Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Boston Medical Center Boston, MA, USA.
Sex Reprod Healthc. 2022 Mar;31:100676. doi: 10.1016/j.srhc.2021.100676. Epub 2021 Nov 6.
To explore how individual, relational, and social contexts influence adolescents' sexual awareness and decision-making in rural Nicaragua.
Eighteen semi-structured interviews were conducted with adolescent boys and girls aged 15 to 19 years. Thematic analysis identified patterns of meaning applying a socio-ecological approach. A thematic map illustrates how the themes are organized according to the socio-ecological model and suggests their interactions.
Six main themes emerged as (1) Adolescence - a period of life changes, (2) Fears as a pathway to awareness and decision-making, (3) Awareness about protective measures, (4) Relational influences on adolescents' sexual health, (5) Service provision and institutional influences on awareness and decision-making and (6) Sociocultural determinants on adolescent sexual health. Informants of both genders expressed concern in several issues of their sexuality. They identified fear of pregnancy, STIs, and their impact on future goals, family communication, and school-based sexual education as protective factors for their sexual decision-making. Adolescents of both genders are challenging social and cultural norms by developing sexual agency.
These findings imply that personal and societal factors in rural Nicaragua produce a multi-dimensional effect on adolescent sexual self-efficacy. Our study is relevant for a wider discussion about sexual awareness to promote positive development and health outcomes particularly among adolescents' girls and boys living in rural settings.
探索个体、关系和社会背景如何影响尼加拉瓜农村青少年的性意识和决策。
对 15 至 19 岁的青少年男孩和女孩进行了 18 次半结构化访谈。采用社会生态学方法对主题分析确定了意义模式。主题图说明了主题如何根据社会生态学模型进行组织，并提出了它们的相互作用。
出现了六个主要主题，分别是（1）青春期——生活变化的时期，（2）恐惧是意识和决策的途径，（3）关于保护措施的意识，（4）对青少年性健康的关系影响，（5）服务提供和机构对意识和决策的影响，以及（6）青少年性健康的社会文化决定因素。男女受访者都对自己的性行为表示担忧。他们认为对怀孕、性传播感染及其对未来目标、家庭沟通和学校性教育的影响的恐惧是他们性决策的保护因素。两性青少年都在通过发展性自主权来挑战社会和文化规范。
这些发现意味着尼加拉瓜农村的个人和社会因素对青少年性自我效能产生了多维度的影响。我们的研究对于更广泛地讨论性意识以促进积极的发展和健康结果具有重要意义，特别是对生活在农村环境中的青少年女孩和男孩。
