Sexual Health

Sexual and reproductive health knowledge and behaviors and prevalence of sexually transmitted infections among adolescents and young adults from Angola.

TL;DR

Among adolescents and young adults in Benguela province, Angola, SRHK was higher than expected but in-depth knowledge was uncommon, unsafe sexual behavior was widespread, and HBV prevalence was higher than expected, suggesting the need for targeted sexual education campaigns and HBV vaccination promotion.

Key Findings

The majority of participants had adequate sexual and reproductive health knowledge, but in-depth knowledge was uncommon.

  • A total of 1400 youths aged 15 to 25 years were included in the cross-sectional study from four municipalities (two urban, two rural) in Benguela province, Angola.
  • 818 (58.4%) participants had adequate SRHK overall.
  • In-depth knowledge was described as uncommon, especially among men from rural areas with lack of access to journals or the internet.
  • The study used a structured questionnaire to assess SRHK and sexual behavior.

Urban origin, older age, female sex, and access to journals and internet were significantly associated with good sexual and reproductive health knowledge.

  • Urban origin was associated with good SRHK (OR 1.52, 95% CI 1.35-2.04).
  • Older age was associated with good SRHK (OR 1.14, 95% CI 1.09-1.20).
  • Being female was associated with good SRHK (OR 2.06, 95% CI 1.57-2.71).
  • Having journals as a main source of information was associated with good SRHK (OR 1.37, 95% CI 1.00-1.86).
  • Having internet as a main source of information was associated with good SRHK (OR 2.33, 95% CI 1.69-3.21).

Nearly half of sexually active participants reported risky sexual behavior, and this was strongly associated with male gender.

  • 453 participants (45.9% of those who had sexual intercourse, n=986) reported risky sexual behavior.
  • Risky sexual behavior was associated with male gender (OR 2.89, 95% CI 2.13-3.92, P<.001).
  • Unsafe sexual behavior was described as 'widespread among our sample.'

The prevalence of hepatitis B virus (HBV) infection was 13.6%, which was higher than expected.

  • 190 out of 1400 participants (13.6%) tested positive for HBV using rapid tests.
  • The authors described this prevalence as 'higher than expected.'
  • HBV prevalence findings were used to support a recommendation for HBV vaccination promotion accompanying sexual education campaigns.

Prevalence of HIV, HCV, and syphilis were low among the study population.

  • 5 participants (0.35%) tested positive for HIV.
  • 4 participants (0.3%) tested positive for HCV.
  • 20 participants (1.4%) tested positive for syphilis.
  • All four STIs (HIV, HCV, HBV, and syphilis) were assessed using rapid tests.

The study was conducted as a baseline assessment prior to a sexual and reproductive health educational intervention in Benguela province, Angola.

  • This was a cross-sectional study design.
  • Participants were aged 15 to 25 years old from two urban and two rural municipalities of Benguela province.
  • The study noted there is 'little information on sexual and reproductive health knowledge and practices in Angola and no data on the prevalence of sexually transmitted infections.'
  • A total of 1400 youths were included.

The authors recommend sexual education campaigns using both digital and non-digital approaches, specifically targeting rural youth with limited internet access, alongside HBV vaccination promotion.

  • The recommendation addresses rural areas 'where internet connection is difficult.'
  • Both digital and non-digital approaches were recommended to reach dispersed rural populations.
  • HBV vaccination promotion was recommended to accompany educational campaigns.
  • This recommendation was based on findings that rural origin, lack of internet/journal access, and male gender were associated with poorer SRHK and higher risk behaviors.

What This Means

This research examined what adolescents and young adults in Angola know about sexual and reproductive health, how they behave sexually, and how common certain sexually transmitted infections (STIs) are among them. The study included 1,400 young people aged 15 to 25 from both urban and rural areas in Angola's Benguela province. Researchers used questionnaires to assess knowledge and behaviors, and rapid blood tests to check for HIV, hepatitis B (HBV), hepatitis C (HCV), and syphilis. The study found that while a slight majority (about 58%) had adequate general knowledge about sexual and reproductive health, detailed knowledge was rare — particularly among young men living in rural areas who lacked access to the internet or printed media like journals. Nearly half (46%) of those who had been sexually active reported engaging in risky sexual behaviors, and this was especially common among males. The most striking infection-related finding was that 13.6% of participants tested positive for hepatitis B, which was higher than anticipated. HIV, hepatitis C, and syphilis rates were comparatively low (0.35%, 0.3%, and 1.4%, respectively). This research suggests that sexual health education programs in Angola need to reach young people in rural areas using methods that do not rely solely on internet access, such as printed materials, community outreach, or radio, alongside digital approaches for urban youth. The high rate of hepatitis B also points to a need for stronger HBV vaccination efforts among young people in this region. The findings are particularly valuable because very little data on STI prevalence and sexual health knowledge had previously been available for Angola.

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Citation

Aixut S, Esteban E, Mart&#xed;nez-Campreci&#xf3;s J, Oliveira P, G&#xf3;mez-Mart&#xed;nez F, Mart&#xed;n-Garc&#xed;a D, et al.. (2025). Sexual and reproductive health knowledge and behaviors and prevalence of sexually transmitted infections among adolescents and young adults from Angola.. Journal of public health (Oxford, England). https://doi.org/10.1093/pubmed/fdaf054