Navigating sexuality information: A comparative study on the actual and preferred sources by young people in Uganda's...

Young people's access to sexuality information plays a central role in shaping sexual behaviour. Sexuality information comes from various sources, yet young people often lack access to their preferred and trusted sources. This paper examined the gap between actual and preferred sources of sexuality information, critical for inclusive and responsive interventions in the underserved, yet high-risk settings.

A cross-sectional mixed-methods study, guided by the Information-Motivation-Behavioral Skills (IMB) and bioecological models, was conducted among young people aged 10-24 years in Kkoome islands communities. A survey of 569 young people and six focus group discussions were conducted. McNemar tests were used to compare differences between actual and preferred sources of sexuality information by topic, and the rationale for preference was analyzed thematically.

Significant differences (p < 0.001) were observed between actual and preferred sources across all sources. Books and recordings were consistently among the most preferred sources (48.2%-49.2%) despite minimal actual use (0.2%-0.4%), while healthcare workers were highly preferred for human body development (46.6% vs. 15.1%) and pregnancy, HIV, and STIs (47.3% vs. 16.2%) topics. Biological parents, teachers, and friends/confidants were also preferred significantly more than they were accessed (all p < 0.001). For higher preference, young people valued privacy, emotional comfort, flexibility, accuracy, and trust in books and recordings; professional expertise and structured guidance from healthcare workers and teachers; and accessibility and emotional support from parents and other close social networks, consistent with the IMB constructs.

The pronounced mismatch between young people's actual and preferred sources of sexuality information indicates a substantial unmet demand for trusted, structured, and young people-responsive sexuality information and education in Uganda's island communities. Strengthening access to books and recordings, the capacity of healthcare workers, and parents to provide sexuality information, and aligning interventions with IMB components may enhance informed decision-making and improve sexual and reproductive health outcomes among young people in high-risk and underserved settings.