Facilitators of Sexual Health Education for Male Adolescents in Iran: A Qualitative Study

Fariba Askari, Khadigeh Mirzaiinajmabadi, Mahmood Saeedy Rezvani, Seyyed-Mohsen Asgharinekah


Background: Adolescence is a period of rapid physical, social, emotional, cognitive, and sexual  development. The widening gap between biological maturity and social transition to adulthood  highlights the importance of adolescents’ need for education, especially in sexual health. The main  objective of this study was to explore the facilitators of Sexual Health Education (SHE) for male  adolescents in Iran.

Materials and Methods: In this qualitative content analysis, a total number of  45 participants were investigated from June 2018 to July 2019 through individual, semi‑structured,  in‑depth interviews in the city of Mashhad, Iran, until data saturated. The participants were selected  using a purposive sampling method. The data were analyzed using a conventional content analysis  method based on the approach developed by Graneheim and Lundman (2004) using MAXQDA  software.

Results: In data analysis, 2 main categories and 9 subcategories emerged. The main  categories included extrapersonal facilitators and intrapersonal facilitators. The category of  extrapersonal facilitators included the 7 subcategories of appropriate policy‑making, use of religious  capacities, consideration of native culture, supportive family environment, school empowerment,  inter‑sectoral integration and collaboration, and reinforcement of parent‑teacher interaction. The  category of intrapersonal facilitators comprised of the 2 subcategories of supporting adolescent  socialization and using distraction techniques in adolescents.

Conclusions: The study revealed that  having an action plan with a scientific, ethical, legal, religious, and cultural background, establishing  a suitable home, school, and community environment, strengthening inter‑sectoral integration,  collaboration, and interpersonal coordination, and utilizing the capabilities and potentials of  adolescents can provide an appropriate SHE for adolescent boys.


Adolescent, education, male, qualitative research, sexual health

Full Text:



Sawyer SM, Azzopardi PS, Wickremarathne D, Patton G. The age of adolescence. Lancet Child Adolesc Health 2018;2:223‑8.

Sawyer SM, Afifi RA, Bearinger LH, Blakemore SJ, Dick MB, Ezeh AC, et al. Adolescence: A foundation for future health. Lancet 2012;379:1630‑40.

Bell DL, Garbers S. Early sexual initiation among boys: What should we do? JAMA Pediatr 2019;173:522‑3.

Gersh E, Richardson LP, Katzman K, Spielvogle H, Arghira AC, Zhou Ch, et al. Adolescent health risk behaviors: Parental concern and concordance between parent and adolescent reports. Acad Pediatr 2018;18:66‑72.

Harhay MO, King CH. Global burden of disease in young people aged 10–24 years. Lancet 2012;379:27‑8.

Kapinga OS, Hyera DF. Pupils’ perceptions of sex and reproductive health education in primary schools in Tanzania: A phenomenological study. J Educ Pract (JEP) 2015;6:106‑13.

Morris JL, Rushwan H. Adolescent sexual and reproductive health: The global challenges. Int J Gynecol Obstet 2015;131:S40‑2.

Baku E. Parent Training and Parent‑Adolescent Communication about Sexuality in Accra Metropolis. Ghana: University of Ghana; 2014.

Chothe V, Khubchandani J, Seabert D, Asalkar M, Rakshe S, Firke A, et al. Students’ perceptions and doubts about menstruation in developing countries: A case study from India. Health Promot Pract 2014;15:319‑26.

Roudsari RL, Javadnoori M, Hasanpour M, Hazavehei SM, Taghipour A. Socio‑cultural challenges to sexual health education for female adolescents in Iran. Iran J Reprod Med 2013;11:101.

Seif SA, Moshiro CS. Caretaker‑adolescent communication on sexual and reproductive health: A cross‑sectional study in Unguja‑Tanzania Zanzibar. BMC Public Health 2018;18:31.

Shariati M, Babazadeh R, Mousavi SA, Mirzaii Najmabadi KH. Iranian adolescent girls’ barriers in accessing sexual and reproductive health information and services: A qualitative study. BMJ sexual & Reprod Health 2014;40:270‑5.

