Tamang Laxmi, Raynes-Greenow Camille, McGeechan Kevin, Black Kirsten I
Discipline of Obstetrics, Gynaecology and Neonatology, University of Sydney, Camperdown, 2050 NSW, Australia.
Sydney School of Public Health, University of Sydney, Sydney, 2006, Australia.
Sex Reprod Healthc. 2017 Mar;11:25-30. doi: 10.1016/j.srhc.2016.09.002. Epub 2016 Sep 14.
Youth have the right to utilise sexual and reproductive health (SRH) services and information to protect themselves from negative SRH outcomes. This study aimed to assess knowledge, experience and use of SRH services amongst youth living in urban areas of the Kathmandu Valley.
We conducted a two stage cluster sampling cross-sectional household survey of young men and women aged 15-24 living in the Kathmandu Valley using a structured questionnaire.
Amongst the 680 young men and 720 young women participants, less than two-thirds had knowledge about the fertile period and less than a half about pregnancy risk at first sex. Over three quarters of young men and women had knowledge of condoms, and pills but less than half knew about implants or intrauterine devices. Age at first sex was similar for men and women but women were significantly less likely to have participated willingly in their first sexual encounter and were less likely to have used any contraception (for both p < 0.001). Almost all men and women (97.9%) had heard of sexually transmitted infections (STIs) but only 8% had heard about the most common STI, Chlamydia. Over 90% of youth reported feelings of shame as the major barrier to accessing SRH services.
Gaps exist between youth SRH knowledge and practices which leave them vulnerable to sexual ill health. This may indicate a lack of confidence in SRH services but also likely reflects the cultural and religious environment that hampers open expression of sexual and reproductive issues, particularly for young women.
青少年有权利用性与生殖健康（SRH）服务和信息来保护自己免受不良SRH后果的影响。本研究旨在评估加德满都谷地城市地区青少年对SRH服务的知识、经验和使用情况。
我们使用结构化问卷对加德满都谷地15 - 24岁的年轻男性和女性进行了两阶段整群抽样横断面家庭调查。
在680名年轻男性和720名年轻女性参与者中，不到三分之二的人了解排卵期，不到一半的人知道首次性行为时的怀孕风险。超过四分之三的年轻男性和女性了解避孕套和避孕药，但不到一半的人知道皮下埋植剂或宫内节育器。男性和女性的首次性行为年龄相似，但女性自愿参与首次性接触的可能性显著较低，使用任何避孕措施的可能性也较低（两者p均<0.001）。几乎所有男性和女性（97.9%）都听说过性传播感染（STIs），但只有8%的人听说过最常见的性传播感染——衣原体。超过90%的青少年表示，羞耻感是获取SRH服务的主要障碍。
青少年的SRH知识与实践之间存在差距，这使他们容易遭受性健康问题。这可能表明对SRH服务缺乏信心，但也可能反映了阻碍性与生殖问题公开表达的文化和宗教环境，尤其是对年轻女性而言。
