Volume 37, Issue 6

Objectives Adolescent knowledge about sexual and reproductive health (SRH) in Indonesia is low and moderate. This study aims to determine the influence of peer mentorship on improving adolescents’ knowledge and attitudes about SRH. Methods This study uses a quasi-experimental pre- and post-test with a control group design. The population is adolescents in high school, aged 15–19. Eight students were selected as volunteers to be trained by professionals as mentors. The sample was selected using a proportional random sampling technique, with 91 students in each group. Peer mentoring was carried out for three months with 12 meetings. A questionnaire measured knowledge and attitudes before and after the intervention. Results The majority of respondents were women (57.1 %) and men (42.9 %), with the most common age being 17 years old (29.7 %). There was no difference between the characteristics of the respondents and the variables studied. Respondents’ knowledge level increased in the high category after the intervention from 67 to 95.6 %; positive attitudes increased from 48.4 to 51.6 %. Conclusions Peer mentoring interventions significantly influenced respondents’ knowledge. The peer mentoring approach effectively increases adolescents’ knowledge and attitudes. It is recommended that this assistance become a school program.

Objectives HIV remains highly prevalent in sub-Saharan Africa, home to approximately 66 % of all people living with HIV and 85 % of children and adolescents living with HIV globally. The region also experiences the highest levels of armed conflict, resulting in a dual burden of violence and infectious diseases like HIV. Despite these challenges, few studies have explored the impact of war and armed conflict on HIV transmission among adolescents in sub-Saharan Africa. To address this gap in the literature, our study examines HIV risk behaviors among adolescents in both conflict and non-conflict zones of Nigeria. Methods This was a cross-sectional study of adolescents aged 15–19 years, identified through the Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS). We assessed the prevalence of HIV risk behaviors across the entire country, stratified by conflict zone status. Bivariate associations between risk behaviors and conflict status were evaluated using the chi-square test. To identify factors associated with HIV infection among adolescents, we employed survey-weighted logistic regression models, reporting adjusted odds ratios (AOR) and 95 % confidence intervals (CI). Results We analyzed 20,518,667 weighted records of adolescents aged 15–19 years, from both conflict (11 %) and non-conflict zones (89 %) of Nigeria. Despite the majority of adolescents residing in non-conflict zones, we found that high-risk behaviors for HIV, such as the non-use of condoms, were more prevalent in conflict zones. However, transactional sex and having two or more sexual partners were significantly higher among adolescents in non-conflict areas. Notably, the risk of HIV infection was over three times higher among adolescents who did not use condoms during sexual intercourse (AOR: 3.22, CI: 1.13, 9.19; p 0.029). Additional risk factors included younger age, educational status, engagement in transactional sex, and having multiple sexual partners. Conclusions This study reports the risk behaviors that contribute to HIV infection among adolescents, particularly within conflict settings. Our findings highlight the link between conflict and heightened HIV risk behaviors among Nigerian adolescents. By identifying these factors and understanding the unique challenges faced by adolescents in conflict zones, more effective, youth-friendly reproductive health programs can be developed for regions impacted by war and conflict.

Objectives To assess Tunisian mothers’ knowledge, attitudes, and perceptions regarding HPV vaccination, in order to better understand the factors influencing their acceptance. Methods A multicenter, cross-sectional analytical study was conducted between December 2024 and January 2025 among 160 mothers residing in Tunisia, each with at least one daughter aged 10–12 years. Data were collected using an anonymous self-administered questionnaire covering socio-demographic information, knowledge of cancer, HPV, and vaccination, as well as attitudes and factors influencing acceptability. Results Almost all participants (99.4 %) had heard of cervical cancer, but only 16.3 % were aware of HPV. Knowledge about the HPV vaccine was low (13.1 %). More than half (59.4 %) expressed concerns about side effects. Acceptance of the vaccine was low, with only 21.9 % expressing favorable opinions and 57.5 % unfavorable. In univariate analysis, a higher level of education and knowledge of HPV were associated with a favorable attitude; however, no independent predictors were identified in the multivariate analysis. Conclusions This study reveals a low level of knowledge and acceptance of HPV vaccination among Tunisian mothers, mainly due to insufficient information and safety concerns. Culturally adapted educational campaigns and active involvement of healthcare professionals are essential to improve vaccination coverage.

Objectives Despite global declines, adolescent pregnancy remains a significant public health issue in the Dominican Republic. We examined the rate of adolescent pregnancy and associated maternal and neonatal outcomes in Consuelo, a semi-rural Dominican town. Methods A retrospective review of labor and delivery records from January 2017 to December 2022 was conducted at Consuelo’s regional hospital. Descriptive analyses compared maternal and neonatal outcomes between adolescent and non-adolescent pregnancies. Results Of 1,292 deliveries, adolescent pregnancies accounted for 22 %, ranging from 14 % in 2022 to 27 % in 2019. There were no differences between adolescent and non-adolescent mothers in rates of low birth weight, macrosomia, pre-term delivery, post-term delivery or neonatal death. Adolescent mothers were more likely to have cephalopelvic disproportion (CPD; p=0.005). Conclusions There is a high incidence of adolescent pregnancy in Consuelo, adolescent mothers were more likely to have CPD, and interventions are needed to reduce the incidence of adolescent pregnancies.

