Sexual well-being among young people in remote rural island communities in Scotland: a mixed methods study

Background
It has been identified that rural young people face barriers to accessing support for their sexual wellbeing such as availability and transport, knowing healthcare staff personally, and fear of being judged negatively within their community. These factors may contribute to widen health inequalities and expose young people living in rural areas to increased risk of poor sexual wellbeing. Little is known about the current needs of adolescents residing in remote rural island communities (RRICs).
Methods
A cross sectional mixed methods study was conducted with 473 adolescents aged 13-18 across the islands of the Outer Hebrides of Scotland. Analysis included descriptive, inferential statistics, and thematic analysis.
Results
59% (n=279) of participants held the perception there was no support, or did not know if there was support, about condoms and contraception in their local area. 48% (n=227) said that free condoms were not easily available for local young people. 60% (n=283) said they would not use youth services if they were locally available. 59 % (n=279) said they did not receive enough RSHP education. Opinion differed significantly by gender, school year group, and sexual orientation. Qualitative analysis identified 3 key themes (i) Alone yet visible, (ii) Silence and Disapproval, (iii) Safe Spaces, with an underpinning theme of Island Cultures.
Conclusions
A need for further sexual wellbeing support that addresses the complexities and challenges for young people residing in RRICs is identified. The intersectionality of being LGBT+ and residing in this context may increase the experience of inequality in sexual wellbeing support.