Parents’ and teachers’ views on sexual health education and screening for sexually transmitted infections among in-school adolescent girls in Kenya: a qualitative study

Abstract

BackgroundTo successfully develop and implement school-based sexual health interventions for adolescent girls, such as screening for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis, it is important to understand parents’ and teachers’ attitudes towards sexual health education and acceptability of sexually transmitted infection (STI) screening interventions.MethodsIn this qualitative study, we approached parents and teachers from three high schools to participate in in-depth interviews (IDIs) and focus-group discussions (FGDs). Parents and teachers were asked about their general knowledge of STIs and sexual health education. In addition, they were asked whether they would support utilizing outreach to schools to facilitate provision of sexual health education and screening for STIs in adolescent girls. Data were audio-recorded, transcribed, and translated into English. An initial coding matrix was developed and refined throughout the coding process. Transcripts were coded by two researchers and analyzed using the content analysis approach.ResultsWe conducted 10 IDIs (5 parents and 5 teachers) and 4 FGDs (2 with parents, 2 with teachers, total of 26 participants). Most parents reported few or no discussions regarding STIs with their adolescent girls. Parents were more comfortable discussing consequences of sexual activity including loss of virginity and the potential for pregnancy. Parents tended to place responsibility for sexual health education with teachers. The teachers, in turn, provided basic sexual and reproductive health education including puberty, abstinence, and overview of STIs. Both parents and teachers found the idea of screening for STIs in adolescent girls to be acceptable, and were comfortable with research staff contacting girls through informational meetings at schools. Parents felt that adolescents’ STI screening results should be shared with their parents.ConclusionIn this African setting, parents and teachers provide limited sexual health education, with a focus on negative consequences including loss of virginity, pregnancy, and risk for STIs. Nonetheless, both parents and teachers were supportive of STI screening for adolescent girls, beginning with school-based informational meetings for the girls. Research and programs that aim to provide STI screening in this setting must offer treatment and address the issue of whether results will be disclosed to parents.

Factors influencing access of HIV and sexual and reproductive health services among adolescent key populations in Kenya

“…The high level of stigma prevents their access and utilization of HIV prevention and treatment services (Musyoki et al 2018). In addition, these young people within key populations often have lower knowledge of HIV risks, or lower ability to mitigate those risks such as negotiating condom use (Dellar et al 2015), compared with their older, more experienced counterparts (Wanje et al 2017) Access to services is influenced by negative health providers attitudes (Godia et al 2014) with HIV service providers often poorly equipped to serve young key populations, while the staff of programs for young people may lack the appropriate sensitivity, skills and knowledge (Delany-Moretlwe et al 2015;Shabani et al 2018) Policy makers and health providers in our study cited the need to address legal provisions that limit the services that those under 18 years can get in the facilities as the law restricts what health providers can provide including HIV testing and counseling services without parental consent. This resonates with other studies across the globe that calls for targeted investments (Mmari and Astone 2014) and policy reforms in health-care systems (Igras et al 2014;Ssewanyana et al 2018).…”

“…Data are not adequately disaggregated by age, gender and risk behavior to aid in planning at national and sub-national levels (Johnston et al 2017). In addition, policy and programming for adolescent key populations are hampered by the fact that the behaviors they engage in such as sex work (Wanje et al 2017) and same sex relations are considered illegal in Kenya (Ssewanyana et al 2018). The aim of this study was to assess the programmatic and policy environment and determine the barriers and opportunities for providing HIV/SRH services to adolescent key populations in Kenya.…”

What do Service Providers in Southern Ethiopia Think About Barriers to using Youth-Friendly Sexual and Reproductive Health Services for Adolescents?: Qualitative Study

“…This nding implies that community sexual and reproductive health promotion is required to support friendly-services among general population, teachers, religious follower, and other stakeholders. Enabling environment for adolescents should be created at the broader health system level to effectively deliver friendly-service model of care for adolescents [29].…”

“…Because, I see that adolescents are in uenced by peers not by theirs own decision." [Female, Age:[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Health Extension] Another participant witnessed disclosing secrecy of adolescents from his experience. "Healthcare providers have a problem of keeping secrets about adolescent and sexual issues.…”

Sexualpädagogik in der Sekundarstufe I in Österreich

“…In Kenia bieten Eltern und Lehrer*innen den Jugendlichen nur eingeschränkt sexuelle Gesundheitserziehung an, meist mit einem Fokus auf negative Folgen, einschließlich Verlust der Jungfräulichkeit, Schwangerschaft und Risiko für sexuell übertragbare Krankheiten. Nichtsdestotrotz unterstützten sowohl Eltern als auch Lehrer*innen Gesundheitsscreenings für junge Mädchen, beginnend mit schulischen Informationsveranstaltungen (Wanje et al 2017). Eines der wenigen ablehnenden Beispiele für schulische Sexualerziehung bildet eine Studie aus dem Iran ab, die deutlich macht, dass voreheliche Sexualität im muslimischen Iran inakzeptabel ist.…”