Work

Sexual and reproductive health knowledge and HBsAg positivity among adolescents and young adults in Benguela Province, Angola: a pooled cross-sectional study

Year: 2026

Type: article

Abstract: Background: Sexual and reproductive health (SRH) knowledge is a key determinant of health outcomes among adolescents and young adults, particularly in low- and middle-income countries. In Angola, young people continue to face substantial SRH challenges, including early childbearing and a high burden of sexually transmitted infections (STIs), yet subnational data remain limited. Objective: To characterise SRH knowledge, sexual behaviours, and STI profiles among adolescents and young adults aged 15–25 years in Benguela Province, Angola. Methods: We conducted a pooled cross-sectional analysis of two independent community-based surveys carried out in 2021 and 2024 in four municipalities of Benguela Province. Participants were recruited through outreach activities in public and community settings. SRH knowledge was assessed using a structured questionnaire, and point-of-care testing was offered for HIV (Alere Determine HIV1/2 antibodies, Abbott), hepatitis B surface antigen (HBsAg) (HBsAg, Nantong diagnosis Biotech-nology), hepatitis C virus (HCV), and syphilis (Treponema pallidum antibodies, Nantong Diagnos Biotechnology). Due to substantial sociodemographic differences between survey rounds, data were pooled and analysed as a single cross-sectional dataset. Multivariate logistic regression was used to identify factors associated with adequate SRH knowledge and HBsAg positivity. Results: A total of 2,802 adolescents and young adults were included. Adequate SRH knowledge was significantly associated with older age, higher educational attainment, and urban residence. While the prevalence of HIV, syphilis, and HCV was low, a high proportion of participants tested positive for HBsAg. HBsAg positivity was more frequent among males and among participants residing in Cubal and Benguela municipalities. Conclusions: Important inequalities in SRH knowledge persist among adolescents and young adults in Benguela Province, particularly affecting younger, with lower education level, and rural populations. The high proportion of HBsAg positivity highlights the need to strengthen hepatitis B prevention strategies, including catch-up vaccination, expanded screening, and integration of HBV services into youth-friendly SRH programmes. These findings underscore the importance of equitable access to SRH information and services to reduce preventable health risks among young people in Angola.

Source: BMC Public Health

DOI: 10.1186/s12889-026-30068-7