Exploring the Use of Technology for Sexual Health Risk-Reduction among Ecuadorean Adolescents

Received a one-time health talk from the local clinic about pregnancy prevention.

Little information from the school about STDs, contraceptives, and self-care.

Females identified many methods of contraception, males only knew of condoms.

“In natural sciences, they explained a little about these themes…including puberty, how to not become pregnant, and the diseases we could catch.”

Clarified quantitative data, that though >80% received sexual health education, it is not sufficient or continual.

Revealed a gap with males in not only contraceptive access, but also knowledge.

Only 4 of 32 have consulted the school psychologist about sexual health.

There is no doctor on staff.

“I have spoken a little [with my parents] but really we haven’t spoken that much. With my mom we talk about it all but not that much with my dad.”

“Yes, we’ve spoken a little. Mostly things like how to take care of myself.”

“I talked to my mom during my last menstruation. She told me how to take care of it and I have talked to her about that.”

Confirms that parents are the most common source of sexual health knowledge.

Reveals that most ask their parents only about topics of puberty, not sexual practices.

All participants reported they have not received sufficient sexual health information.

27 of 32 participants reported they would like to receive more sexual health information.

Desired biweekly lectures from medical students to discuss sexual health.

Participants recommend the program be “cool, fun and relaxed” and “relatable to students.”

“They have not given us sufficient information.”

“I would like to receive information about everything we are talking about. All of it! In my house, neither, we don’t discuss these topics. My parents tell me it’s important to know about these things, but we have never discussed them.”

“I would like more information about how to take care of myself. How to prevent pregnancy.”

Participants desire more sexual health information; confirms quantitative data.

Desire pregnancy prevention, STD and self-care information; confirms write-in responses.

Program design suggestions confirm write-in responses, that students want the program to be relatable and fun.

Younger groups prefer Facebook for its accessibility.

Older group prefers WhatsApp for its privacy.

Preference for WhatsApp over text messaging.

There is a wide range in cell phone access according to age.

All participants had computer access.

31 of 32 participants have Facebook and use Messenger feature.

Facebook Messenger was identified as appropriately private.

“I think yes, I would like access to a Facebook page with doctors’ cell phone numbers because this would serve some people without phones. And they could decide what they want to see and others they don’t.”

“I would use the cell phone messaging because it is much more private.”

“WhatsApp is better because…I don’t know…I use it more.”

Preference for WhatsApp over text messaging for asking private questions.

Suggests a joint-system with Facebook to upload public information and WhatsApp for private inquiries.

Privacy concern differences, with older participants more conscious of anonymity.

Difference in technology access and sexual behaviors suggest age-dependent curriculum.

High Facebook usage confirms quantitative data.

Female participants enthusiastically responded “no” when asked if their male counterparts have the same interest as them in sexual health information.

“Boys are not interested in such topics [on sexual health].”

“Boys only look for mischievous things.”

Male participants refused to answer the question about females, stating “there is not confidence to say.”

Female participant perception agrees with quantitative responses that females are more interested in sexual health topics than male participants.

Lack of knowledge regarding the other gender’s sexual health interest shows little communication between each population.

Most participants were excited to spend afternoons at a sexual health lecture.

Male participants used the computer an average of 2 hours per day, while a little more than half had daily exercise.

Less than half of female participants reported daily exercise.

“I usually go home, maybe watch television, talk on the phone or take a nap.”

Lack of scheduled activities and participant recommendations suggest hosting afternoon medical student lectures.

Future studies could focus on designing recreational and exercise opportunities.

Younger participants were much less willing to talk.

Participants checked for social cues from other participants before responding.

The male group was particularly hesitant. Responses required calling individual participants by name, which usually led to one-word responses.

Later conversations with the school psychologist confirmed a lack of confidence among students, and a classroom dynamic to encourage passive learning.

Older adolescents could be abler in their health.

Male participants could require a specifically designed program to engage them.

Studies could focus on classroom empowerment.

Empowerment and autonomy should be part of a well-designed intervention.