{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T18:13:08Z","timestamp":1779387188468,"version":"3.53.1"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"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>Adolescent sexual and reproductive health (SRH) literacy remains uneven in conservative settings. We assessed SRH knowledge among female secondary-school students in Al-Madinah Al-Monawara and examined socio-demographic correlates and parent\u2013daughter communication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Cross-sectional survey of 389 students (grades 10\u201312) selected via stratified cluster sampling from government and private schools (20 June\u201320 July 2024). A validated Arabic questionnaire measured domain-specific SRH knowledge (menstruation, reproductive anatomy, contraception, sexual relationships), sexually transmitted disease (STD) awareness, and parent\u2013daughter communication. Analyses included\n                      <jats:italic>t<\/jats:italic>\n                      -tests\/ANOVA, Pearson correlations, and multivariable OLS with HC3-robust SEs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Knowledge gaps were concentrated in contraception and sexual relationships; 61 students incorrectly endorsed casual contact as a transmission route for STDs. Private-school students had higher composite SRH scores than government-school peers (\n                      <jats:italic>t<\/jats:italic>\n                      -test,\n                      <jats:italic>p\u2009&lt;\u20090.01<\/jats:italic>\n                      ). Maternal education correlated with SRH knowledge (\n                      <jats:italic>r\u2009=\u20090.38, p\u2009&lt;\u20090.001<\/jats:italic>\n                      ). Scores varied by age (ANOVA\n                      <jats:italic>F\u2009=\u20094.67, p\u2009=\u20090.009<\/jats:italic>\n                      ), but age was not an independent predictor in regression. In multivariable models, private-school attendance (\n                      <jats:italic>\u03b2\u2009=\u20090.212, p\u2009=\u20090.018<\/jats:italic>\n                      ) and higher maternal education (\n                      <jats:italic>\u03b2\u2009=\u20090.043, p\u2009=\u20090.019<\/jats:italic>\n                      ) independently predicted higher SRH knowledge; paternal education, age, and family size were non-significant. Parent\u2013daughter discussions were infrequent; 72% of students supported school-based SRH education.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SRH literacy among Saudi adolescent girls is uneven, with prominent misconceptions in contraception and transmission. School type and maternal education are actionable levers. Culturally attuned, standardized curricula\u2014especially in government schools\u2014combined with parent-focused communication supports are warranted to close knowledge gaps and reduce stigma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0347429","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T17:31:53Z","timestamp":1779384713000},"page":"e0347429","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adolescent sexual and reproductive health literacy in Saudi Arabia: The roles of school type and maternal education"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3145-2506","authenticated-orcid":true,"given":"Asma","family":"Alshanqiti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reem 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Central Saudi Arabia","volume":"33","author":"AM Alquaiz","year":"2012","journal-title":"Saudi Med J"},{"issue":"3","key":"pone.0347429.ref003","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1097\/jnr.0000000000000105","article-title":"Effects of reproductive health education on knowledge and attitudes among female adolescents in Saudi Arabia","volume":"23","author":"HMM Tork","year":"2015","journal-title":"Journal of Nursing Research"},{"issue":"1","key":"pone.0347429.ref004","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1186\/s12978-022-01408-8","article-title":"Parental communication on sexual and reproductive health issues to their adolescents and affecting factors at Asella town, Ethiopia: a community-based, cross-sectional study","volume":"19","author":"D Bekele","year":"2022","journal-title":"Reprod Health"},{"issue":"10","key":"pone.0347429.ref005","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1007\/s10964-010-9546-1","article-title":"Demographic and psychological predictors of parent-adolescent communication about sex: a representative statewide analysis","volume":"39","author":"P Jerman","year":"2010","journal-title":"J Youth Adolesc"},{"issue":"1","key":"pone.0347429.ref006","article-title":"Parent\u2013child communication about sexual and reproductive health: perspectives of Jordanian and Syrian parents","volume":"28","author":"A Othman","year":"2020","journal-title":"Sex Reprod Health Matters"},{"key":"pone.0347429.ref007","author":"PIG Sagnia","year":"2020","journal-title":"African Journal of Primary Health Care & Family Medicine"},{"issue":"1","key":"pone.0347429.ref008","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1001\/jamapediatrics.2015.2731","article-title":"Parent-Adolescent Sexual Communication and Adolescent Safer Sex Behavior: A Meta-Analysis","volume":"170","author":"L Widman","year":"2016","journal-title":"JAMA Pediatrics"},{"key":"pone.0347429.ref009","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s12978-016-0166-4","article-title":"Knowledge on legislation of abortion and experience of abortion among female youth in Nepal: A cross sectional study","volume":"13","author":"R Adhikari","year":"2016","journal-title":"Reprod Health"},{"issue":"1","key":"pone.0347429.ref010","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1186\/s12978-019-0778-6","article-title":"Reproductive health communication between mother and adolescent daughter in Bangladesh: a cross-sectional study","volume":"16","author":"M Zakaria","year":"2019","journal-title":"Reprod Health"},{"issue":"8","key":"pone.0347429.ref011","first-page":"53","article-title":"Knowledge, attitude and practice related to reproductive health among female adolescents","volume":"8","author":"SM Gaferi","year":"2018","journal-title":"J Nurs Educ Pract"},{"key":"pone.0347429.ref012","article-title":"Adolescents\u2019 attitudes toward gender roles and women\u2019s empowerment in Oman","volume":"11","author":"Y