HIV Prevention among Urban Teenage Students in Osun State, Nigeria: Exploring Gender Socialization and Health Literacy

Abstract

Early adolescence (ages 10–14 years) represents a critical developmental stage for shaping lifelong sexual and reproductive health behaviors, yet it remains understudied in HIV prevention research. In Nigeria, adolescent girls bear a disproportionate burden of new HIV infections, underscoring the role of gender norms in shaping HIV risk. This secondary analysis examined how gender socialization influenced HIV prevention health literacy among 715 in-school urban adolescents in Osun State, Nigeria between 2019 and 2021. Boys reported greater health literacy at baseline. However, sex-equitable outcomes and overall increases in health literacy scores at two-year endline highlight the potential of school-based interventions to reduce gender gaps in HIV knowledge and increase HIV prevention health literacy. Familial gender socialization was found to be significantly associated with health literacy. Adolescents with empowering gender socialization from their families reported greater health literacy than those with disempowering socialization. Peer and societal gender socialization showed no significant associations with health literacy. Findings highlight the importance of early, gender-responsive interventions that target family dynamics to improve HIV prevention among young adolescents.