Knowledge and risk factors of sexual and reproductive health among adolescents

Objectives: Adolescents in rural communities of Nigeria often face significant challenges regarding sexual and reproductive health (SRH), including limited access to accurate information, services, and support systems. This study explored the knowledge and risk factors associated with SRH among adolescents in the rural area of Oyo State, Nigeria. Materials and Methods: A mixed-method cross-sectional study design was adopted. Quantitative data were collected from 240 adolescents aged 10–19 years, using interviewer-administered questionnaires through an open data kit, while qualitative data were obtained through 12 Focus Group Discussions. Quantitative data were analyzed using the Statistical Package for the Social Sciences (Version 28) with descriptive and inferential statistics, while thematic analysis was used for qualitative data through qualitative data analysis (QDA) Miner. Results: A total of 54.2% of adolescents had poor SRH knowledge, while 48.8% reported engaging in risky SRH behaviors. Although 89.2% had heard of condoms, only 14.0% reported using them. Older adolescents (15–19 years) were significantly more likely to have good SRH knowledge (adjusted odds ratio AOR = 4.96; p = 0.046), as were those with tertiary education (AOR = 17.44; p = 0.012) and those with sexual partners (AOR = 3.64; p < 0.001). Female adolescents had significantly higher odds of engaging in risky behaviors compared to males. Conclusion: Adolescents in this surveyed setting face substantial SRH challenges due to inadequate knowledge, low service utilization, and socio-cultural constraints. There is a critical need for comprehensive sexual education, expansion of youth-friendly SRH services, and community-based interventions that address gender norms and cultural barriers to support safe and informed adolescent decision-making in rural settings.