{ "abstract": "Background\n\nAdolescents living in conflict-affected settings face major barriers to accessing sexual and reproductive health (SRH) information and services. Evidence on SRH knowledge, attitudes and practices (KAP) among adolescents in eastern Democratic Republic of the Congo (DRC) remains limited. This study assessed SRH KAP and identified factors associated with good SRH knowledge among school-going adolescents in North and South Kivu.Methods\n\nA school-based cross-sectional study was conducted from April to July 2023 among 559 school-going adolescents from 28 secondary schools in seven health zones of North and South Kivu. Data were collected using a pre-tested structured questionnaire. Good SRH knowledge was defined as an overall knowledge score of ≥75%. Factors associated with good SRH knowledge were assessed using Poisson regression with robust variance, and adjusted prevalence ratios (aPRs) with 95% confidence intervals (95% CIs) were estimated.Results\n\nOverall, 559 participants were included and 50.5% were girls. After age recoding, mean age was 17.2 ± 1.3 years. Overall, 29.7% had ever had sexual intercourse, while 8.1% had ever used SRH services. High domain knowledge was recorded for 32.7% of the 379 participants with general genital-organ categories, 30.2% for HIV transmission, and 26.8% for contraceptive methods. In the adjusted analysis (n=550), high overall SRH knowledge was associated with South Kivu residence (aPR=6.94; 95% CI: 3.84-12.56; p<0.001), Internet information (aPR=1.53; 95% CI: 1.22-1.93; p<0.001), information from another doctor (aPR=1.64; 95% CI: 1.26-2.15; p<0.001), and information from the mother (aPR=1.56; 95% CI: 1.08-2.24; p=0.017). Household size was inversely associated with high knowledge (aPR=0.957 per additional person; 95% CI: 0.917-0.999; p=0.046). Age and school year were not significant after adjustment.Conclusion\n\nAdolescents in North and South Kivu showed substantial gaps in SRH knowledge, low utilization of SRH services, and several indicators of sexual vulnerability. Important differences in SRH knowledge were observed between the two provinces, with higher prevalence of good knowledge among adolescents in South Kivu. Strengthening comprehensive sexuality education and improving access to reliable, adolescent-friendly SRH information through schools, families, healthcare providers, digital platforms, and other appropriate communication channels may help address these gaps. Interventions should also consider the social and contextual barriers that may affect adolescents' access to SRH information and services in conflict-affected settings.", "abstract_shown": true, "affiliations": [ "École Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo.", "Institut Supérieur de Techniques Médicales Kanyamulande, Walungu, South Kivu, Democratic Republic of Congo.", "Competence Center for Methodology and Statistics, Luxembourg Institute of Health, Strassen, Luxembourg.", "Department of Obstetrics and Gynecology, General Referral Hospital of Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo." ], "article_type": "research article", "arxiv": null, "author_total": 14, "authors": [ { "affs": [ 0, 1 ], "name": "Gaylord Amani Ngaboyeka", "orcid": "0000-0003-4906-1851" }, { "affs": [ 0 ], "name": "Aladin Mugisho Snr", "orcid": "0009-0006-9453-3984" }, { "affs": [ 2 ], "name": "Anouk Neven" }, { "affs": [ 0 ], "name": "Claude Kisubi Idumbo" }, { "affs": [ 0 ], "name": "Christian Byamungu Mugisho", "orcid": "0009-0007-7650-0107" }, { "affs": [ 0 ], "name": "Jean Corneille Zubulu Lembebu" }, { "affs": [ 0 ], "name": "Joelle Nsimire", "orcid": "0009-0007-9392-5748" }, { "affs": [ 0, 1 ], "name": "Musafiri Namegabe Moïse Snr" }, { "affs": [ 0 ], "name": "Armand Bisimwa Mulume" }, { "affs": [ 3 ], "name": "Serge Chentwali" }, { "affs": [ 0 ], "name": "Julien Bacirhukenge Migabo Snr", "orcid": "0009-0002-3732-4642" }, { "affs": [ 0 ], "name": "Bony Bugugu", "orcid": "0009-0009-3255-4933" }, { "affs": [ 0 ], "name": "Ghislain Bisimwa Balaluka" }, { "affs": [ 0 ], "name": "Pacifique Mwene-Batu", "orcid": "0000-0003-0413-2732" } ], "bibtex": "https://research.draconitic.com/paper/d19bh8hn8m2dw.bib", "cited_by": 0, "doi": "10.2147/oajc.s628858", "fulltext_url": "https://europepmc.org/articles/PMC13693512", "id": "d19bh8hn8m2dw", "issns": [ "1179-1527" ], "landing_url": "https://europepmc.org/article/MED/42921525", "language": "eng", "licence": "CC-BY-NC", "licence_label": "CC BY-NC", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "3600|Adolescent Sexual and Reproductive Health" ] ], "openalex": "W7222973301", "pdf_url": "https://europepmc.org/articles/PMC13693512?pdf=render", "pmcid": "PMC13693512", "pmid": "42921525", "published": "2026-10-19", "publisher": null, "ris": "https://research.draconitic.com/paper/d19bh8hn8m2dw.ris", "sources": [ { "first_seen": "2026-10-30T12:20:33Z", "native_id": "MED:42921525", "source": "europepmc", "url": "https://europepmc.org/article/MED/42921525" } ], "subjects": [ { "field": "medicine", "origin": "journal-openalex:F27", "subfield": "general" } ], "title": "Sexual and Reproductive Health Knowledge, Attitudes, Practices and Associated Factors Among School-Going Adolescents in Conflict-Affected Eastern Democratic Republic of Congo: A Cross-Sectional Study.", "title_text": "Sexual and Reproductive Health Knowledge, Attitudes, Practices and Associated Factors Among School-Going Adolescents in Conflict-Affected Eastern Democratic Republic of Congo: A Cross-Sectional Study.", "type": "peer-reviewed", "updated_at": "2026-10-30T12:20:33Z", "url": "https://research.draconitic.com/paper/d19bh8hn8m2dw", "venue": "Open access journal of contraception", "versions": [] }