农村留守青少年生殖健康认知和行为的定性研究

Qualitative study on reproductive health related knowledge and behavior among rural left-behind young people

目的了解农村留守青少年生殖健康相关认知和行为,为开展农村留守青少年生殖健康促进项目提供依据。方法抽取重庆市和湖南省各1个县的33名10-24岁校内外留守青少年,对成长的自然、社会和家庭环境,生殖健康相关认知和行为,以及遇到生殖健康问题时的求助情况开展个人深入访谈,在与留守青少年相关的人员中就青少年生殖健康相关社会和家庭环境开展个人访谈。结果农村留守青少年的上学路途、住宿条件艰苦,工作环境复杂,对青春期、月经、遗精、自慰、艾滋病、性行为和性侵犯等生殖健康知识的了解不完备;婚前性行为较多且安全性行为采纳较少,尤其是校外青少年。在生殖健康方面,农村留守青少年缺乏来自父母、看护人、同学与同事、老师、雇主、医生等及时正确的指导或支持,忍受缺少父母关爱的痛苦,在自身安全方面存在诸多隐患,在遇到生殖健康相关问题时难以获得恰当帮助;校内、外男、女青少年均是如此。结论农村留守青少年生殖健康问题值得特别关注。需从公共卫生角度建立专门应对机制,营建有利的自然、社会和家庭环境与促进适应一般社会规范并重。

Objective To understand reproductive health （RH） related knowledge and behaviors in rural left-behind young people { RLBYP）, and thus to provide basis for design and conduct of RLBYP RH promotion. Methods Individual deep interviews were conducted in 33 in-school and out-schooling male and female left-behind young people （ Parents were away from home to work in other provinces for 6 months or more ） aged 10-24 year-old in 1 county of Chongqing and Hunan Province respectively. RH related knowledge and behaviors, as well as help-seeking when encountering RH problems. Individual interviews were conducted in RLBYP related persons on young people＇s social and family environments. Results The conditions of road to school and accommodation were harsh for RLBYP. Knowledge on puberty, menstruation, nocturnal emission, masturbation, HIV/AIDS, sexual behavior and sexual abuse were lack and inaccurate. The frequency of premarital sexual behavior was high while safe sexual behavior was less adopted especially among out-schooling young people. For both in-school and out-school RLBYP, they were lack of proper guidance and supports from their parents, colleagues, caregivers, teachers, employers or professionals. They were enduring the pain of lacking of parental care and facing many security issues. It is difficult for them to obtain proper help when encountering RH relevant issues. Conclusion RH issues among RLBYP deserve special attention and need to establish special coping mechanism from public health perspective. Favorable natural and social environment is vital for RLBYP to shape social norms