Sexual Health Literacy Level and Associated Sociodemographic Factors among Sri Lankan Adolescents: A Cross‑sectional Analysis of Selected Urban and Rural Areas in Kandy District

Introduction: This study addresses a gap in the existing literature by investigating the sexual health literacy (SHL) of adolescents in the Kandy district of Sri Lanka. Methods: This was conducted in 2022 as a cross-sectional analysis study, it involved 1690 students aged 14–18 using multistage cluster sampling. Participants completed a self-administered questionnaire on SHL, and scores were calculated based on the HLS-EU Sinhala version. Results: Of 1675 adolescents, 49.6% lived in rural areas and 50.4% lived in urban areas. 52.5% were females and 47.5% were males. 14–16 years old were 59.8% and 17%–18% were 40.2%. The mean age was 14.0 years (standard deviation = 0.49). Regarding socioeconomic status, 46.4% (n = 777) were in the upper and lower quintiles. The results revealed that 47.4% of the total respondents exhibited limited SHL. Rural youth have significantly higher levels of limited SHL compared to their urban counterparts. The factors associated with SHL were identified through logistic regression as an urban residence (odds ratio [OR] = 0.61) and older age (17–18) (OR = 0.65) was negatively associated with limited SHL. Conclusion: These findings underscore the need for targeted and comprehensive sexuality education programs tailored to the specific needs of rural adolescents in Sri Lanka.