Safe spaces hold significant potential to improve youth sexual and reproductive health outcomes by fostering informed decision-making and reducing risky behaviors, though evidence for long-term efficacy and sustainability was limited.
Key Findings
Results
Schools were the most common type of safe space identified in the literature for delivering sexual and reproductive health interventions to youth.
Schools appeared in 37 studies, making them the most frequently studied safe space setting.
School-based safe spaces were associated with effectively increasing condom use, SRH knowledge, and service utilization.
The review covered studies published between January 2013 and December 2023.
Youth aged 15 to less than 25 years were the target population across included studies.
Results
Community-based initiatives were identified as critical in reducing stigma and fostering positive sexual and reproductive health attitudes among youth.
Community-based settings included youth clubs and outreach programs.
These settings complemented school-based approaches by reaching youth outside formal education environments.
The review used narrative synthesis to summarize findings across diverse global contexts.
Both primary studies and grey literature in English were included.
Results
Digital platforms demonstrated potential to address high-risk behaviors and unplanned pregnancies among youth.
Digital platforms were identified as a distinct category of safe space alongside schools and community-based settings.
The authors noted that more emphasis should be placed on innovative, digital approaches.
Digital platforms were described as having potential rather than established efficacy, reflecting limited evidence in this area.
The review called for further evaluation of long-term impact of digital interventions.
Results
Interventions delivered in safe spaces commonly included educational sessions, resource distribution, counseling, and peer support.
These four intervention types were identified through descriptive statistics and narrative synthesis.
Most studies reported positive outcomes across these intervention modalities.
The review did not restrict to specific intervention types, capturing a broad range of safe space programming.
Peer support was highlighted as a recurring component across multiple safe space settings.
Results
Evidence for the long-term efficacy and sustainability of safe space interventions for youth sexual and reproductive health was limited.
While most studies reported positive outcomes, the review explicitly noted that long-term evidence was lacking.
The authors emphasized that the effectiveness of interventions should be critically evaluated.
The review followed Arksey and O'Malley's scoping review framework and searched Medline, EMBASE, CINAHL, and Scopus.
Screening was conducted using Covidence software by two independent reviewers.
Scoping and systematic reviews were excluded, limiting findings to primary study designs and grey literature.
Conclusions
Tailored, inclusive, and sustainable strategies were identified as essential to address the diverse needs of youth globally.
The review included studies from diverse global contexts, capturing variation in cultural, geographic, and social settings.
Societal taboos and lack of accessible information were identified as common challenges youth face regarding SRH.
The authors concluded that safe spaces must address the diverse needs of youth rather than applying uniform approaches.
Non-English studies were excluded, which may limit generalizability to non-English-speaking populations.
What This Means
This research suggests that 'safe spaces' — structured environments where young people can access sexual and reproductive health (SRH) information and support without fear of judgment — can meaningfully improve health outcomes for youth between the ages of 15 and 24. By reviewing studies published over a decade (2013–2023) across multiple academic databases, the researchers found that schools were the most commonly used safe space settings (appearing in 37 studies), where programs helped increase condom use, health knowledge, and use of health services. Community programs like youth clubs and outreach efforts were also found to reduce stigma and improve attitudes toward sexual and reproductive health, while online and digital platforms showed promise for reaching young people at risk of unplanned pregnancies or high-risk behaviors.
The types of activities offered in these safe spaces varied but commonly included educational sessions, distribution of resources like contraceptives or informational materials, counseling, and peer support programs. Across most of the studies reviewed, these interventions were associated with positive outcomes for young people. However, the researchers noted a significant gap: very few studies tracked whether these benefits lasted over time or whether the programs could be maintained long-term, making it difficult to know how durable the improvements really are.
This research suggests that creating well-designed, inclusive safe spaces — especially in schools and communities — has real potential to help young people make more informed decisions about their sexual and reproductive health. The findings point to a need for more investment in digital approaches and longer-term studies to better understand which strategies work best and for which populations, particularly given the wide diversity of cultural and social contexts young people around the world navigate.
Meherali S, Aynalem Y, Nisa S, Ishola A, Lassi Z. (2025). Safe spaces enhancing sexual and reproductive health for youth: a scoping review.. Reproductive health. https://doi.org/10.1186/s12978-025-02009-x