Understanding sexual and reproductive health need of unmarried adolescents and youth in urban slums: evidence from a formative study in Uttar Pradesh, India.
Sahni H, Sharma M, et al. • Reproductive health • 2025
Unmarried adolescents and youth in urban slums of Uttar Pradesh, India face limited and often inaccurate sexual and reproductive health knowledge, gendered access to information, and structural barriers to services, highlighting a clear need for multi-faceted strategies targeting sexual health education, adolescent-responsive SRH services, and expanded digital outreach with verified content.
Key Findings
Results
Unmarried adolescents and youth in urban slums had limited awareness of SRH issues and often inaccurate knowledge of modern contraceptives.
The study was conducted among unmarried adolescents and youth aged 15–24 years in the slums of two cities in Uttar Pradesh, India.
Comprehensive knowledge about contraception was limited, with awareness mostly restricted to methods such as condoms and pills, but in-depth knowledge was lacking.
Misinformation and misconceptions were prevalent due to lack of social networks and support, communication gaps, and limited reach of health providers.
Results
Access to SRH information was clearly gendered, with boys benefitting from wider peer networks while girls relied on familial networks.
The major sources of SRH knowledge were peers for boys and sisters-in-law for girls.
The social network of boys was wider than that of girls, giving boys broader access to SRH information.
Girls faced greater structural constraints including stigma and mobility restrictions that marginalized them from accessing reliable SRH services.
Results
Social media and online sources served as a key source of SRH knowledge among unmarried adolescents and youth, but concerns remained about accuracy and reliability.
There is an increasing tide of information through online content in social media, which serves as a key source of knowledge among adolescents.
The accuracy and reliability of information accessed through social media and online sources was identified as questionable.
Despite the concerns about reliability, digital sources represented a significant and growing channel for SRH information among this population.
Results
Healthcare worker outreach among unmarried youth in urban slums was minimal.
Limited reach of health providers was identified as a major contributor to misinformation and misconceptions about SRH.
Structural constraints such as provider bias further marginalized unmarried youth, especially girls, from accessing reliable SRH services.
The study calls for policy and program intervention to address the gap in healthcare worker outreach to this population.
Results
Physical intimacy among unmarried youth is increasing in some parts of India despite traditional norms disapproving of premarital sex.
The study noted this trend in the context of exploring SRH needs in urban slums.
This increasing physical intimacy, combined with limited SRH knowledge and service access, underscores the urgency of addressing unmet SRH needs among unmarried youth.
The context of massive urbanization and growing slum populations was identified as contributing to the overlooked situation of unmarried AY, with greater program focus historically placed on married youth.
Methods
The study employed a formative qualitative design using in-depth interviews (IDIs) and focus group discussions (FGDs) guided by grounded theory and narrative inquiry principles.
Participants were unmarried adolescents and youth aged 15–24 years residing in slums of two cities in Uttar Pradesh.
Thematic analysis used both inductive and deductive approaches.
The research explored SRH knowledge, sources of information, contraceptive use, and engagement with the healthcare system.
Conclusions
The study identified a need for multi-faceted strategies including sexual health education, adolescent-responsive SRH services, and expanded digital outreach with verified content.
Targeted intervention through system-level approaches for AY was recommended as helpful for dispelling myths and providing accurate information.
The authors identified unmarried youth in urban slums as a vulnerable population whose SRH needs have been overlooked by programs with greater focus on married youth.
The findings call for comprehensive, adolescent-responsive approaches that address both demand-side knowledge gaps and supply-side service barriers.
What This Means
This research studied the sexual and reproductive health (SRH) knowledge and service access of unmarried young people aged 15 to 24 living in urban slums in Uttar Pradesh, India. Using interviews and group discussions, researchers found that these young people had limited and often incorrect information about sexual health and contraception — mostly only aware of condoms and pills, with little deeper understanding. A major finding was that how young people get information depends heavily on their gender: boys learn mostly from peers through wider social networks, while girls rely more narrowly on family members like sisters-in-law. Healthcare workers rarely reached these young people at all, leaving a significant gap in reliable guidance.
Social media and the internet have become important sources of SRH information for these young people, but the accuracy of what they find online is unreliable, contributing to persistent myths and misconceptions. Girls faced additional barriers including social stigma, restrictions on their movement, and bias from healthcare providers, making it even harder for them to access correct information or services. Despite traditional norms against premarital sex, the researchers noted that physical intimacy among unmarried youth is increasing, making these unmet information and service needs especially important to address.
This research suggests that current health programs in India have largely overlooked unmarried young people living in urban slums, focusing instead on married youth. The findings point to the need for targeted approaches that combine better sex education in schools and communities, youth-friendly health services that do not stigmatize unmarried people, and carefully verified digital health content that can reach young people through the online channels they already use.
Sahni H, Sharma M, Panda B, Das E, Behera S, Pandey N, et al.. (2025). Understanding sexual and reproductive health need of unmarried adolescents and youth in urban slums: evidence from a formative study in Uttar Pradesh, India.. Reproductive health. https://doi.org/10.1186/s12978-025-02025-x