communication including training modules for caregivers on parent-child SRH communication. Data was collected (October 2021-November 2021) using a narrative interviewing technique with thirty caregivers (8 males and 22 females), who received the parent-child communication intervention in Mbarara district, south-western Uganda. We explored caregivers' experiences with the intervention based on four domains of change: caregiver-young adolescent communication on SRH issues, knowledge and attitudes towards adolescent SRH, parenting skills, and personal life and family. Thematic analysis was used to code and analyse the data, with attention to gender differences. Findings highlight positive parenting as a key attribute of SRH communication, along with a transformation of knowledge and attitudes towards the SRH of young adolescents leading to an overall improvement in SRH communication. However, communication is still limited to comfortable topics. Our findings indicate improved caregiver-adolescent SRH communication practices following a community intervention. Programming for adolescent health on broader sexuality topics, comfortability and attitude change among caregivers could promote behaviour change on a long term. Future studies may focus on the long term impacts of interventions of this nature and test interventions aimed at addressing comfortability with discussingSRH issues.

A cross-sectional study of knowledge and practices related to sexual and reproductive health among adolescents in 'unrestricted environments' in Ghana: A policy implementation context view

Background: Sexual and reproductive health (SRH) is key to the growth and development of adolescents. Inadequate information exposes adolescents to some challenges. This becomes more pronounced as they move from restricted unrestricted environments such as pertains universities where there is virtually no control. It is importantto assess their knowledge of issues related to adolescent sexual and reproductive health (ASRH) needs and how that knowledge influences their sexual practices. Objective: To assess the knowledge and practice of adolescents in public universities across Ghana on their SRH needs. Study Participants: 672 adolescents from the three selected public institutions who met the inclusion criteria and consented to the study. Study Setting: The Study Setting was the University of Professional Studies Accra (UPSA); Kwame Nkrumah University of Science and Technology (KNUST), Kumasi; and the University for Development Studies (UDS) in Tamale, all in Ghana. Study Design: A cross-sectional study of adolescents in public universities across Ghana. Results: The study found that over 80% of university respondentshad high knowledge of ASRH issues. However, more than two-thirds (67%) of the respondents indicated that they had no knowledge that sexually transmitted infections (STIs) could be transmitted through unprotected sex. Regarding their sexual practices, the study found that 70% of the respondents were sexually active however, the prevalence of contraceptive use among them was extremely low (7%). Conclusion: A high level of knowledge on SRH issues among a large proportion of sexually active adolescents does not correspond to levels of practising safe sex making themsusceptible to STIsand unplanned pregnancies. Knowledge was thus disproportionally associated with safe sexual practices among adolescents in the unrestricted environments surveyed. Implementing behavioural change interventions through sexual education and improved access to ASRH services could improve the situation. These findings are thus relevant for SRH policy reforms and implementation programmes.

Ethnographic understandings of sexual and reproductive health and HIV care for adolescents in Blantyre, Malawi

Sexual and reproductive health (SRH) care and support are provided to adolescents living with HIV, with the aim to build safer sex negotiation skills, sexual readiness and reproductive preparedness while reducing unintended pregnancies and sexually transmitted infections. We consider how different settings might either constrain or facilitate access to resources and support. Ethnographic research was conducted in Malawi in teen club clinic sessions at an enhanced antiretroviral clinic from November 2018 to June 2019. Twenty-one individual and five group interviews were conducted with young people, caregivers, and healthcare workers, and were digitally recorded, transcribed, and translated into English for thematic analysis. Drawing on socio-ecological and resilience theories, we considered the different ways in which homes, schools, teen club clinics, and community settings all functioned as interactional, relational, and transformational spaces to allow young people to talk about and receive information on sexuality and health. Young people perceived that comprehensive SRH support enhanced their knowledge, sexual readiness, and reproductive preparedness. However, their desire to reproduce at an early age complicated their adoption of safer sex negotiation skills and SRH care. Engaging and talking about SRH and related issues varied according to physical and social space, suggesting the value of multiple locations for support and resources for young people with HIV.