Abdul‑Rahman L, Marrone G, Johansson A. Trends in contraceptive use among female adolescents in Ghana. Afr J Reprod Health 2011;15:45‑55.

UNAIDS data 2018. Available from: https://www.unaids.org/en/ resources/documents/2018/unaids‑data‑2018. [Last accessed on 2019 Jul 10].

Ismail S, Shajahan A, Rao TS, Wylie K. Adolescent sex education in India: Current perspectives. Indian J Psychiatry 2015;57:333‑7.

Ali M. Boyshondhi Shikka is Obligatory for Religious and Medical Reasons: Bangladeshi Imams’ perceptions about Adolescent Sexual and Reproductive Health Education: An In‑depth Interview Study in Bangladesh. 2018. Available from: http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-352627

Danquah PA. Sexual and Reproductive Health Education among Adolescents at Awukugua. University of Ghana; 2018. Available from: http://ugspace.ug.edu.gh/handle/123456789/27608. [Last accessed on 2019 May 23].

Mirzaii Nagmabadi K, Babazadeh R, Shariati M, Mousavi SA. Iranian adolescent girls and sexual and reproductive health information and services: A qualitative study. Iran J Obstet Gynecol Infertil 2014;17:9‑18. [In Persian].

Walsh SD, Harel‑Fisch Y, Fogel‑Grinvald H. Parents, teachers and peer relations as predictors of risk behaviors and mental well‑being among immigrant and Israeli born adolescents. Soc Sci Med 2010;70:976‑84.

Shahhosseini Z, Simbar M, Ramezankhani A, Alavi Majd H. Supportive family relationships and adolescent health in the socio‑cultural context of Iran: A qualitative study. Ment Health Fam Med 2012;9:251‑6.

Kerpelman JL, McElwain AD, Pittman JF, Adler‑Baeder FM. Engagement in risky sexual behavior: Adolescents’perceptions of self and the parent–child relationship matter. Youth Soc 2016;48:101‑25.

Ali M. Adolescent sexual reproductive health (ASRH) education: Perspectives of muslims in South Asia and Middle East countries. J Knowl Global 2018;10:27‑48.

Alimoradi Z, Kariman N, Ahmadi F, Simbar M. Preparation for sexual and reproductive self‑care in Iranian adolescent girls: A qualitative study. Int J Adolesc Med Health (IJAMH) 2017;30. doi: 10.1515/ijamh‑2016‑0094.

Robinson KH, Smith E, Davies C. Responsibilities, tensions and ways forward: Parents’ perspectives on children’s sexuality education. Sex Educ 2017;17:333‑47.

Bostani‑Khalesi Z, Simbar M, Azin SA. An explanation of empowerment‑based sexual health education strategies: A qualitative study. J Qual Res Health Sci 2017;6:253‑65. [In Persian].

Bleakley A, Hennessy M, Fishbein M, Jordan A. How sources of sexual information relate to adolescents’ beliefs about sex. Am J Health Behav 2009;33:37‑48.

Breuner CC, Mattson G. Sexuality education for children and adolescents. Pediatrics 2016;138:e20161348.

WHO. Strengthening Intersectoral Collaboration for Adolescent Health. World Health Organization; 2016. Available form: https:// apps.who.int/iris/handle/10665/204359. [Last accessed on 2019 May 15].

Hirschi T. Causes of Delinquency. 1st ed. New York: Routledge; 2017.

Hoffmann JP, Erickson LD, Spence KR. Modeling the association between academic achievement and delinquency: An application of interactional theory. Criminology 2013;51:629‑60.

Andreescu V. Family, school, and peer influences on alcohol abstinence and use among American Indian and white female adolescents. Deviant Behav 2019;40:56‑73.

Jeynes WH. A meta‑analysis on the relationship between student abstinence‑only programs and sexual behavior and attitudes. Educ Urban Soc 2019:1‑18.

Stanger‑Hall KF, Hall DW. Abstinence‑only education and teen pregnancy rates: Why weneed comprehensive sex education in the US. PloS One 2011;6:10.


  • There are currently no refbacks.