Knowledge and Practice of Contraception Among Male Adolescents of High Schools in Kathmandu Metropolitan City

In the complex landscape of human health, few stages of life are as pivotal or as vulnerable as adolescence. It is a time defined by rapid physical growth and the emergence of independence, where young people begin to navigate their own sexual lives. Central to this journey is the concept of contraception, the intentional prevention of pregnancy through various methods, ranging from physical barriers to chemical agents. While the ability to prevent conception is a fundamental aspect of reproductive health, the knowledge required to use these methods effectively is not always present, particularly among young men. Globally, adolescents often possess the lowest levels of understanding regarding contraception, leaving them exposed to unintended pregnancies and health risks. In societies where family planning has traditionally focused on women, the role of men is frequently overlooked, creating a gap in education that can have lasting consequences for individuals and communities alike.

A recent investigation in Kathmandu, Nepal, sought to illuminate this specific gap by looking directly at the male students in high schools. Researchers gathered a group of 384 young men, aged roughly 17, from a mix of government and private institutions across the city. Their goal was not to judge, but to understand what these young men knew about preventing pregnancy and whether they were putting that knowledge into action. The team used a structured questionnaire, adapted from international standards, to ask questions about their understanding of different methods, their personal experiences, and how they communicated with their families about sensitive topics. The study took place over twelve days in early 2023, capturing a snapshot of the current reality for these students before they entered adulthood.

The findings revealed a landscape where information is often incomplete. While nearly all the students had heard of condoms, and most understood that a man could use one before sexual activity, deeper knowledge was surprisingly scarce. For instance, only a small fraction of the respondents knew that oral contraceptive pills must be taken every day to be effective. When the researchers scored the students on their overall understanding, less than half were able to demonstrate good knowledge. The majority fell short, indicating that while the idea of contraception is familiar, the practical details required to use it correctly are not. This lack of clarity was not evenly distributed; students attending private schools showed significantly better understanding than their peers in government schools, and older students knew more than younger ones.

The study also peeled back the curtain on the personal lives of these adolescents, revealing that a portion of them had already become sexually active. About one in five of the young men surveyed reported having had sex at some point. For many, this first experience happened between the ages of 14 and 18. Interestingly, when these students did engage in sexual activity, they were often prepared; the vast majority reported using some form of protection during their first time. However, this initial caution did not always translate into a consistent habit. As they continued their sexual lives, the use of protection dropped, with only a third reporting that they used contraception every time. This pattern suggests that while the initial spark of knowledge or fear might prompt protection, maintaining that behavior over time is a different challenge entirely.

Communication played a critical role in this picture, or rather, the lack of it. The study highlighted a profound silence within families regarding sexual health. The overwhelming majority of these young men had never discussed sex or contraception with their fathers, and very few had done so with their mothers. This absence of dialogue at home meant that the school environment became the primary, and often insufficient, source of information. The researchers noted that the type of school a student attended was a major factor in what they knew, with private institutions providing a much stronger foundation of knowledge than government schools. Yet, even with better knowledge, the link between knowing what to do and actually doing it consistently remained weak.

Ultimately, this research paints a clear picture of a generation that is navigating a critical life stage with incomplete maps. The young men in Kathmandu are not entirely unaware of the tools available to them, but their understanding is often fragmented, and their ability to apply that knowledge consistently is hindered by a lack of open conversation and structured education. The study concludes that the current level of knowledge is unsatisfactory and points to an urgent need for comprehensive sexual health education that is integrated directly into school curricula. It suggests that to truly protect the health and future of these adolescents, schools must do more than just provide information; they must foster an environment where young men can learn the skills to make safe decisions, supported by open communication with the adults in their lives.