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            <front>

                <journal-meta>
                                                                <journal-id>pam med j</journal-id>
            <journal-title-group>
                                                                                    <journal-title>Pamukkale Medical Journal</journal-title>
            </journal-title-group>
                                        <issn pub-type="epub">1308-0865</issn>
                                                                                            <publisher>
                    <publisher-name>Pamukkale University</publisher-name>
                </publisher>
                    </journal-meta>
                <article-meta>
                                        <article-id pub-id-type="doi">10.31362/patd.1733682</article-id>
                                                                <article-categories>
                                            <subj-group  xml:lang="en">
                                                            <subject>Public Health (Other)</subject>
                                                    </subj-group>
                                            <subj-group  xml:lang="tr">
                                                            <subject>Halk Sağlığı (Diğer)</subject>
                                                    </subj-group>
                                    </article-categories>
                                                                                                                                                        <title-group>
                                                                                                                        <article-title>Sexual and reproductive health stigma and associated factors among female medical students at Pamukkale University: a cross-sectional survey</article-title>
                                                                                                                                                                                                <trans-title-group xml:lang="tr">
                                    <trans-title>Pamukkale Üniversitesi Tıp Fakültesi’nde öğrenim gören kadın tıp öğrencilerinin perspektifinden cinsel ve üreme sağlığı damgalanması ve ilişkili etmenler: kesitsel bir çalışma</trans-title>
                                </trans-title-group>
                                                                                                    </title-group>
            
                                                    <contrib-group content-type="authors">
                                                                        <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0000-0002-3231-8123</contrib-id>
                                                                <name>
                                    <surname>Sevinç</surname>
                                    <given-names>Özgür</given-names>
                                </name>
                                                                    <aff>PAMUKKALE UNIVERSITY</aff>
                                                            </contrib>
                                                    <contrib contrib-type="author">
                                                                    <contrib-id contrib-id-type="orcid">
                                        https://orcid.org/0009-0005-0267-0950</contrib-id>
                                                                <name>
                                    <surname>Peşdere</surname>
                                    <given-names>Simge</given-names>
                                </name>
                                                                    <aff>PAMUKKALE ÜNİVERSİTESİ, TIP FAKÜLTESİ</aff>
                                                            </contrib>
                                                                                </contrib-group>
                        
                                        <pub-date pub-type="pub" iso-8601-date="20260413">
                    <day>04</day>
                    <month>13</month>
                    <year>2026</year>
                </pub-date>
                                        <volume>19</volume>
                                        <issue>2</issue>
                                        <fpage>429</fpage>
                                        <lpage>441</lpage>
                        
                        <history>
                                    <date date-type="received" iso-8601-date="20250703">
                        <day>07</day>
                        <month>03</month>
                        <year>2025</year>
                    </date>
                                                    <date date-type="accepted" iso-8601-date="20251001">
                        <day>10</day>
                        <month>01</month>
                        <year>2025</year>
                    </date>
                            </history>
                                        <permissions>
                    <copyright-statement>Copyright © 2008, Pamukkale Medical Journal</copyright-statement>
                    <copyright-year>2008</copyright-year>
                    <copyright-holder>Pamukkale Medical Journal</copyright-holder>
                </permissions>
            
