Family-based sexual health interventions significantly improved adolescents' sexual health knowledge in low- and middle-income countries, but their impact on attitudes, practices, and family communication around sexual health was inconsistent.
Family-based sexual health interventions (FBSHI) significantly improved adolescents' sexual health knowledge in low- and middle-income countries.
The impact of FBSHI on adolescents' sexual health attitudes, practices, and family communication around sexual health topics was inconsistent.
Combined interventions involving both adolescents and their parents were highlighted as important for eliciting better sexual and reproductive health outcomes.
The systematic review identified significant geographical gaps, particularly the under-representation of Asian countries in FBSHI research in LMICs.
The systematic review included nine studies with a total of 2404 adolescent participants and their families, all conducted in low- and middle-income countries.
This research synthesized evidence from nine studies involving over 2,400 adolescents and their families across low- and middle-income countries (LMICs) to understand whether family-based sexual health programs actually work in these settings. The researchers searched major academic databases for studies published over roughly two decades (2000–2023) and used statistical methods to combine results where possible. The review found that programs involving family members — such as parents, siblings, or caregivers — alongside adolescents were effective at improving young people's knowledge about sexual health. However, whether these programs changed attitudes, behaviors, or how openly families talked about sexual health topics was much less consistent across the studies. Programs that engaged both adolescents and their parents together appeared to produce better results than those targeting only one group. This research suggests there is a meaningful gap in where these programs have been tested — particularly in Asia — and that existing programs may not always account for local cultural contexts, which could limit how well they work. Policymakers and program designers in LMICs may benefit from developing interventions that are specifically tailored to local cultures and that actively involve parents alongside young people, rather than relying on programs designed for higher-income settings.
Mataraarachchi D, Shepherd T, Bajpai R, Ariyadasa G, Corp N, Paudyal P. (2025). Family-based sexual health interventions for adolescents in low- and middle-income countries: systematic analysis and meta-analysis.. International health. https://doi.org/10.1093/inthealth/ihaf017