来自南非三个城镇的青少年学习者的性与生殖健康及权利知识、认知和经历:“女孩获得力量(间隔年)试验”的定性研究结果
Sexual and reproductive health and rights knowledge, perceptions, and experiences of adolescent learners from three South African townships: qualitative findings from the Girls Achieve Power (GAP Year) Trial.
作者信息
Pleaner Melanie, Milford Cecilia, Kutywayo Alison, Naidoo Nicolette, Mullick Saiqa
机构信息
Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, 2193, South Africa.
MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, University of the Witwatersrand, Durban, Kwa zulu Natal, 4001, South Africa.
出版信息
Gates Open Res. 2022 Nov 30;6:60. doi: 10.12688/gatesopenres.13588.2. eCollection 2022.
Adolescence is a time of psycho-social and physiological changes, with increased associated health risks including vulnerability to pregnancy, HIV, sexually transmitted infections, and gender-based violence. Adolescent learners, from three townships in South Africa, participated in a 44 session, after-school asset-building intervention (GAP Year), over 2 years providing sexual and reproductive health (SRH) education. This paper explores adolescent learners' SRH, sexual risk and rights knowledge; perceptions about transactional sex; and contraceptive method preferences and decision-making practices. The intervention was conducted in 13 secondary schools across Khayelitsha, Thembisa, and Soweto, South Africa. A baseline survey collected socio-demographic data prior to the intervention. Overall, 26 focus group discussions (FGDs): 13 male and 13 female learner groups, purposively selected from schools, after completing the intervention (2 years after baseline data collection). Descriptive analyses were conducted on baseline data. Qualitative data were thematically coded, and NVivo was used for data analysis. In total, 194 learners participated in the FGDs. Mean age at baseline was 13.7 years (standard deviation 0.91). Participants acquired SRH and rights knowledge during the GAP Year intervention. Although transactional sex was viewed as risky, some relationships were deemed beneficial and necessary for material gain. Negative healthcare provider attitudes were the main barrier to healthcare service utilisation. There was awareness about the benefits of contraceptives, but some myths about method use. The injectable was the preferred contraceptive method, followed by the implant, with equal preference for condoms and oral pill. An afterschool intervention at school is a viable model for the provision of SRH and rights education to learners. Recommendations include the need for risk reduction strategies in the curriculum, dealing with misconceptions, and the promotion of informed decision making. Endeavours to ensure health services are youth friendly is a priority to limit barriers to accessing these services.
青春期是心理社会和生理发生变化的时期,相关的健康风险增加,包括易怀孕、感染艾滋病毒、性传播感染以及遭受基于性别的暴力。来自南非三个城镇的青少年学习者参加了一项为期两年、共44节的课外资产建设干预项目(间隔年),该项目提供性健康和生殖健康(SRH)教育。本文探讨青少年学习者的性健康和生殖健康、性风险及权利知识;对交易性行为的看法;以及避孕方法偏好和决策实践。该干预项目在南非开普敦、滕比萨和索韦托的13所中学开展。在干预之前通过基线调查收集社会人口统计学数据。总体而言,在完成干预后(基线数据收集两年后),从学校中有目的地挑选了26个焦点小组讨论(FGD):13个男性学习者小组和13个女性学习者小组。对基线数据进行了描述性分析。对定性数据进行了主题编码,并使用NVivo进行数据分析。共有194名学习者参加了焦点小组讨论。基线时的平均年龄为13.7岁(标准差0.91)。参与者在间隔年干预期间获得了性健康和生殖健康及权利知识。尽管交易性行为被视为有风险,但一些关系被认为对物质获取有益且必要。医疗服务提供者的负面态度是利用医疗服务的主要障碍。人们意识到了避孕措施的好处,但对方法的使用存在一些误解。注射剂是首选的避孕方法,其次是植入剂,对避孕套和口服避孕药的偏好相同。学校的课外干预是为学习者提供性健康和生殖健康及权利教育的可行模式。建议包括在课程中需要制定风险降低策略、处理误解以及促进明智决策。努力确保卫生服务对青少年友好是限制获取这些服务障碍的优先事项。
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