Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyō, Japan.
PLoS One. 2021 Feb 19;16(2):e0246917. doi: 10.1371/journal.pone.0246917. eCollection 2021.
BACKGROUND: Adolescents are vulnerable to various sexual and reproductive health (SRH) problems such as unintended pregnancy, HIV or other sexually transmitted infections (STIs), and unsafe abortion. Adolescent-friendly health services offer SRH services such as SRH counseling, contraceptive services, STI and HIV services, and abortion-related services, which may help prevent these risks. Parent-adolescent communication about SRH prevents adolescents from adopting unhealthy SRH practices. However, its association with the utilization of SRH services is less known. Therefore, this study examined the association between parent-adolescent communication on SRH issues and the utilization of adolescent-friendly health services in Nepal. METHODS: This was a school-based, cross-sectional study conducted in Kailali district, Nepal, among students aged 15-19 years in Grade 11 and 12 from seven schools. We used multivariable logistic regression analysis to examine the association between parent-adolescent communication and service utilization. RESULTS: We analyzed the data from 594 students. Students with a higher score of parent-adolescent communication on SRH were significantly more likely to use adolescent-friendly health services (adjusted odds ratio, AOR: 1.70, 95% Confidence Interval, CI: 1.29-2.23, p<0.001). Those who reported having engaged in sexual intercourse in the past year were more likely to use services than those who did not (AOR: 29.11, 95% CI: 13.65-62.08, p<0.001). Those who belonged to the Janajati ethnic group were more likely to use these services than those from the Brahmin/Chhetri ethnic group (AOR: 2.86, 95% CI: 1.28-6.42, p = 0.01). Those living alone were less likely to use services than those living with both parents (AOR: 0.12, 95% CI: 0.02-0.66, p = 0.01). CONCLUSION: Students with a higher score on parent-adolescent communication on SRH were more likely to use adolescent-friendly health services. Thus, parental involvement in SRH communication could contribute to the use of adolescent-friendly health services and ultimately prevent negative SRH outcomes among students in late adolescence.
背景：青少年易受到各种性与生殖健康（SRH）问题的影响，如非意愿妊娠、艾滋病毒或其他性传播感染（STI）以及不安全的堕胎。青少年友好型卫生服务提供 SRH 咨询、避孕服务、性传播感染和艾滋病毒服务以及与堕胎相关的服务，这可能有助于预防这些风险。父母与青少年就 SRH 问题进行沟通可防止青少年采取不健康的 SRH 做法。然而，其与利用青少年友好型卫生服务之间的关联尚不清楚。因此，本研究在尼泊尔卡利拉利地区开展了一项以学校为基础的横断面研究，调查了青少年友好型卫生服务的利用与青少年与父母就 SRH 问题进行沟通之间的关联。
方法：该研究在尼泊尔卡利拉利区的七所学校中，对 11 年级和 12 年级的 15-19 岁学生进行了调查。我们使用多变量逻辑回归分析来检验父母与青少年就 SRH 问题进行沟通与服务利用之间的关联。
结果：我们分析了 594 名学生的数据。在 SRH 方面，父母与青少年沟通得分较高的学生利用青少年友好型卫生服务的可能性显著更高（调整后的优势比，AOR：1.70，95%置信区间，CI：1.29-2.23，p<0.001）。与未发生过性行为的学生相比，报告过去一年有过性行为的学生更有可能利用这些服务（AOR：29.11，95%CI：13.65-62.08，p<0.001）。与婆罗门/切特里族学生相比，属于 Janajati 族的学生更有可能利用这些服务（AOR：2.86，95%CI：1.28-6.42，p = 0.01）。与与父母双方同住的学生相比，独自生活的学生利用这些服务的可能性较低（AOR：0.12，95%CI：0.02-0.66，p = 0.01）。
结论：父母与青少年就 SRH 问题进行沟通得分较高的学生更有可能利用青少年友好型卫生服务。因此，父母参与 SRH 沟通可能有助于利用青少年友好型卫生服务，并最终防止青少年晚期学生出现不良的 SRH 结局。
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