Factors associated with sexual and reproductive health stigma among adolescent girls in Ghana
Outcomes: Gender‑Based Violence, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways The study highlights how pervasive gendered social norms frame adolescent sexuality as shameful and dangerous. These norms fuel stigma around contraception, pregnancy, and SRH care-seeking. Interventions must challenge these beliefs through comprehensive SRH education, supportive dialogue, and community-wide norm change efforts that empower girls with information, confidence, and access to services.
Objectives This study explored the factors associated with perceived sexual and reproductive health (SRH) stigma among adolescent girls and young women in Ghana. It aimed to understand how stigma operates in relation to key SRH issues—such as sexual activity, pregnancy, contraception, abortion, and use of family planning services—and how these perceptions are influenced by individual demographics, experiences, and community context.
Methods Researchers conducted a cross-sectional survey with 1,063 girls aged 15–24 in Accra and Kumasi, Ghana. Participants were recruited using cluster sampling from schools, health facilities, and universities. The study introduced and applied a 20-item Adolescent SRH Stigma Scale, which included three subscales: Internalized Stigma, Enacted Stigma, and Stigmatizing Lay Attitudes. Multivariable linear regression models with a recruitment site cluster effect were used to analyze associations between stigma scores and factors such as physical and mental health and social wellbeing, age, education, religion, and sexual and reproductive history characteristics.
Results Stigma was prevalent across all domains, with the highest scores related to abortion and pregnancy stigma. Higher stigma scores were significantly associated with being younger, unemployed, less educated, Muslim, or having a history of pregnancy. Girls who had never had sex, never used contraception, or never accessed family planning services also reported higher levels of stigma. Conversely, girls who were older, had sexual experience, or had accessed services generally had lower stigma scores.
Conclusions Adolescents internalize and perceive high levels of SRH stigma even before experiencing key SRH events. Additional research is needed to inform more holistic, evidence-based practices, programs and policies that can foster stigma resilience at the individual level and counter adolescent SRH stigma at the environmental level in order to improve SRH outcomes for young women.
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