This paper reports findings of a pilot survey of adolescent sexual and reproductive health (ASRH) knowledge and behaviour in Homabay County of western Kenya. The study was based on a cross-sectional survey of 523 male and female adolescents aged 10–19 years from 32 Community Health Units (CHUs). Bivariate analysis of gender differences and associations between ASRH knowledge and behaviour was followed with two-level logistic regression analysis of predictors of ASRH behaviour (sexual activity, unprotected sex, HIV testing), taking individual adolescents as level-1 and CHUs as level-2. The findings reveal important gender differences in ASRH knowledge and behaviour. While male adolescents reported higher sexual activity (ever had sex, unprotected last sex), female adolescents reported higher HIV testing. Despite having lower HIV/AIDS knowledge, female adolescents were more likely to translate their SRH knowledge into appropriate behaviour. Education emerged as an important predictor of ASRH behaviour. Out-of-school adolescents had significantly higher odds of having ever had sex (aOR=3.3) or unprotected last sex (aOR=3.2) than their in-school counterparts of the same age, gender and ASRH knowledge, while those with at least secondary education had lower odds of unprotected sex (aOR=0.52) and higher odds of HIV testing (aOR=5.49) than their counterparts of the same age, gender and SRH knowledge who had primary education or lower. However, being out of school was associated with higher HIV testing (aOR=2.3); and there was no evidence of significant differences between younger (aged 10–14) and older (aged 15–19) adolescents in SRH knowledge and behaviour. Besides individual-level predictors, there were significant community variations in ASRH knowledge and behaviour, with relatively more-deprived CHUs being associated with poorer indicators. The overall findings have important policy/programme implications. There is a need for a comprehensive approach that engages schools, health providers, peers, parents/adults and the wider community in developing age-appropriate ASRH interventions for both in-school and out-of-school adolescents in western Kenya.

本文报告了肯尼亚西部霍马贝县青少年性与生殖健康 (ASRH) 知识和行为试点调查的结果。该研究基于对来自 32 个社区卫生单位 (CHU) 的 523 名 10-19 岁的男性和女性青少年的横断面调查。对 ASRH 知识和行为之间的性别差异和关联进行双变量分析，然后对 ASRH 行为的预测因子（性活动、无保护性行为、HIV 检测）进行两级逻辑回归分析，将个别青少年作为一级，将 CHU 作为二级. 研究结果揭示了 ASRH 知识和行为的重要性别差异。虽然男性青少年报告了更高的性活动（曾经发生过性行为，最后一次无保护的性行为），但女性青少年报告了更高的艾滋病毒检测。尽管对艾滋病毒/艾滋病的了解较少，女性青少年更有可能将她们的 SRH 知识转化为适当的行为。教育成为 ASRH 行为的重要预测因素。校外青少年发生性行为（aOR=3.3）或上一次无保护性行为（aOR=3.2）的几率显着高于同龄、性别和 ASRH 知识的校内同龄人，而至少有与具有相同年龄、性别和性与生殖健康知识的受过初等教育或更低的同龄人相比，中等教育的无保护性行为发生率较低（aOR=0.52）和艾滋病毒检测发生率较高（aOR=5.49）。然而，失学与更高的 HIV 检测相关（aOR=2.3）；没有证据表明年轻（10-14 岁）和年长（15-19 岁）青少年在性与生殖健康知识和行为方面存在显着差异。除了个人层面的预测因素外，ASRH 知识和行为也存在显着的社区差异，相对贫困的 CHU 与较差的指标相关。总体调查结果具有重要的政策/计划含义。需要一种综合方法，让学校、医疗保健提供者、同龄人、父母/成人和更广泛的社区参与为肯尼亚西部的在校和失学青少年制定适合年龄的 ASRH 干预措施。