                                                                                                <abstract><p>Purpose: The aim of this study is to evaluate the perceptions of stigmatization regarding sexual and reproductive health and the associated factors among female students at Pamukkale University Faculty of Medicine.Materials and methods: This study is a cross-sectional research conducted at Pamukkale University Faculty of Medicine between February 17 and 27, 2025. The study population consisted of 850 female students enrolled in the 2024–2025 academic year, and based on the sample size calculation performed using the G*Power program, a minimum of 369 participants was determined. A convenience sampling method was employed. The dependent variable of the study was the Sexual and Reproductive Health Stigmatization Scale in Young Women. Data were collected through Google Forms. Higher total scores obtained from the scale indicate increased stigmatizing attitudes toward sexual and reproductive health. The minimum possible score on the scale is 0, while the maximum score is 20.Results: Female students scored 7.20±2.98 points on the scale. Approximately 25.2% (n=93) of the participants reported obtaining their basic knowledge on sexual matters from friends, while 26.6% (n=98) stated that their families exert pressure on their freedom of life and worldview. Within the family context, about 82.3% (n=304) indicated that sexual health issues were not discussed. The stigmatization score of those who obtained basic knowledge from their families (6.58±3.64) was significantly lower compared to those who obtained information from websites (7.75±2.78) (p=0.024); on the other hand, the stigmatization score of participants who perceived family pressure (8.13±2.61) was significantly higher (p&amp;lt;0.001).Conclusion: The sexual and reproductive health stigmatization scores of female students were below the moderate level. This finding indicates that even medical education does not completely eliminate stigmatization.</p></abstract>
                                                                                                                                    <trans-abstract xml:lang="tr">
                            <p>Amaç: Bu çalışmada, Pamukkale Üniversitesi Tıp Fakültesi’ndeki kadın öğrencilerin cinsel ve üreme sağlığına dair damgalama algıları ve etkileyen faktörlerin değerlendirilmesi amaçlanmaktadır.Gereç ve yöntem: Pamukkale Üniversitesi Tıp Fakültesi’nde 17-27 Şubat 2025 tarihleri arasında gerçekleştirilen kesitsel bir çalışmadır. 2024-2025 akademik yılında öğrenim gören 850 kadın öğrenci evreni oluştururken, G*Power programı kullanılarak yapılan örneklem hesabında, minimum 369 katılımcı belirlenmiştir. Kolayda örnekleme yöntemi kullanılmıştır. Araştırmanın bağımlı değişkeni, Genç Kadınlarda Cinsel ve Üreme Sağlığı Damgalama Ölçeği’dir. Veriler, Google Forms üzerinden toplanmıştır. Ölçekten alınan toplam puanın artması cinsel ve üreme sağlığına yönelik damgalama tutumunun arttığını göstermektedir. Ölçekten alınabilecek en düşük puan “0”, en yüksek puan “20”dir.Bulgular: Kadın öğrenciler ölçekten 7,20±2,98 puan almışlardır. Katılımcıların yaklaşık %25,2’si (n=93) cinsel konularla ilgili temel bilgilerini arkadaşlarından edinmekte, %26,6&#039;sı (n=98) ise ailelerinin yaşam özgürlüğü ve dünya görüşü üzerinde baskı oluşturduğunu düşünmektedir. Aile içinde, katılımcıların yaklaşık %82,3&#039;ü (n=304) cinsel sağlık konularının tartışılmadığını belirtmiştir. Temel bilgiyi aileden edinenlerin damgalama puanı (6,58±3,64), web sitelerinden bilgi alanlara (7,75±2,78) göre anlamlı olarak daha düşük (p=0,024); aile baskısı algısı olanların damgalama puanı (8,13±2,61) ise anlamlı derecede daha yüksektir (p&amp;lt;0,001).Sonuç: Kadın öğrencilerin cinsel ve üreme sağlığı damgalama puanları orta düzeyin altındadır. Bu durum tıp eğitiminin dahi damgalamayı tam olarak ortadan kaldırmadığını göstermektedir.</p></trans-abstract>
                                                            
            
                                                            <kwd-group>
                                                    <kwd>Sexual and reproductive health</kwd>
                                                    <kwd>  stigmatization</kwd>
                                                    <kwd>  sexual health</kwd>
                                                    <kwd>  stigmatization of sexual and reproductive health among women</kwd>
                                            </kwd-group>
                                                        
