Exploring the drivers of adolescent sexual and reproductive healthcare-seeking behavior in northwestern Botswana: a cross-sectional analysis
Abstract Background Research examining young people’s healthcare-seeking behaviors in Sub-Saharan Africa has largely focused on university or out-of-school youth who are sexually active and/or HIV-positive. Healthcare-seeking behavior in younger adolescents has been less well studied even though it...
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BMC
2025-02-01
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| Online Access: | https://doi.org/10.1186/s12889-025-21629-3 |
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| author | Mackenzie Lawson Helen Apps Peggie Ramaphane Francis Barchi |
| author_facet | Mackenzie Lawson Helen Apps Peggie Ramaphane Francis Barchi |
| author_sort | Mackenzie Lawson |
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| description | Abstract Background Research examining young people’s healthcare-seeking behaviors in Sub-Saharan Africa has largely focused on university or out-of-school youth who are sexually active and/or HIV-positive. Healthcare-seeking behavior in younger adolescents has been less well studied even though it is during secondary school years that the majority of adolescents become sexually active. There is limited evidence to guide strategies that schools, health facilities, and social service agencies use to encourage adolescents to utilize sexual and reproductive health resources prior to sexual debut. Methods This study used cross-sectional data collected in 2021 during school hours from eleven secondary schools in the Northwest District of Botswana. Adolescents ages 14–19 years completed surveys using hand-held tablets. Descriptive statistics were run for all variables; bivariate analyses examined their association with skipped visits. Logistic regression identified correlates of forgone visits. The outcome variable of interest was whether a respondent had ever forgone a visit to a health clinic for sexual and reproductive health information or services. Results 553 adolescents, provided information used for analysis. One fifth of respondents had had sexual intercourse (21%). Most had not been tested for HIV (54%), did not know their HIV status (60%), or had not had an STI other than HIV (92%). Teachers (31%) and female family members (31%) were the most frequently consulted sources on bodily changes during adolescence. In the bivariate analysis, age, gender, sexual experience, HIV testing, awareness of HIV status, and having had an STI were significantly associated with forgone visits. At the multivariate level, younger respondents and those who had never been tested for HIV or had an STI had lower odds of forgone visits compared to their older peers and those who had been tested or had an STI. The most common reasons for forgoing visits reflected perceptions that nurses were unfriendly and did not believe adolescents should have sex. Students identified logistical barriers, including not knowing where to go, long distances to services, and limited operating hours. Conclusions While logistical barriers might be easily addressed, perceived barriers, including negative staff attitudes and behaviors towards adolescents, require concerted and collaborative efforts by educators, health professionals, and policy makers to change. |
| format | Article |
| id | doaj-art-20d9ca6a4b1e4932b87120194e246190 |
| institution | Kabale University |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | BMC Public Health |
| spelling | doaj-art-20d9ca6a4b1e4932b87120194e2461902025-02-09T12:57:42ZengBMCBMC Public Health1471-24582025-02-0125111510.1186/s12889-025-21629-3Exploring the drivers of adolescent sexual and reproductive healthcare-seeking behavior in northwestern Botswana: a cross-sectional analysisMackenzie Lawson0Helen Apps1Peggie Ramaphane2Francis Barchi3Edward J. Bloustein School of Planning & Public Policy, The State University of New JerseyWoMen Against RapeWoMen Against RapeEdward J. Bloustein School of Planning & Public Policy, The State University of New JerseyAbstract Background Research examining young people’s healthcare-seeking behaviors in Sub-Saharan Africa has largely focused on university or out-of-school youth who are sexually active and/or HIV-positive. Healthcare-seeking behavior in younger adolescents has been less well studied even though it is during secondary school years that the majority of adolescents become sexually active. There is limited evidence to guide strategies that schools, health facilities, and social service agencies use to encourage adolescents to utilize sexual and reproductive health resources prior to sexual debut. Methods This study used cross-sectional data collected in 2021 during school hours from eleven secondary schools in the Northwest District of Botswana. Adolescents ages 14–19 years completed surveys using hand-held tablets. Descriptive statistics were run for all variables; bivariate analyses examined their association with skipped visits. Logistic regression identified correlates of forgone visits. The outcome variable of interest was whether a respondent had ever forgone a visit to a health clinic for sexual and reproductive health information or services. Results 553 adolescents, provided information used for analysis. One fifth of respondents had had sexual intercourse (21%). Most had not been tested for HIV (54%), did not know their HIV status (60%), or had not had an STI other than HIV (92%). Teachers (31%) and female family members (31%) were the most frequently consulted sources on bodily changes during adolescence. In the bivariate analysis, age, gender, sexual experience, HIV testing, awareness of HIV status, and having had an STI were significantly associated with forgone visits. At the multivariate level, younger respondents and those who had never been tested for HIV or had an STI had lower odds of forgone visits compared to their older peers and those who had been tested or had an STI. The most common reasons for forgoing visits reflected perceptions that nurses were unfriendly and did not believe adolescents should have sex. Students identified logistical barriers, including not knowing where to go, long distances to services, and limited operating hours. Conclusions While logistical barriers might be easily addressed, perceived barriers, including negative staff attitudes and behaviors towards adolescents, require concerted and collaborative efforts by educators, health professionals, and policy makers to change.https://doi.org/10.1186/s12889-025-21629-3Health-seekingHealthcare-seeking, AfricaAdolescentsSexual and reproductive healthStigma |
| spellingShingle | Mackenzie Lawson Helen Apps Peggie Ramaphane Francis Barchi Exploring the drivers of adolescent sexual and reproductive healthcare-seeking behavior in northwestern Botswana: a cross-sectional analysis BMC Public Health Health-seeking Healthcare-seeking, Africa Adolescents Sexual and reproductive health Stigma |
| title | Exploring the drivers of adolescent sexual and reproductive healthcare-seeking behavior in northwestern Botswana: a cross-sectional analysis |
| title_full | Exploring the drivers of adolescent sexual and reproductive healthcare-seeking behavior in northwestern Botswana: a cross-sectional analysis |
| title_fullStr | Exploring the drivers of adolescent sexual and reproductive healthcare-seeking behavior in northwestern Botswana: a cross-sectional analysis |
| title_full_unstemmed | Exploring the drivers of adolescent sexual and reproductive healthcare-seeking behavior in northwestern Botswana: a cross-sectional analysis |
| title_short | Exploring the drivers of adolescent sexual and reproductive healthcare-seeking behavior in northwestern Botswana: a cross-sectional analysis |
| title_sort | exploring the drivers of adolescent sexual and reproductive healthcare seeking behavior in northwestern botswana a cross sectional analysis |
| topic | Health-seeking Healthcare-seeking, Africa Adolescents Sexual and reproductive health Stigma |
| url | https://doi.org/10.1186/s12889-025-21629-3 |
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