Adolescents’ experiences of sexual and reproductive health and rights communication and perceived support needs across school and social contexts: a qualitative study in Sweden

OBJECTIVE: This study explored how 15-16-year-old adolescents experience communication about SRHR within the school setting, among peers and family, and in digital contexts, as well as their perceived needs and gaps in support. METHODS: Eight focus group discussions (FGDs) were conducted in March 2024 with 40 adolescents (aged 15-16 years) in Sweden, separated by sex (F = 19; M = 21). The FGDs were recorded, transcribed and analysed using qualitative content analysis. RESULTS: Three categories summarised the findings: the pervasive nature of online sexual and psychological violence, illustrating the context in which adolescents live and interact daily, where exposure to unsolicited sexual content reinforce normative sexual scripts; gendered imbalances in SRHR communication, highlighting how male adolescents often carried their SRHR-related concerns in silence, while their female peers generally had more socially accepted avenues for discussion; and unmet needs for SRHR communication within the school setting, emphasising the mismatch between provided content and adolescents' expressed needs. The categories were connected by an overarching theme - bridging gaps in adolescent SRHR awareness through open communication - emphasising the adolescents' desire for adult-initiated conversations and regular exposure to SRHR topics. CONCLUSIONS: The adolescents described feeling ill-equipped to navigate SRHR-related concerns and experiences of online sexual violence, and they had unmet needs for conversations about SRHR with teachers and school health professionals. Routine and open discussions within the school setting, initiated by adults, could be key to addressing existing gender imbalances and stereotypes by normalising SRHR conversations and encouraging help-seeking behaviour.