Bint","year":"2005","journal-title":"Eastern Mediterranean Health J"},{"key":"pone.0347429.ref013","doi-asserted-by":"crossref","DOI":"10.1787\/76df15a2-en","article-title":"Education in Saudi Arabia.","author":"OECD","year":"2020"},{"issue":"6","key":"pone.0347429.ref014","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.4103\/jfmpc.jfmpc_279_18","article-title":"Knowledge, readiness, and myths about menstruation among students at the Princess Noura University","volume":"7","author":"KK Alharbi","year":"2018","journal-title":"J Family Med Prim Care"},{"issue":"1","key":"pone.0347429.ref015","doi-asserted-by":"crossref","first-page":"1731296","DOI":"10.1080\/26410397.2020.1731296","article-title":"Sexually transmitted infection knowledge and attitudes among Muslim women worldwide: a systematic review","volume":"28","author":"N Alomair","year":"2020","journal-title":"Sex Reprod Health Matters"},{"issue":"1","key":"pone.0347429.ref016","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s12978-020-0888-1","article-title":"Factors influencing sexual and reproductive health of Muslim women: a systematic review","volume":"17","author":"N Alomair","year":"2020","journal-title":"Reprod Health"},{"issue":"3","key":"pone.0347429.ref017","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.jpag.2015.09.005","article-title":"Experience of menarche among jordanian adolescent girls: an interpretive phenomenological analysis","volume":"29","author":"O Al Omari","year":"2016","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"pone.0347429.ref018","doi-asserted-by":"crossref","unstructured":"Alquaiz AM, Kazi A, Al Muneef M. Determinants of sexual health knowledge in adolescent girls in schools of Riyadh-Saudi Arabia: a cross sectional study. 2013.","DOI":"10.1186\/1472-6874-13-19"},{"key":"pone.0347429.ref019","unstructured":"Al Sheeha M. Awareness and use of contraceptives among Saudi women attending primary care centers in Al-Qassim, Saudi Arabia. 2023."},{"issue":"2","key":"pone.0347429.ref020","first-page":"67","article-title":"Evaluation of Female Youth Educational Needs about Reproductive Health in Non-Medical Students in the City of Qom","volume":"7","author":"F Bazarganipour","year":"2013","journal-title":"J Family Reprod Health"},{"issue":"1","key":"pone.0347429.ref021","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.adolescence.2011.06.008","article-title":"Mother-daughter communication about sexual maturation, abstinence and unintended pregnancy: experiences from an informal settlement in Nairobi, Kenya","volume":"35","author":"J Crichton","year":"2012","journal-title":"J Adolesc"},{"issue":"3","key":"pone.0347429.ref022","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0193780","article-title":"Sexual and reproductive health outcomes are positively associated with comprehensive sexual education exposure in Mexican high-school students","volume":"13","author":"F de Castro","year":"2018","journal-title":"PLoS One"},{"issue":"25","key":"pone.0347429.ref023","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/S0968-8080(05)25181-9","article-title":"The sexual and reproductive health of young people in the Arab countries and Iran","volume":"13","author":"J DeJong","year":"2005","journal-title":"Reprod Health Matters"},{"issue":"2","key":"pone.0347429.ref024","doi-asserted-by":"crossref","first-page":"198","DOI":"10.4103\/UA.UA_14_17","article-title":"Knowledge and attitude about sexually transmitted diseases among youth in Saudi Arabia","volume":"10","author":"HS El-Tholoth","year":"2018","journal-title":"Urol Ann"},{"issue":"5","key":"pone.0347429.ref025","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002803","article-title":"Women\u2019s and girls\u2019 experiences of menstruation in low- and middle-income countries: A systematic review and qualitative metasynthesis","volume":"16","author":"J Hennegan","year":"2019","journal-title":"PLoS Med"},{"issue":"6","key":"pone.0347429.ref026","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1080\/14681811.2020.1843424","article-title":"How should school-based sex education be provided for adolescents in Saudi Arabia? Views of stakeholders","volume":"21","author":"N Horanieh","year":"2020","journal-title":"Sex Education"},{"issue":"4","key":"pone.0347429.ref027","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1080\/14681811.2019.1669150","article-title":"Abstinence versus harm reduction approaches to sexual health education: views of key stakeholders in Saudi Arabia","volume":"20","author":"N Horanieh","year":"2019","journal-title":"Sex Education"},{"issue":"5","key":"pone.0347429.ref028","doi-asserted-by":"crossref","first-page":"3177","DOI":"10.7314\/APJCP.2013.14.5.3177","article-title":"Prevalence of human papillomavirus in women from Saudi Arabia","volume":"14","author":"R Turki","year":"2013","journal-title":"Asian Pac J Cancer Prev"},{"issue":"4","key":"pone.0347429.ref029","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1136\/jfprhc-2013-100856","article-title":"Iranian adolescent girls\u2019 barriers in accessing sexual and reproductive health information and services: a qualitative study","volume":"40","author":"M Shariati","year":"2014","journal-title":"J Fam Plann Reprod Health Care"},{"issue":"1","key":"pone.0347429.ref030","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1093\/her\/cyt071","article-title":"Accessing sexual health information online: use, motivations and consequences for youth with different sexual orientations","volume":"29","author":"KJ Mitchell","year":"2014","journal-title":"Health Educ Res"},{"issue":"3","key":"pone.0347429.ref031","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1080\/13557858.2016.1263285","article-title":"\u201cIf I went to my mom with that information, I\u2019m dead\u201d: sexual health knowledge barriers among immigrant and refugee Somali young adults in Ohio","volume":"23","author":"C Kingori","year":"2018","journal-title":"Ethn Health"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0347429","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T17:32:01Z","timestamp":1779384721000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0347429"}},"subtitle":[],"editor":[{"given":"Laura","family":"Brunelli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":31,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0347429","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,21]]}}}