Adolescents' and young people's perspectives on school-based sexuality education in low- and middle-income countries: a scoping review

Background: Sexuality education plays a crucial role in supporting adolescents’ and young people’s (AYP’s) health, well-being and gender equality and is increasingly recognised in global policies. In low- and middle-income countries (LMICs), research has raised concerns about the availability and sub-optimal implementation of sexuality education, yet few studies address these concerns considering AYP’s views. This limits insights for developing relevant and effective sexuality education programmes that can support AYP in their journey to adulthood. This review explores AYP’s perspectives on school-based sexuality education in LMICs.

Methods: A scoping review was conducted across five academic databases and key stakeholder websites, identifying studies published between 2013 and 2024 in English. Following screening and systematic data extraction, 66 studies were included. Findings on characteristics of studies, AYP’s perspectives on needs, experiences and preferences related to sexuality education content and delivery, as well as socio-ecological influences were synthesized using a narrative approach.

Results: The review found that while AYP across LMICs generally expressed high needs for school-based sexuality education, these often remain unmet. AYP consistently reported dissatisfaction with sexuality education as they wish for education that extends beyond cognitive learning about biology and negative implications of sexuality, to include more comprehensively its emotional, physical, and social aspects. Participants’ age, gender and urban or rural residence influence delivery preferences. Gaps in participatory, inclusive, and empowering education approaches reinforce gender norms, exclude diverse identities, and fail to address the specific needs of adolescent girls, young women, and marginalized youth. The review underscored the scarcity of research on AYP’s perspectives regarding age- and context-appropriateness, inclusivity of content, and regarding delivery formats. Studies from certain geographic regions and focusing on younger adolescents, youth with diverse social identity markers and those living in rural areas were especially underrepresented.

Conclusions: For the first time, this article synthesizes direct AYP perspectives on school-based sexuality education, while also pointing to remaining knowledge gaps when capturing views of AYP in LMICs. Concerted efforts are needed to diversify research, calling for more rigorous, inclusive and youth-participatory research efforts to inform sexuality education policies and programmes that are responsive to AYP’s needs.