Keywords: Sexuality; Adolescent; Adolescence; Sexual Health; Reproductive Health; Risk factors; Rural; Coastal.
Background:
Adolescence is a precarious period, sometimes characterised by sexual exploration and those in rural/coastal environments face disproportionate challenges to maintaining good sexual and reproductive health (SRH). Geography and high levels of deprivation create barriers to accessing appropriate services which, in turn, puts adolescents at increased risk of adverse health outcomes, compared with their urban counterparts. This study provides a global overview of the factors that place rural/coastal adolescents at increased risk of poor SRH.
Aim of the study:
To understand the factors that place adolescents in rural/coastal environments at increased risk of poor SRH.
Methodology:
A rapid literature review on adolescent SRH in rural/coastal environments published in English (2013-2023), in Medline and CINAHL. The quality of studies was assessed using the Mixed Methods Appraisal Tool (MMAT) and extracted data were analysed thematically.
Results:
106 articles met the inclusion criteria. The main thematic areas in access to SRH services were physical geography and socio-cultural barriers. Specifically, barriers to the use of contraception included lack of access, religious and community beliefs, and lack of accurate knowledge. Residing in rural or coastal environments was associated with adolescent sexual risk-taking behaviours in all but two studies. Key factors influencing sexual initiation and high-risk behaviour included being married young, being in love and coercion. High rates of pregnancy in adolescence in rural environments were associated with poor use of contraceptives and sex with multiple partners, alcohol and other substance use, sexual coercion, having older parents, engaging in transactional sex.
Conclusions:
Lack of access to SRH services among adolescents in rural/coastal settings remains a salient issue. There is a need to further understand the nuances of how different access barriers place adolescents at risk of poor SRH in order to co-create innovative effective, tailored intervention and strategies for equitable access to appropriate services for this population.
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