背景技术青少年的性健康至关重要,因为它为他们一生的性健康奠定了基础。马来西亚卫生部(MOH)主要提供性生殖健康(SRH)服务。除了卫生部,国家人口家庭发展委员会(NPFDB),在妇女部的职权范围内,马来西亚家庭和社区发展和生殖健康协会联合会,与卫生部密切合作,确保提供SRH信息和服务。尽管马来西亚有SRH服务,尚不确定年轻人是否意识到并使用这些服务。这项研究旨在确定影响马来西亚18-24岁青年使用SRH服务的因素。方法论这个基于网络的,横断面研究于2022年3月至2022年6月进行,使用自我管理的预先测试问卷.使用Andersen的卫生服务利用行为模型来识别调查中包含的变量。使用双变量和多变量逻辑回归模型来确定与SRH服务利用显着相关的因素。调整后的比值比(AOR)和95%置信区间(CI),p值<0.05被认为是统计学意义。结果共有617名18~24岁青少年参与调查。只有20.4%(n=126)的青少年一生中曾参观过SRH服务,在过去一年中,只有8.4%(n=52)的年轻人访问了SRH服务。诱发因素如年龄、婚姻状况,接触家庭和政府机构如NPFDB的SRH信息,SRH服务的可用性和舒适性等有利因素,和需求因素,如诊断为SRH相关疾病的年轻人,与SRH利用显著相关。与18-19岁年龄组相比,年龄较大的年龄组(20-24岁)更有可能使用SRH服务(AOR=1.634,95%CI=1.041,2.564,p=0.033)。已婚参与者使用SRH服务的可能性是单身参与者的三倍(AOR=2.910,95%CI=1.356,6.249,p=0.006)。使用电子烟的参与者使用SRH服务的几率更高(AOR=1.793,95%CI=1.014,3.174,p=0.045)暴露于家庭SRH信息的参与者组使用SRH服务的几率高于未从家庭接收SRH信息的参与者(AOR=1.964,95%CI=1.229,3.138,p=0.005)。同样,从政府机构获得SRH信息的参与者更有可能利用SRH服务(AOR=1.929,95%CI=1.202,3.095,p=0.006).与SRH利用率相关的启用因素是服务的可用性,描述为药店自购药(AOR=1.830,95%CI=1.184,2.855,p=0.007),和服务的舒适性(AOR=1.928,95%CI=1.250,2.974,p=0.003)。被诊断为SRH疾病(需求因素)的年轻人使用SRH服务的可能性是其四倍(AOR=4.490,95%CI=1.935,10.410,p<0.001)。结论马来西亚青少年的SRH服务利用率和认知度普遍较差,这是可以改进的。这项研究的结果可用于影响SRH提供者,以提供更多针对年龄的意识计划,以满足年轻人的各种SRH需求。
Background The sexual well-being of youths is crucial as it establishes the foundation for their sexual health throughout their lives. Malaysia\'s Ministry of Health (MOH) mainly delivers sexual reproductive health (SRH) services. Besides MOH, the National Population Family Development Board (NPFDB), under the purview of the Ministry of Women, Family and Community Development and Federation of Reproductive Health Association Malaysia, works closely with MOH to ensure the delivery of SRH information and services. Despite the availability of SRH services in Malaysia, it is uncertain whether youths are aware of and utilize these services. This study aims to identify factors that affect the utilization of SRH services among youths aged 18-24 years in Malaysia. Methodology This web-based, cross-sectional study was conducted from March 2022 to June 2022 using a self-administered pre-tested questionnaire. Andersen\'s Behavioral Model of Health Service Utilization was used to identify the variables included in the survey. Bivariate and multivariate logistic regression models were used to determine factors significantly associated with the utilization of SRH services. Adjusted odds ratio (AOR) and 95% confidence interval (CI) with a p-value <0.05 were considered to denote statistical significance. Results A total of 617 youths aged 18-24 years participated in the survey. Only 20.4% (n = 126) of youths had visited SRH services in their entire life, and only 8.4% (n = 52) of youths had visited SRH services in the past year. Predisposing factors such as age, marital status, exposure to SRH information from family and governmental agencies such as the NPFDB, enabling factors such as availability and comfort of SRH services, and need factors such as youths diagnosed with SRH-related diseases were significantly associated with SRH utilization. The older age group (20-24 years old) was more likely to utilize SRH services compared to the 18-19-year age group (AOR = 1.634, 95% CI = 1.041, 2.564, p = 0.033). Married participants were three times more likely to utilize SRH services than single participants (AOR = 2.910, 95% CI = 1.356, 6.249, p = 0.006). Participants who vaped had more odds of utilizing SRH services (AOR = 1.793, 95% CI = 1.014, 3.174, p = 0.045) The group of participants exposed to information on SRH from family had more odds of utilizing SRH service than those who did not receive information on SRH from the family (AOR = 1.964, 95% CI = 1.229, 3.138, p = 0.005). Likewise, participants who received SRH information from governmental agencies were more likely to utilize SRH services (AOR = 1.929, 95% CI = 1.202, 3.095, p = 0.006). Enabling factors that were associated with SRH utilization were the availability of services, described as self-buying medicine in pharmacies (AOR = 1.830, 95% CI = 1.184, 2.855, p = 0.007), and the comfortability of services (AOR = 1.928, 95% CI = 1.250, 2.974, p = 0.003). Youths who were diagnosed with SRH diseases (need factor) were four times more likely to utilize SRH services (AOR = 4.490, 95% CI = 1.935, 10.410, p < 0.001). Conclusions There is generally poor SRH service utilization and awareness among youths in Malaysia, which could be improved. The findings of this study can be used to influence SRH providers to offer a more age-targeted awareness program to meet the various SRH needs of youths.