AUTHOR=Koumba Maguena Ruth-Janet , Alves Jorge Sara , Ngoungou Edgard Brice , Van den Broucke Stephan 

TITLE=Determinants of Adolescent Sexual Behavior in Sub-Saharan Africa: A Systematic Review of In-School and Out-of-School Adolescents

JOURNAL=Public Health Reviews

VOLUME=Volume 46 - 2025

YEAR=2025

URL=https://www.ssph-journal.org/journals/public-health-reviews/articles/10.3389/phrs.2025.1608357

DOI=10.3389/phrs.2025.1608357

ISSN=2107-6952

ABSTRACT=ObjectivesThis review aims to identify the main determinants of various sexual behaviors among in-school and out-of-school adolescents in sub-Saharan Africa, using Bronfenbrenner’s ecological system theory as a framework.MethodsA systematic review with narrative synthesis was performed of empirical studies about the determinants of sexual behavior among in-school and out-of-school adolescents aged 10 to 19 in sub-Saharan Africa, using quantitative data from Embase, PubMed, PsycInfo, SCOPUS, AJOL, and Google Scholar.ResultsA total of 132 studies were retrieved, identifying determinants of sexual behaviors such as sexual intercourse, sexual initiation at early age, multipartnership, condom use, contraceptive use, sexual abstinence, or sexual violence. Only four of these 132 studies involved out-of-school adolescents. Determinants of adolescent sexual behavior include demographic characteristics, socio-cognitive factors, problem behaviors, experiences, family relations, peers’ influence, relationships, school dynamics, education system, health system, information system, sociodemographic characteristics, socio-economic characteristics, religion, and societal values and norms.ConclusionTo design interventions that address adolescents’ sexual and reproductive health needs, public health policymakers must consider the multifaceted and interconnected determinants of sexual behaviors among in-school and out-of-school adolescents.