Sexual health literacy among young adult university students in Ghana: a cross-sectional mixed-methods study

Q2 Nursing

International Journal of Africa Nursing Sciences Pub Date : 2026-01-01 Epub Date: 2026-08-11 DOI:10.1016/j.ijans.2026.101154

Jasmine Quarcoe, Andrew Porter, Mary Y.O. Jeremiah, Yui Matsuda

{"title":"Sexual health literacy among young adult university students in Ghana: a cross-sectional mixed-methods study","authors":"Jasmine Quarcoe, Andrew Porter, Mary Y.O. Jeremiah, Yui Matsuda","doi":"10.1016/j.ijans.2026.101154","DOIUrl":null,"url":null,"abstract":"<div><h3>Background/objectives</h3><div>Sexual health literacy (SHL), defined as the knowledge, beliefs, attitudes, and abilities to obtain, understand, and apply sexual health information, is critical for reducing sexually transmitted infections (STIs) and unintended pregnancies. Despite documented risky sexual behaviors among Ghanaian youth, SHL among university students in Ghana remains understudied. This study examined SHL among first-year university students in Ghana, a group navigating increased sexual autonomy with limited access to comprehensive sex education.</div></div><div><h3>Methods</h3><div>A cross-sectional convergent mixed-methods design was used. Participants (<em>N</em> = 100) were recruited via convenience sampling from a private urban university in Ghana. Eligible participants were currently enrolled students aged 18 or older who provided written informed consent. SHL was assessed using a structured questionnaire measuring three subscales: knowledge/awareness, attitudes/perceptions, and behaviors/practices (each scored 0–10; composite 0–30), adapted from <span><span>Rashidi et al. (2023)</span></span> and <span><span>Thongnopakun et al. (2024)</span></span>. Quantitative data were analyzed using descriptive statistics, independent samples <em>t</em>-tests, one-way ANOVAs, and ordinal regression in SPSS (v. 28). One open-ended question asked participants to define SHL; responses were analyzed using a grounded theory approach.</div></div><div><h3>Results</h3><div>Participants demonstrated moderate knowledge (M = 5.37/10), positive attitudes (M = 6.80/10), and low engagement in preventive behaviors (M = 3.21/10). Students who had received formal sex education prior to university scored significantly higher on SHL Knowledge (t(98) = 4.32, <em>p</em> < .001) and SHL Attitudes (t(98) = 4.00, p < .001), but not SHL Behavior (<em>p</em> = .485). Age and SHL scores were significantly associated with condom use; gender was not. Qualitative themes included stigma, cultural influences on disclosure, and informed decision-making.</div></div><div><h3>Conclusion</h3><div>Despite general STI awareness, students exhibited behavioral risks and knowledge gaps. The knowledge–behavior gap was evident across gender, age, and prior education subgroups. Findings underscore the need for culturally sensitive, university-based SHL interventions that address not only knowledge deficits but practical behavioral skills, youth-friendly services, and stigma-free communication</div></div>","PeriodicalId":38091,"journal":{"name":"International Journal of Africa Nursing Sciences","volume":"26 ","pages":"Article 101154"},"PeriodicalIF":0.0000,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Africa Nursing Sciences","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214139126001812","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/8/11 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"Nursing","Score":null,"Total":0}

引用次数: 0

Abstract

Background/objectives

Sexual health literacy (SHL), defined as the knowledge, beliefs, attitudes, and abilities to obtain, understand, and apply sexual health information, is critical for reducing sexually transmitted infections (STIs) and unintended pregnancies. Despite documented risky sexual behaviors among Ghanaian youth, SHL among university students in Ghana remains understudied. This study examined SHL among first-year university students in Ghana, a group navigating increased sexual autonomy with limited access to comprehensive sex education.

Methods

A cross-sectional convergent mixed-methods design was used. Participants (N = 100) were recruited via convenience sampling from a private urban university in Ghana. Eligible participants were currently enrolled students aged 18 or older who provided written informed consent. SHL was assessed using a structured questionnaire measuring three subscales: knowledge/awareness, attitudes/perceptions, and behaviors/practices (each scored 0–10; composite 0–30), adapted from Rashidi et al. (2023) and Thongnopakun et al. (2024). Quantitative data were analyzed using descriptive statistics, independent samples t-tests, one-way ANOVAs, and ordinal regression in SPSS (v. 28). One open-ended question asked participants to define SHL; responses were analyzed using a grounded theory approach.

