Association of Sexual and Reproductive Health Literacy With Related Service Utilization Among Young People Aged 15–24 Years in Southwest Nigeria: A Cross-Sectional Data Analysis

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Abstract

Sexual and reproductive health literacy may influence whether young people recognize care needs, identify appropriate services, and seek timely support. This secondary cross-sectional analysis assessed the association between sexual and reproductive health literacy and related service utilization among young people aged 15–24 years in Southwest Nigeria. An anonymized dataset containing 1,096 participants was analyzed using descriptive statistics, chi-square tests, independent-samples t-tests, reliability analysis, and binary logistic regression. Sexual and reproductive health literacy was assessed across nine domains and summarized using a standardized 0–100 index, while facility-based service utilization was treated as the primary outcome. Mean age was 19.02 ± 2.55 years, 56.5% were female, and 69.4% were in school. Only 12.9% had utilized facility-based sexual and reproductive health services. The mean literacy score was 56.56 ± 16.76, with excellent internal consistency (Cronbach’s alpha = 0.951). Utilization increased from 9.7% in the low-literacy group to 18.6% in the high-literacy group. Each 10-point increase in literacy was associated with higher adjusted odds of utilization (adjusted odds ratio = 1.39, 95% confidence interval: 1.23–1.57). Previous sexual intercourse was the strongest predictor. Improving literacy, provider support, confidentiality, navigation skills, and youth-friendly access may strengthen preventive service use among young Nigerians. Findings support integrated interventions linking reliable health information with accessible, respectful, confidential clinical services.