Adolescent Knowledge, Acceptance, Uptake, and Challenges of Telemedicine for Sexual Reproductive Health in Lagos, Nigeria: A Cross-Sectional Study

Background: Low utilization of sexual and reproductive health (SRH) services among adolescents in sub-Saharan African countries has contributed to the high prevalence of adverse sexual and reproductive health outcomes, such as increased rates of sexually transmitted infections, teenage pregnancies, and limited use of modern contraception methods. In the last decade, telehealth has emerged as a tool to address barriers to SRH services, such as service availability, affordability, and distance to care—but despite its growing ubiquity, research on the usability and effectiveness of tele- health remains limited. This study assessed adolescents’ knowledge, acceptability, and challenges in using telemedicine for SRH services in Lagos, Nigeria. Methods: We conducted a cross-sectional study of adolescents aged 16-19 years from four public institutions of higher learning in Lagos, Nigeria. Self-administered paper-based questionnaires were used to assess study participant’s SRH-related characteristics. Descriptive analyses and risk ratios examined differences by age, gender, parental income, religion, sexual activity, and previous use of SRH care. Results: Among 505 students, 77% reported being sexually active. Knowledge of telemedicine for SRH care was reported by 25% (CI: 21, 29), but only 5% (CI: 3, 7) had ever used it. Fifty-two percent (CI: 47, 56) expressed willingness to use telemedicine, and 77% (CI: 73, 81) would recommend it to a peer. Sexually active participants had higher knowledge, uptake, and acceptability. Those who sought SRH care in the past 12 months were more likely to use telemedicine (Risk Ratio [RR (95% CI)]: 4.8 (2.2, 10.7)). Higher parental income was linked to increased telemedicine uptake. The most cited benefits of using telemedicine were ease of access (55%) and respect for privacy (50%). Challenges included concerns about virtual consultations (41%), internet access (15%), and affordability (14%). Conclusion : Despite limited knowledge and uptake of telemedicine for SRH care, adolescents expressed a strong willingness to use it. Creating awareness of the existence and feasibility of accessing care through telemedicine among adolescents and addressing barriers such as cost, and internet access is key to increasing its uptake.