Navigating between Relevance and Reality - Young People’s Perspectives Toward Sexuality Education in Low- and Middle-Income Countries : An Integrative Review

Sammanfattning

Background: Sexuality education is essential for promoting young people’s health, wellbeing and rights, contributing to safer sexual behaviours and reduced health risks. Over time, sexuality education has evolved into comprehensive sexuality education, a holistic and rights-based approach addressing biological, social and emotional aspects of sexuality. Despite global policy support, challenges in implementation remain, particularly in low- and middle-income countries. Limited resources, cultural barriers and lack of adaptation reduce program effectiveness. Understanding young people’s perspectives is crucial to improving the relevance and impact of sexuality education. Aim: The aim of this integrative review is to describe young people’s perspectives towards sexuality education in low- and middle-income countries. Methodology: An integrative review was conducted to examine young people’s perspectives on sexuality education following Whittemore and Knafl’s framework. Literature searches were performed in four databases using a structured strategy and studies between 2015 and 2026 were selected based on predefined criteria. Quality appraisal followed JBI criteria and 18 studies were analysed using reflexive thematic analysis. This approach enabled a systematic and comprehensive understanding of the topic. Results: The findings reveal one overarching theme, Navigating between relevance and reality, highlighting the complexity of young people’s experiences of sexuality education, which is often perceived as insufficient, limited and poorly adapted, with social norms acting as key barriers. Despite these challenges, sexuality education is also viewed as valuable and empowering. Young people emphasise the need for more comprehensive, interactive and contextually relevant education, along with improved teacher competence and broader societal involvement. Conclusion: In conclusion, this review shows that sexuality education in low- and middle-income countries is often insufficient despite being valued for knowledge and empowerment. It is limited by gaps in content, teacher competence and sociocultural, religious and gender norms that restrict access and open discussion. The sexuality education should therefore be understood as shaped by multiple societal levels, requiring a more holistic and contextsensitive approach. Ultimately, stronger action is needed to ensure all young people receive the comprehensive sexuality education they are entitled to, which requires a more coordinated approach across all societal levels.