                                                                            <kwd-group xml:lang="tr">
                                                    <kwd>Cinsel üreme sağlığı</kwd>
                                                    <kwd>  damgalama</kwd>
                                                    <kwd>  cinsel sağlık</kwd>
                                                    <kwd>  kadınlarda cinsel üreme sağlığı damgalamasI</kwd>
                                            </kwd-group>
                                                                                                            </article-meta>
    </front>
    <back>
                            <ref-list>
                                    <ref id="ref1">
                        <label>1</label>
                        <mixed-citation publication-type="journal">Scavello I, Maseroli E, Di Stasi V, Vignozzi L. Sexual health in menopause. Medicina (Kaunas). 2019;55(9):559. doi:10.3390/medicina55090559</mixed-citation>
                    </ref>
                                    <ref id="ref2">
                        <label>2</label>
                        <mixed-citation publication-type="journal">Marcell AV, Burstein GR, Committee on Adolescence. Sexual and reproductive health care services in the pediatric setting. Pediatrics. 2017;140(6):e20172858. doi:10.1542/peds.2017-2858</mixed-citation>
                    </ref>
                                    <ref id="ref3">
                        <label>3</label>
                        <mixed-citation publication-type="journal">World Health Organization. Sexual health. Geneva: World Health Organization; 2018. Available at: https://www.who.int/health-topics/sexual-health#tab=tab_1. Accessed February 18, 2025</mixed-citation>
                    </ref>
                                    <ref id="ref4">
                        <label>4</label>
                        <mixed-citation publication-type="journal">Duman BN, Yilmazel G, Topuz S, Basci AB, Kocak YD, Buyukgonenc L. The knowledge, attitudes and behaviours of university youth regarding reproductive and sexual health. Yildirim Beyazit Univ Fac Health Sci Nurs E-Journal. 2015;3:19-32.</mixed-citation>
                    </ref>
                                    <ref id="ref5">
                        <label>5</label>
                        <mixed-citation publication-type="journal">United Nations Fund for Population Activities. Adolescent and youth demographics: a brief overview. Available at: https://www.unfpa.org/sites/default/files/resource-pdf/One%20pager%20on%20youth%20demographics%20GF.pdf. Accessed February 25, 2025</mixed-citation>
                    </ref>
                                    <ref id="ref6">
                        <label>6</label>
                        <mixed-citation publication-type="journal">McManus A, Dhar L. Study of knowledge, perception and attitude of adolescent girls towards STIs/HIV, safer sex and sex education: a cross-sectional survey of urban adolescent school girls in South Delhi, India. BMC Womens Health. 2008;8(12):1-6. doi:10.1186/1472-6874-8-12</mixed-citation>
                    </ref>
                                    <ref id="ref7">
                        <label>7</label>
                        <mixed-citation publication-type="journal">Kyilleh JM, Tabong PTN, Konlaan BB. Adolescents’ reproductive health knowledge, choices and factors affecting reproductive health choices: a qualitative study in the West Gonja District in Northern Region, Ghana. BMC Int Health Hum Rights. 2018;18(6):1-12. doi:10.1186/s12914-018-0147-5</mixed-citation>
                    </ref>
                                    <ref id="ref8">
                        <label>8</label>
                        <mixed-citation publication-type="journal">Lim MS, Zhang XD, Kennedy E, et al. Sexual and reproductive health knowledge, contraception uptake, and factors associated with unmet need for modern contraception among adolescent female sex workers in China. PLoS One. 2015;10(1):1-17. doi:10.1371/journal.pone.0115435</mixed-citation>
                    </ref>
                                    <ref id="ref9">
                        <label>9</label>
                        <mixed-citation publication-type="journal">Tenore JL, Lipsky MS. Preventive services for the adolescent (13-20 years). Clin Fam Pract. 2000;2(2):289-311. doi:10.1016/S1522-5720(05)70020-9</mixed-citation>
                    </ref>
                                    <ref id="ref10">
                        <label>10</label>
                        <mixed-citation publication-type="journal">Koluacik S, Gunes G, Pehlivan E. Knowledge levels and service expectations regarding reproductive health among Inonu University students. Inonu Univ Fac Med J. 2010;17(1):7-14.</mixed-citation>
                    </ref>
                                    <ref id="ref11">
                        <label>11</label>
                        <mixed-citation publication-type="journal">Kocak DY, Duman NB, Topuz S, Yilmazel G, Gungor T, Basci AB. Knowledge, attitudes, and behaviors regarding emergency contraception among women of reproductive age. J Gynecol Obstet Neonatol Med. 2016;138(3):112-116.</mixed-citation>
                    </ref>
                                    <ref id="ref12">
                        <label>12</label>
                        <mixed-citation publication-type="journal">Atan SU, Tasci Duran E, Sen S, Bolsoy N, Sevil U. University students’ knowledge, opinions, and practices regarding sexuality and family planning methods. Ege Univ Fac Nurs J. 2012;28(1):13-25.</mixed-citation>
                    </ref>
                                    <ref id="ref13">
                        <label>13</label>
                        <mixed-citation publication-type="journal">Bayrakceken E, Eryilmaz G. Validity and reliability of the Turkish version of the Stigma Scale for Sexual and Reproductive Health in Young Women. Int J Caring Sci. 2021;14(3):1961-1969. Available at: http://www.internationaljournalofcaringsciences.org/docs/45_esra_original_14_3.pdf. Accessed August 22, 2025</mixed-citation>
                    </ref>
