Knowledge, attitudes, and factors associated with the utilization of youth-friendly sexual and reproductive health services among teenagers and young adults in Kigali City, Rwanda.

BACKGROUND

Youth-friendly sexual and reproductive health (SRH) services support teenagers and Young Adults' development into healthy adults by preventing unintended pregnancies and sexually transmitted infections, including HIV/AIDS. In Rwanda, these services are provided by trained health providers in health facilities and youth centers. In particular, youth centers may also offer vocational courses like welding, cooking, football, and computer literacy. However, there is limited information on the use of these services, especially in Kigali City. This study determined knowledge, attitudes, and factors associated with the utilization of youth-friendly sexual and reproductive health services among teenagers and young adults.

METHODS

This was a quantitative cross-sectional survey in which data were collected from July 8 to 22, 2024. The collected data were analyzed via STATA version 17. A generalized estimating equation (GEE) model was used to identify factors associated with the utilization of Youth-friendly sexual and reproductive health services. Statistical significance was assumed at a p-value of less than 0.05.

SETTING

Data were collected in three districts of Kigali City in Rwanda, Eastern Africa.

RESULTS

This study revealed that out of the 850 TYAs included in the study, both sexes were nearly equally represented: 49.4% females versus 50.6% males. The proportions of TYAs with adequate knowledge positive attitudes, and those who have ever attended SRHs were 76.9%, 70.0%, and 60.0%, respectively. The predictors of Youth-friendly sexual and reproductive health services use include living in the Gasabo district [aOR:4 with 95% C.I: 2.5-6.1], being aware of the services [aOR:3.8 with 95% C. I: 2.3-6.2], having adequate knowledge of Youth-friendly sexual and reproductive health services [aOR: 2.6 with 95% C. I: 1.7-3.9], being a student in a school located near lodges/guest houses [aOR:1.6 with 95% C. I: 1.0-2.6], being female [aOR: 1.6 with 95% C. I: 1.1-2.3], being cared for by a father [aOR:2.4 with 95% C. I: 1.4-4.1] or a mother only [aOR: 1.8 with 95% C. I: 1.8-2.7], and having positive attitudes toward Youth-friendly sexual and reproductive health services [aOR: 1.8 with 95% C. I: 1.2-2.7]. Furthermore, TYAs who have ever used Youth-friendly sexual and reproductive health services were 2.2 times more likely to be using contraceptives [aOR: 2.2 with 95% C.I.: 0.9-5.1] and 2.4 times more likely to have been tested for HIV [aOR: 2.4 with 95% C.I.: 1.6-3.4] than those who were not.

CONCLUSION

Youth-friendly sexual and reproductive health (YFSRH) services improve HIV testing and contraception uptake among adolescents in Kigali, but utilization remains low due to limited knowledge, especially among males. Efforts should focus on raising awareness, targeting males and those identified to be at higher risk of HIV and unintended pregnancies.