{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:34:19Z","timestamp":1792204459911,"version":"4.4.0"},"reference-count":58,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T00:00:00Z","timestamp":1613692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Adolescents are vulnerable to various sexual and reproductive health (SRH) problems such as unintended pregnancy, HIV or other sexually transmitted infections (STIs), and unsafe abortion. Adolescent-friendly health services offer SRH services such as SRH counseling, contraceptive services, STI and HIV services, and abortion-related services, which may help prevent these risks. Parent\u2013adolescent communication about SRH prevents adolescents from adopting unhealthy SRH practices. However, its association with the utilization of SRH services is less known. Therefore, this study examined the association between parent\u2013adolescent communication on SRH issues and the utilization of adolescent-friendly health services in Nepal.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This was a school-based, cross-sectional study conducted in Kailali district, Nepal, among students aged 15\u201319 years in Grade 11 and 12 from seven schools. We used multivariable logistic regression analysis to examine the association between parent\u2013adolescent communication and service utilization.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We analyzed the data from 594 students. Students with a higher score of parent\u2013adolescent communication on SRH were significantly more likely to use adolescent-friendly health services (adjusted odds ratio, AOR: 1.70, 95% Confidence Interval, CI: 1.29\u20132.23, p&lt;0.001). Those who reported having engaged in sexual intercourse in the past year were more likely to use services than those who did not (AOR: 29.11, 95% CI: 13.65\u201362.08, p&lt;0.001). Those who belonged to the Janajati ethnic group were more likely to use these services than those from the Brahmin\/Chhetri ethnic group (AOR: 2.86, 95% CI: 1.28\u20136.42, p = 0.01). Those living alone were less likely to use services than those living with both parents (AOR: 0.12, 95% CI: 0.02\u20130.66, p = 0.01).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Students with a higher score on parent\u2013adolescent communication on SRH were more likely to use adolescent-friendly health services. Thus, parental involvement in SRH communication could contribute to the use of adolescent-friendly health services and ultimately prevent negative SRH outcomes among students in late adolescence.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0246917","type":"journal-article","created":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T03:04:16Z","timestamp":1613790256000},"page":"e0246917","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":26,"title":["Parent\u2013adolescent communication on sexual and reproductive health and the utilization of adolescent-friendly health services in Kailali, Nepal"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2405-3628","authenticated-orcid":true,"given":"Bharat Raj","family":"Bhatta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6862-7860","authenticated-orcid":true,"given":"Junko","family":"Kiriya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Shibanuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masamine","family":"Jimba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,2,19]]},"reference":[{"key":"pone.0246917.ref001","author":"World Health Organization","year":"2018"},{"key":"pone.0246917.ref002","doi-asserted-by":"crossref","DOI":"10.18356\/1b5b217a-en","volume-title":"The state of world population 2014","author":"United Nations Population Fund","year":"2014"},{"key":"pone.0246917.ref003","volume-title":"Turning the tide against AIDS will require more concentrated focus on adolescents and young people","author":"United Nations Children\u2019s Fund","year":"2017"},{"key":"pone.0246917.ref004","doi-asserted-by":"crossref","first-page":"2423","DOI":"10.1016\/S0140-6736(16)00579-1","article-title":"Our future: a lancet commission on adolescent health and wellbeing","volume":"387","author":"GC Patton","year":"2016","journal-title":"Lancet"},{"key":"pone.0246917.ref005","doi-asserted-by":"crossref","first-page":"S22","DOI":"10.1016\/j.jadohealth.2014.09.012","article-title":"Effective strategies to provide adolescent sexual and reproductive health services and to increase demand and community support","volume":"56","author":"DM Denno","year":"2015","journal-title":"J Adolesc Health"},{"key":"pone.0246917.ref006","volume-title":"Making health services adolescent friendly, developing national quality standards for adolescent friendly health services","author":"World Health Organization","year":"2012"},{"key":"pone.0246917.ref007","author":"World Health Organization","year":"2002"},{"key":"pone.0246917.ref008","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1093\/her\/14.2.185","article-title":"Knowledge, risk perception of AIDS and reported sexual behaviour among students in secondary schools and colleges in Tanzania","volume":"14","author":"ES Maswanya","year":"1999","journal-title":"Health Educ Res"},{"key":"pone.0246917.ref009","first-page":"49","article-title":"Utilization of youth friendly services and associated factors in Mekelle town, Tigray, Northern Ethiopia","volume":"33","author":"K Kahsay","year":"2016","journal-title":"Int J Therap Appl"},{"key":"pone.0246917.ref010","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.1016\/S0020-7292(09)60049-7","article-title":"149 Contraception for adolescents and young people in the era of HIV\/AIDS","volume":"107","author":"E. 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