BACKGROUND Sexual choices and practices of adolescents living in conservative societies, including Morocco, can be influenced either positively or negatively by the prevailing contextual and social norms. These norms not only limit the access to reproductive health information and services but also lead to abstinence among devout adolescents. Thus, identifying contextual risks and protective factors of risky sexual behaviors leading to sexually transmitted infections (STIs) in adolescents, as well as exploring perceptions of adolescents, parents and teachers regarding effective intervention preferences could improve the sexual health of adolescents. METHODS We conducted a qualitative study using focus group discussions (FGDs) based on the socio-ecological model as a theoretical framework. Sample groups of adolescents, parents, and teachers were selected from two public middle schools (disadvantaged and advantaged according to socio-economic level) in Taza city, Morocco, from May to July 2016. Participants were polled on protective factors and perceived facilitators of risky sexual behaviors leading to sexually transmitted infections (STIs) in adolescents as well on their perception of intervention preferences to reduce the risks. Three sets of data were initially formed, coded, and analyzed using thematic analysis. RESULTS Seventeen FGDs were conducted, including 8 groups of adolescents (28 boys and 28 girls, 14-16 years old), 5 groups of parents (21 males and 5 females), and 4 groups of teachers (13 males and 5 females). Five overall themes seemed to influence risky sexual behaviors in adolescents: (1) risky sexual practices and STIs; (2) the adolescent's social domain; (3) the role of school; (4) media, including internet and social media; and (5) socio-cultural norms. Participants also suggested a number of possible interventions to improve the sexual health of adolescents and to reduce the risk of STIs, which could be applied at multiple levels. CONCLUSIONS Successful intervention programs should target the multifaceted factors affecting the adolescent's sexual behaviors, from the individual to the societal level. Allowing parents, teachers, and adolescents to work together could help reduce the socio-cultural and personal barriers that prevent effective communication about sexuality. Furthermore, schools can play a vital role in reducing risky sexual behaviors and STI acquisition rates in adolescents by promoting sex education in school curriculum and encouraging adolescents to engage in extracurricular activities and awareness campaigns.

中文翻译：

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摩洛哥青少年、家长和教师对导致青少年性传播感染的危险性行为的风险和保护因素的看法和干预偏好：定性发现。

背景 生活在包括摩洛哥在内的保守社会中的青少年的性选择和性行为可能会受到普遍背景和社会规范的积极或消极影响。这些规范不仅限制了获得生殖健康信息和服务的机会，而且还导致虔诚的青少年禁欲。因此，识别导致青少年性传播感染（STI）的危险性行为的背景风险和保护因素，并探索青少年、家长和教师对有效干预偏好的看法，可以改善青少年的性健康。方法我们以社会生态模型为理论框架，利用焦点小组讨论（FGD）进行了定性研究。2016 年 5 月至 7 月，从摩洛哥塔扎市的两所公立中学（根据社会经济水平处于弱势和优势）中选取了由青少年、家长和教师组成的样本组。对参与者进行了关于保护因素和感知到的风险促进因素的调查。导致青少年性传播感染（STI）的性行为以及他们对降低风险的干预偏好的看法。最初使用主题分析形成、编码和分析三组数据。结果共进行17次FGD，其中青少年组8组（男28例，女28例，14~16岁），家长组5组（男21例，女5例），教师组4组（男13例，女5例）。五个总体主题似乎影响青少年的危险性行为：（1）危险性行为和性传播感染；(2) 青少年的社会领域；(3) 学校的角色；(4) 媒体，包括互联网和社交媒体；(5) 社会文化规范。与会者还提出了一些可能的干预措施，以改善青少年的性健康并降低性传播感染的风险，这些干预措施可以在多个层面上应用。结论 成功的干预计划应针对影响青少年性行为的多方面因素，从个人到社会层面。让父母、教师和青少年共同努力可以帮助减少阻碍有效沟通性行为的社会文化和个人障碍。此外，学校可以通过在学校课程中推广性教育并鼓励青少年参加课外活动和宣传活动，在减少青少年危险性行为和性传播感染率方面发挥至关重要的作用。