Key Social Norms Take-aways This study illustrates how deeply embedded religious and cultural norms in Kaduna, Nigeria, create stigma around adolescent sexual activity and the use of sexual and reproductive health services (SRHS). These norms, which equate premarital sex with immorality, result in strong community disapproval and internalized shame among adolescents—particularly girls. Adolescents fear being labeled as promiscuous or “spoiled,” leading many to avoid formal SRHS or seek them in secret. Social expectations also prevent open conversations about sexuality, further limiting knowledge and access. While married adolescents face fewer barriers, unmarried youth—especially girls—remain constrained by norms that discourage their autonomy and reinforce silence around sexual health.
Objectives The study aimed to explore how stigma, shaped by social norms, affects adolescents’ access to and utilization of SRHS in Kaduna. It also sought to identify adolescents’ and health workers’ views on potential strategies to reduce these barriers.
Methods An exploratory qualitative study was conducted through semi-structured interviews with 14 adolescents aged 16–19 and three nurses from selected primary healthcare centers. Adolescents were selected via convenience sampling and nurses through purposive sampling. Thematic analysis guided by Braun and Clarke was used to analyze the data.
Results Despite understanding the importance of SRHS, adolescents were reluctant to use them due to stigma rooted in religious and cultural expectations. Community norms deemed discussions of sex taboo and viewed adolescent contraceptive use as morally inappropriate. Girls especially feared being seen at health facilities, risking judgment from both providers and community members. Adolescents described feelings of shame, fear, and guilt, with some believing that offering contraception would encourage sexual behavior. Confidentiality breaches and judgmental attitudes from health workers compounded these issues. Adolescents preferred obtaining services from private outlets like pharmacies to maintain anonymity. Suggestions to improve access included youth-only services, better confidentiality practices, and community awareness efforts involving religious and family leaders.
Conclusions Stigma driven by social norms significantly limits adolescents’ access to SRHS in Kaduna. These norms shape both community attitudes and adolescents’ own perceptions, reinforcing silence, shame, and fear. Addressing these barriers requires youth-friendly, confidential services and broader efforts to shift harmful norms through community engagement and provider training.