Results

Participants demonstrated moderate knowledge (M = 5.37/10), positive attitudes (M = 6.80/10), and low engagement in preventive behaviors (M = 3.21/10). Students who had received formal sex education prior to university scored significantly higher on SHL Knowledge (t(98) = 4.32, p < .001) and SHL Attitudes (t(98) = 4.00, p < .001), but not SHL Behavior (p = .485). Age and SHL scores were significantly associated with condom use; gender was not. Qualitative themes included stigma, cultural influences on disclosure, and informed decision-making.

Conclusion

Despite general STI awareness, students exhibited behavioral risks and knowledge gaps. The knowledge–behavior gap was evident across gender, age, and prior education subgroups. Findings underscore the need for culturally sensitive, university-based SHL interventions that address not only knowledge deficits but practical behavioral skills, youth-friendly services, and stigma-free communication

查看原文本刊更多论文

加纳青年大学生的性健康素养：一项横断面混合方法研究

背景/目的性健康素养（SHL），定义为获取、理解和应用性健康信息的知识、信念、态度和能力，对于减少性传播感染（sti）和意外怀孕至关重要。尽管加纳青年中有危险的性行为记录，但加纳大学生中的性暴力问题仍未得到充分研究。这项研究调查了加纳大学一年级学生中的SHL，这一群体在获得全面性教育的机会有限的情况下，获得了越来越多的性自主权。方法采用横截面收敛混合方法设计。参与者（N = 100）通过方便抽样从加纳的一所私立城市大学招募。符合条件的参与者是目前入学的18岁或以上的学生，并提供书面知情同意书。SHL采用结构化问卷进行评估，测量三个子量表：知识/意识、态度/感知和行为/实践（每个得分为0-10分；综合得分为0-30分），改编自Rashidi等人（2023）和Thongnopakun等人（2024）。定量数据采用描述性统计、独立样本t检验、单因素方差分析和SPSS （v. 28）中的有序回归进行分析。一个开放式问题要求参与者定义SHL；使用扎根理论方法分析响应。结果被调查者对预防行为的了解程度一般（M = 5.37/10），态度积极（M = 6.80/10），参与程度较低（M = 3.21/10）。在大学之前接受过正规性教育的学生在SHL知识（t(98) = 4.32, p < .001）和SHL态度（t(98) = 4.00, p < .001）上得分显著较高，但在SHL行为（p = .485）上得分不高。年龄和SHL评分与避孕套使用显著相关；性别则不然。定性主题包括耻辱、对信息披露的文化影响和知情决策。结论学生对性传播感染有一定的认识，但存在行为风险和知识差距。知识-行为差异在性别、年龄和先前教育亚组中都很明显。研究结果强调，需要对文化敏感，以大学为基础的SHL干预措施，不仅要解决知识缺陷，还要解决实际的行为技能，青年友好服务和无耻辱感的沟通

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Africa Nursing Sciences Nursing-Nursing (all)

CiteScore

2.40

自引率

0.00%

发文量

114

审稿时长

21 weeks

期刊介绍： International Journal of Africa Nursing Sciences (IJANS) is an international scientific journal published by Elsevier. The broad-based journal was founded on two key tenets, i.e. to publish the most exciting research with respect to the subjects of Nursing and Midwifery in Africa, and secondly, to advance the international understanding and development of nursing and midwifery in Africa, both as a profession and as an academic discipline. The fully refereed journal provides a forum for all aspects of nursing and midwifery sciences, especially new trends and advances. The journal call for original research papers, systematic and scholarly review articles, and critical papers which will stimulate debate on research, policy, theory or philosophy of nursing as related to nursing and midwifery in Africa, technical reports, and short communications, and which will meet the journal''s high academic and ethical standards. Manuscripts of nursing practice, education, management, and research are encouraged. The journal values critical scholarly debate on issues that have strategic significance for educators, practitioners, leaders and policy-makers of nursing and midwifery in Africa. The journal publishes the highest quality scholarly contributions reflecting the diversity of nursing, and is also inviting international scholars who are engaged with nursing and midwifery in Africa to contribute to the journal. We will only publish work that demonstrates the use of rigorous methodology as well as by publishing papers that highlight the theoretical underpinnings of nursing and midwifery as it relates to the Africa context.