Towards more helpful and satisfactory sexuality education: First-hand accounts from adolescents and young people in low- and middle-income settings  

Towards more helpful and satisfactory sexuality education: First-hand accounts from adolescents and young people in low- and middle-income settings | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Towards more helpful and satisfactory sexuality education: First-hand accounts from adolescents and young people in low- and middle-income settings Hannah Kabelka, Chantal Lakis, Marielle Le Mat, Henny Bos, Yasmine El Addouli, and 9 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9186417/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction Sexuality education is increasingly recognised as essential for adolescents’ and young people’s well-being, yet their own perspectives on its relevance and delivery remain underexplored. This mixed-methods, youth-participatory study examined adolescents’ and young people’s perceptions of school-based sexuality education across diverse low- and middle-income contexts. Methods A global online survey with 9,288 respondents aged 16–24, complemented by qualitative research with 405 participants in Burkina Faso, Cameroon, Colombia, the Kyrgyz Republic, and Trinidad and Tobago, explored associations between perceived helpfulness of and satisfaction with sexuality education and content received, delivery methods, perceived classroom safety, and sociodemographic factors. Results While most respondents identified schools as their preferred learning space, only about half felt that sexuality education had prepared them for real-life relationships and sexual and reproductive health decisions. Only selected topics independently predicted perceived helpfulness: HIV/STIs were positively associated, while anatomy was negatively associated, and that the perceived value of relational or sensitive topics depends on pedagogical conditions rather than coverage alone. Perceived classroom safety was the strongest predictor of both helpfulness and satisfaction, and participatory delivery methods were consistently associated with higher helpfulness and satisfaction. Older respondents and those outside sub-Saharan Africa reported lower satisfaction with school-based sexuality education. Conclusion The study underscores that effectiveness of sexuality education should be assessed through learners’ perceptions of quality and responsiveness to their needs. Policy implications Policies should prioritise culturally grounded, skills-based curricula delivered through participatory pedagogy, alongside systemic investment in teacher training, classroom safety, accountability mechanisms, and institutionalised youth feedback systems. Sexuality education Sexual and reproductive health and rights Adolescents Young people Youth participation Safe learning environments Full Text Additional Declarations No competing interests reported. Supplementary Files Appendicesandsupplementarymaterial.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9186417","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":626094347,"identity":"175cf7cf-40d0-4ce2-a783-ec162c6c1459","order_by":0,"name":"Hannah Kabelka","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1ElEQVRIie3OsQqCUBSA4SMXrssx11rsFW4ERkvPojT0AC6CgUJwJ2ku6CHyDYwLufgGOtji1NDkGJkQtN07Bt1/O4fzwQHQ6X4wBuAZCeQwQjCaYWWqEopA2LAicgIfQsdKZAHQGIdt7VAUbWTxFSxkZJn0j52v7Zxa3K0svoblTvZY3pOGCp/b4FZYEmBCiTxFzG2zC7CMFUnGhUet1CUYCgUiwLsc9+2MYxlMTmGBclKk/i3t6qmNm+xxZ5HDikRiCHr594yS+3dmLj3R6XS6P+8F/dU/8uxLQEIAAAAASUVORK5CYII=","orcid":"","institution":"University of Amsterdam","correspondingAuthor":true,"prefix":"","firstName":"Hannah","middleName":"","lastName":"Kabelka","suffix":""},{"id":626094348,"identity":"58f49e63-c38c-413f-8629-7777991c7038","order_by":1,"name":"Chantal Lakis","email":"","orcid":"","institution":"Royal Tropical Institute","correspondingAuthor":false,"prefix":"","firstName":"Chantal","middleName":"","lastName":"Lakis","suffix":""},{"id":626094349,"identity":"9ee7420c-e38b-4c7b-acbb-4391cf7a2096","order_by":2,"name":"Marielle Le Mat","email":"","orcid":"","institution":"Royal Tropical Institute","correspondingAuthor":false,"prefix":"","firstName":"Marielle","middleName":"Le","lastName":"Mat","suffix":""},{"id":626094352,"identity":"40e96440-f5ee-49c0-a923-49c8dfba2d8e","order_by":3,"name":"Henny Bos","email":"","orcid":"","institution":"University of Amsterdam","correspondingAuthor":false,"prefix":"","firstName":"Henny","middleName":"","lastName":"Bos","suffix":""},{"id":626094353,"identity":"aafbac8f-6c0c-41ed-adfd-ce24f97ffbb6","order_by":4,"name":"Yasmine El Addouli","email":"","orcid":"","institution":"Royal Tropical Institute","correspondingAuthor":false,"prefix":"","firstName":"Yasmine","middleName":"El","lastName":"Addouli","suffix":""},{"id":626094354,"identity":"6f6e99bf-1ca6-4be0-9e53-713e846da396","order_by":5,"name":"Laura Acevedo","email":"","orcid":"","institution":"Barranquilla+20","correspondingAuthor":false,"prefix":"","firstName":"Laura","middleName":"","lastName":"Acevedo","suffix":""},{"id":626094355,"identity":"1ca6799d-b8e5-45d9-840b-d5810f140f2d","order_by":6,"name":"Enow Awah","email":"","orcid":"","institution":"Organization For Health in Sustainable Development","correspondingAuthor":false,"prefix":"","firstName":"Enow","middleName":"","lastName":"Awah","suffix":""},{"id":626094356,"identity":"af2c073c-1240-4f08-bf70-1bb20362ea3a","order_by":7,"name":"Ashlee Burnett","email":"","orcid":"","institution":"Feminitt Caribbean","correspondingAuthor":false,"prefix":"","firstName":"Ashlee","middleName":"","lastName":"Burnett","suffix":""},{"id":626094357,"identity":"13c8bedd-1df3-4d3d-9d71-0bea8e205731","order_by":8,"name":"Uluk Batyrgaliev","email":"","orcid":"","institution":"Reproductive Health Alliance Kyrgyzstan","correspondingAuthor":false,"prefix":"","firstName":"Uluk","middleName":"","lastName":"Batyrgaliev","suffix":""},{"id":626094358,"identity":"c4a25e18-b207-429c-b9fc-ce460c03898b","order_by":9,"name":"Carole