Adolescents' Sexual Health During the COVID-19 Outbreak: A Systematic Review

IF 2.1 Q2 MEDICINE, GENERAL & INTERNAL

Health Science Reports Pub Date : 2025-04-29 DOI:10.1002/hsr2.70774

Elahe Ahmadnia, Arezoo Haseli, Atefeh Davoudian, Mina Abbasi

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Abstract

Background and Aims

The COVID-19 pandemic has greatly disrupted adolescents' access to sexual health services, resulting in a decline in their overall sexual well-being. This systematic review explored adolescent sexual health during the COVID-19 pandemic.

Methods

A systematic review of quantitative studies—including observational research, clinical trials, and quasi-experimental interventions—examined English-language articles published between January 2020 and February 10, 2025, sourced from databases such as PubMed, Web of Science, Scopus, and Google Scholar. Study quality was evaluated using the Newcastle−Ottawa Scale (NOS) for observational studies, Cochrane RoB 2 for clinical trials, and ROBINS-1 for quasi-experimental designs. Due to the heterogeneity of the data.

Results

After identifying 781 articles, 10 studies with a total sample size of 636,873 participants were included in the final systematic review. Observational studies during the COVID-19 pandemic revealed diminished access to sexual and reproductive health (SRH) services, greater dependence on informal information sources, widening health inequalities, and negative impacts on adolescent sexual behavior. Intervention studies on online SRH education demonstrate significant positive impacts across key areas: access to SRH services, safe sex practices, communication with parents about sexual health, lower acceptance of dating violence, normative beliefs regarding adolescent sexuality, HIV/STI awareness, and condom use. The findings emphasize notable improvements in communication, knowledge, and attitudes toward sexual health, driven by these targeted interventions.

Conclusion

The COVID-19 pandemic disrupted adolescent SRH globally, reducing service access and amplifying inequities. While some behaviors (e.g., sexual activity) showed resilience, systemic gaps in education and healthcare persist. Multisectoral efforts are needed to ensure adolescents' SRH rights are upheld during crises. However, the interventional studies underscore the viability of digital, media-literate interventions in improving adolescent sexual health.

Trial Registration

The review study was officially registered on the PROSPERO website on 02/08/2023 under the code CRD42023438631 and received approval from the jury.

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新冠肺炎疫情期间青少年性健康状况的系统评价

背景和目的2019冠状病毒病大流行严重扰乱了青少年获得性健康服务的机会，导致他们的总体性健康水平下降。本系统综述探讨了COVID-19大流行期间青少年的性健康。方法对定量研究（包括观察性研究、临床试验和准实验干预）进行系统回顾，分析了2020年1月至2025年2月10日期间发表的英语文章，这些文章来自PubMed、Web of Science、Scopus和谷歌Scholar等数据库。观察性研究采用纽卡斯尔-渥太华量表（NOS），临床试验采用Cochrane RoB 2，准实验设计采用ROBINS-1。由于数据的异质性。结果在确定781篇文章后，最终的系统评价纳入了10项研究，总样本量为636,873名参与者。2019冠状病毒病大流行期间的观察性研究表明，获得性健康和生殖健康（SRH）服务的机会减少，对非正式信息来源的依赖增加，卫生不平等现象扩大，并对青少年性行为产生负面影响。关于在线性健康和生殖健康教育的干预研究表明，在以下关键领域产生了显著的积极影响：获得性健康和生殖健康服务、安全性行为、与父母就性健康进行沟通、对约会暴力的接受程度降低、对青少年性行为的规范信念、对艾滋病毒/性传播感染的认识以及避孕套的使用。研究结果强调，在这些有针对性的干预措施的推动下，对性健康的沟通、知识和态度有了显著改善。结论2019冠状病毒病大流行扰乱了全球青少年性健康和生殖健康，减少了服务可及性，加剧了不公平现象。虽然一些行为（如性活动）显示出弹性，但教育和医疗保健方面的系统性差距仍然存在。需要多部门努力确保在危机期间维护青少年的性健康和生殖健康权利。然而，干预研究强调了数字、媒体素养干预在改善青少年性健康方面的可行性。该综述性研究于2023年2月8日在普洛斯彼罗网站上正式注册，代码为CRD42023438631，并获得评审团的批准。

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