Objectives This study assessed the perceptions and practices of menstrual waste management (MWM) and explored the associated facilitators and barriers in schools of Yadadri-Bhuvanagiri district, Telangana, India. Methods A mixed-method approach was adopted. A cross-sectional survey was done among adolescent girls and in-depth interviews among the school teachers from seven schools. Results Of the total 394 adolescent girls included in the study, 96.5 % used disposable sanitary pads, with 95 % disposing of them in waste bins at schools, which were incinerated, burnt in open places or buried deep. From the in-depth interviews conducted among the teachers, cultural beliefs, inadequate infrastructure, and limited awareness about reusable menstrual products emerged as significant barriers for safe MWM practices. Non-availability of sanitary workers, electricity fluctuations affecting incineration, and the lack of structured educational materials were some of the challenges that emerged from the in-depth interview. Facilitators for MWM included teacher engagement, availability of dustbins, and support from health workers. Conclusions The findings underscore the need for focused interventions, such as sustainable disposal solutions, education on MWM, and community involvement, to improve menstrual waste management among adolescents.

Objectives Child marriage remains a critical public health concern in Indonesia, with significant implications for reproductive health and maternal well-being. In South Kalimantan, Indonesia, the practice is often justified through court-approved dispensations, exposing young brides to higher risks of complications during pregnancy and childbirth, perpetuating cycles of poverty and inequality. This study investigates the determinants influencing judicial decisions on child marriage dispensation applications from a reproductive health perspective, focusing on 13 Religious Courts in South Kalimantan, Indonesia. Methods Utilizing a mixed-method design, this study combines quantitative descriptive analysis with qualitative approaches to understand judges’ considerations. Data were collected from secondary data source and review of 249 child marriage dispensations case documents from 13 Religious Court in South Kalimantan in 2024. Results Among 249 child marriage dispensation cases in 2024, only 27 (10.84 %) involved health examinations for both partners. This disparity indicates that grooms are less likely to comply with health examination requirements, with 181 grooms and 10 brides granted dispensations without health certificates. Despite brides presenting general health certificates, judges often grant dispensations, potentially overlooking significant health risks. Approximately 71.49 % of cases are approved without comprehensive health examinations. Most examinations only provide general health information, with 79.12 % of cases involving health assessments solely for brides, highlighting a significant disparity in pre-marital health evaluations. Conclusions Thorough health evaluations and legal age adherence in marriage dispensations protect minors’ physical, emotional, and socio-economic well-being. Judges should enforce strict evaluations to safeguard minors’ health and rights.

Objectives Cervical cancer remains a significant public health challenge in low- and middle-income countries like India. Despite the efficacy of HPV vaccination, its uptake remains suboptimal. This qualitative study aimed to explore parental attitudes, knowledge, and decision-making regarding HPV vaccination for school-going adolescents in Ganjam, Odisha, to inform effective intervention strategies. Methods This qualitative study utilized semi-structured interviews, conducting Focus Group Discussions (FGDs), In-Depth Interviews (IDIs), and Key Informant Interviews (KIIs) of total 47 participants. Data were collected from December 2024 to January 2025 in Ganjam, Odisha. Data were analyzed using thematic analysis, aided by MAXQDA 2020 software. Results Five core themes emerged: Knowledge and Awareness Gaps (low awareness, confusion with other vaccines, information needs); Attitudes Towards HPV Vaccination (mixed institutional trust, accountability demands); Barriers to HPV Vaccination (cultural/social hesitancy, fear-driven hesitancy, individual and systemic barriers); Role of School Authorities (education and communication gaps); and Potential Collaborative Strategies (community engagement, policy and systems alignment). Participants showed positive sentiments towards trusted sources and community engagement, while negative sentiments were associated with fear, cultural norms, and systemic challenges. Conclusions HPV vaccine uptake is hindered by knowledge gaps, cultural/fear-driven hesitancy, and systemic barriers. Improving coverage and health literacy in resource-limited settings requires intensive communication, school-based education, paternal involvement, intersectoral collaboration, and policy changes, including UIP integration.

Objectives Human papillomavirus (HPV) and COVID-19 can be prevented and mitigated by vaccines. Few studies have focused on dentists’ role in vaccine decision making, and even fewer have explored adolescent perspectives; a target population for both vaccinations. This study aimed to address this gap with a focus on whether opinions vary between diseases. Methods We administered a validated cross-sectional survey to adolescent patients (11–19 years) in an orthodontic clinic in Vancouver, British Columbia from July-August 2023. The survey included questions pertaining to patient background, vaccine history and knowledge, and dentists’ roles in vaccination education, discussion, and administration. Responses were compiled and analyzed to determine differences between vaccines and across demographic groups. Results Adolescents surveyed (n=93) overall agreed with dentist involvement in COVID-19 and HPV vaccines, with variability according to disease and dentist role. Comfort with dentist-administered vaccines was higher for COVID-19 (60 %) than HPV (37 %, p<0.05). There was a significant knowledge difference, with 85 % aware that the COVID-19 vaccine can prevent severe illness, but only 22 % aware that the HPV vaccine can prevent oropharyngeal cancer (p<0.05). Patients showed overall willingness to discuss COVID-19/HPV vaccines with dentists (58 % and 49 %) and less agreement that dentists were qualified to educate about COVID-19/HPV vaccines (43 % and 37 %). Conclusions Findings indicate mixed adolescent perception of including dentists in vaccinations, with higher comfort around COVID-19 over HPV vaccines. Openness to discussion may present an opportunity for dentists to expand scope of practice into additional education, particularly around HPV and its connection with oropharyngeal cancer.