Compaore","email":"","orcid":"","institution":"SOS Jeunesse et Défis","correspondingAuthor":false,"prefix":"","firstName":"Carole","middleName":"","lastName":"Compaore","suffix":""},{"id":626094359,"identity":"5ea3f8df-47aa-442e-afee-b1d20136df60","order_by":10,"name":"Jim Monkel","email":"","orcid":"","institution":"Independent researcher","correspondingAuthor":false,"prefix":"","firstName":"Jim","middleName":"","lastName":"Monkel","suffix":""},{"id":626094360,"identity":"cd81f172-596f-428f-a9ac-720fae24e74d","order_by":11,"name":"Kathleen Chau","email":"","orcid":"","institution":"United Nations Educational, Scientific and Cultural Organization","correspondingAuthor":false,"prefix":"","firstName":"Kathleen","middleName":"","lastName":"Chau","suffix":""},{"id":626094361,"identity":"b7428f3c-8262-4a02-af46-c287ca9689c2","order_by":12,"name":"Leonie Werner","email":"","orcid":"","institution":"United Nations Educational, Scientific and Cultural Organization","correspondingAuthor":false,"prefix":"","firstName":"Leonie","middleName":"","lastName":"Werner","suffix":""},{"id":626094362,"identity":"d5f4f6de-07e4-4e59-9f7c-f18551b8925d","order_by":13,"name":"Maryse Kok","email":"","orcid":"","institution":"Liverpool School of Tropical Medicine","correspondingAuthor":false,"prefix":"","firstName":"Maryse","middleName":"","lastName":"Kok","suffix":""}],"badges":[],"createdAt":"2026-03-21 14:24:31","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9186417/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9186417/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107707216,"identity":"5e463ed4-b671-40a2-a21a-e4ac3569556e","added_by":"auto","created_at":"2026-04-24 09:19:49","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":545725,"visible":true,"origin":"","legend":"","description":"","filename":"SRSPManuscriptTowardsmorehelpfulandsatisfactorySE1.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9186417/v1_covered_f3bda628-c716-44bd-9132-40ab34912640.pdf"},{"id":107627963,"identity":"3a450782-602f-41ea-974d-936694fe3533","added_by":"auto","created_at":"2026-04-23 11:01:49","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":193962,"visible":true,"origin":"","legend":"","description":"","filename":"Appendicesandsupplementarymaterial.docx","url":"https://assets-eu.researchsquare.com/files/rs-9186417/v1/1e17f7a64746fb600c57319e.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Towards more helpful and satisfactory sexuality education: First-hand accounts from adolescents and young people in low- and middle-income settings ","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Sexuality education, Sexual and reproductive health and rights, Adolescents, Young people, Youth participation, Safe learning environments","lastPublishedDoi":"10.21203/rs.3.rs-9186417/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9186417/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction\u003c/h2\u003e \u003cp\u003eSexuality education is increasingly recognised as essential for adolescents\u0026rsquo; and young people\u0026rsquo;s well-being, yet their own perspectives on its relevance and delivery remain underexplored. This mixed-methods, youth-participatory study examined adolescents\u0026rsquo; and young people\u0026rsquo;s perceptions of school-based sexuality education across diverse low- and middle-income contexts.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA global online survey with 9,288 respondents aged 16\u0026ndash;24, complemented by qualitative research with 405 participants in Burkina Faso, Cameroon, Colombia, the Kyrgyz Republic, and Trinidad and Tobago, explored associations between perceived helpfulness of and satisfaction with sexuality education and content received, delivery methods, perceived classroom safety, and sociodemographic factors.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eWhile most respondents identified schools as their preferred learning space, only about half felt that sexuality education had prepared them for real-life relationships and sexual and reproductive health decisions. Only selected topics independently predicted perceived helpfulness: HIV/STIs were positively associated, while anatomy was negatively associated, and that the perceived value of relational or sensitive topics depends on pedagogical conditions rather than coverage alone. Perceived classroom safety was the strongest predictor of both helpfulness and satisfaction, and participatory delivery methods were consistently associated with higher helpfulness and satisfaction. Older respondents and those outside sub-Saharan Africa reported lower satisfaction with school-based sexuality education.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe study underscores that effectiveness of sexuality education should be assessed through learners\u0026rsquo; perceptions of quality and responsiveness to their needs.\u003c/p\u003e\u003ch2\u003ePolicy implications\u003c/h2\u003e \u003cp\u003ePolicies should prioritise culturally grounded, skills-based curricula delivered through participatory pedagogy, alongside systemic investment in teacher training, classroom safety, accountability mechanisms, and institutionalised youth feedback systems.\u003c/p\u003e","manuscriptTitle":"Towards more helpful and satisfactory sexuality education: First-hand accounts from adolescents and young people in low- and middle-income settings ","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-23 11:01:45","doi":"10.21203/rs.3.rs-9186417/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"af7e91af-aa90-423f-b1a2-9606f352524f","owner":[],"postedDate":"April 23rd, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-05-11T19:44:38+00:00","index":27,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-23T11:01:45+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-23 11:01:45","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9186417","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9186417","identity":"rs-9186417","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}