Abstract:
Contraceptive knowledge is essential for preventing unplanned pregnancies and Sexually Transmitted
Infections (STIs). Despite free family planning services in Sri Lanka, adolescents face
knowledge gaps. This study assesses contraceptive knowledge, attitudes, and practices among
Advanced Level (A/L) students in the Ratnapura District to identify disparities and improve
reproductive health education. A cross-sectional study was conducted among 304 A/L students
using stratified sampling. The sample consisted of 49.7% females (n = 151) and 50.3%
males (n = 153) from five academic streams (Mathematics 21.4%, Biology 22.4%, Technology
17.1%, Commerce 20.0%, Arts 19.1%). Data were collected using a structured questionnaire
and analysed using JASP (Version 0.19.1) with descriptive statistics and Chi-square tests. The
questionnaire was based on contraceptive knowledge, sexual health education, and related behaviours.
While 77% of students were aware of at least one contraceptive method, only 21%
correctly identified the effective time period for Emergency Contraceptive Pills (ECPs). Male
students exhibited higher contraceptive knowledge than female students (p<0.001). Students
from the Biology (61.77%) and Mathematics (52.3%) streams demonstrated higher contraceptive
knowledge. Social media was the primary source of contraceptive information, with 53.7%
citing it over other sources. While 69.6% of students supported sexual health education starting
from Grades 8–11, and 75.6% supported STI screening, actual contraceptive use (4.7%) and STI
screening rates (0.8%) were very low, indicating barriers to healthcare access and social stigma.
Further, 7.3% of students reported engaging in sexual activities. This study highlights the need
for improved sexual health education, especially for females and non-science stream students.
While the majority of the students are aware of contraceptive methods, detailed knowledge remains
low, and contraceptive use is limited despite awareness. STI screening rates are also
extremely low despite strong support. The results indicate barriers to access, social stigma, and
educational gaps that require targeted interventions.