                                    <ref id="ref14">
                        <label>14</label>
                        <mixed-citation publication-type="journal">Goffman E. Stigma: Notes on the Management of Spoiled Identity. New York: Simon and Schuster; 1963. Available at: https://archive.org/details/stigmanotesonma00goff. Accessed February 27, 2025</mixed-citation>
                    </ref>
                                    <ref id="ref15">
                        <label>15</label>
                        <mixed-citation publication-type="journal">Link BG, Phelan JC. Conceptualizing stigma. Annu Rev Sociol. 2001;27:363-385. doi:10.1146/annurev.soc.27.1.363</mixed-citation>
                    </ref>
                                    <ref id="ref16">
                        <label>16</label>
                        <mixed-citation publication-type="journal">Hussein J, Ferguson L. Eliminating stigma and discrimination in sexual and reproductive health care: a public health imperative. Sex Reprod Health Matters. 2019;27(3):1-5. doi:10.1080/26410397.2019.1697103</mixed-citation>
                    </ref>
                                    <ref id="ref17">
                        <label>17</label>
                        <mixed-citation publication-type="journal">Cook RJ, Cusack S, Dickens BM. Unethical female stereotyping in reproductive health. Int J Gynecol Obstet. 2010;109(3):255-258. doi:10.1016/j.ijgo.2010.02.002</mixed-citation>
                    </ref>
                                    <ref id="ref18">
                        <label>18</label>
                        <mixed-citation publication-type="journal">Watts C, Hossain M, Zimmerman C. War and sexual violence – mental health care for survivors. N Engl J Med. 2013;368(23):2152-2154. doi:10.1056/NEJMp1304712</mixed-citation>
                    </ref>
                                    <ref id="ref19">
                        <label>19</label>
                        <mixed-citation publication-type="journal">Starrs AM, Ezeh AC, Barker G, et al. Accelerate progress—sexual and reproductive health and rights for all: report of the Guttmacher Lancet Commission. Lancet. 2018;391(10140):2642-2692. doi:10.1016/S0140-6736(18)30293-9</mixed-citation>
                    </ref>
                                    <ref id="ref20">
                        <label>20</label>
                        <mixed-citation publication-type="journal">Bilge A, Cam O. Combating stigma toward mental illness. TAF Prev Med Bull. 2010;9(1):71-78. Available at: https://www.bibliomed.org/mnsfulltext/1/khb_009_01-71.pdf?1630240389. Accessed February 19, 2025</mixed-citation>
                    </ref>
                                    <ref id="ref21">
                        <label>21</label>
                        <mixed-citation publication-type="journal">Cam O, Cuhadar D. The process of stigmatization and internalized stigma among individuals with mental illness. Psychiatr Nurs J. 2011;2(3):136-140. Available at: https://jag.journalagent.com/phd/pdfs/PHD_2_3_136_140.pdf. Accessed February 22, 2025</mixed-citation>
                    </ref>
                                    <ref id="ref22">
                        <label>22</label>
                        <mixed-citation publication-type="journal">Taskin E. Stigmatizing attitudes toward mental illness and stigmatization. In: Taskin EO, ed. Attitudes and Stigma Toward Mental Illness in Turkey. 1st ed. Izmir: Meta Printing; 2007:255-278. (In Turkish). [URL]. Accessed February 24, 2025</mixed-citation>
                    </ref>
                                    <ref id="ref23">
                        <label>23</label>
                        <mixed-citation publication-type="journal">Saewyc EM, Poon CS, Homma Y, Skay CL. Stigma management? The links between enacted stigma and teen pregnancy trends among gay, lesbian, and bisexual students in British Columbia. Can J Hum Sex. 2008;17(3):123-139. doi:10.3138/cjhs.17.3.123</mixed-citation>
                    </ref>
                                    <ref id="ref24">
                        <label>24</label>
                        <mixed-citation publication-type="journal">Cook RJ, Dickens BM. Reducing stigma in reproductive health. Int J Gynecol Obstet. 2014;125(1):89-92. doi:10.1016/j.ijgo.2014.01.002</mixed-citation>
                    </ref>
                                    <ref id="ref25">
                        <label>25</label>
                        <mixed-citation publication-type="journal">Bohren MA, Vazquez Corona M, Odiase OJ, et al. Strategies to reduce stigma and discrimination in sexual and reproductive healthcare settings: a mixed-methods systematic review. PLOS Glob Public Health. 2022;2(6):e0000582. doi:10.1371/journal.pgph.0000582</mixed-citation>
                    </ref>
                                    <ref id="ref26">
                        <label>26</label>
                        <mixed-citation publication-type="journal">Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2018. Atlanta: US Department of Health and Human Services; 2019. Available at: https://www.cdc.gov/sti/statistics/2018/. Accessed February 24, 2025</mixed-citation>
                    </ref>
                                    <ref id="ref27">
                        <label>27</label>
                        <mixed-citation publication-type="journal">Hall KS, Kusunoki Y, Gatny H, Barber J. Social discrimination, stress, and risk of unintended pregnancy among young women. J Adolesc Health. 2015;56(3):330-337. doi:10.1016/j.jadohealth.2014.11.008</mixed-citation>
                    </ref>
                                    <ref id="ref28">
                        <label>28</label>
                        <mixed-citation publication-type="journal">Rueda S, Park Wyllie LY, Bayoumi AM, et al. Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: a series of meta-analyses. BMJ Open. 2016;6(7):e011453. doi:10.1136/bmjopen-2016-011453</mixed-citation>
                    </ref>
                                    <ref id="ref29">
                        <label>29</label>
                        <mixed-citation publication-type="journal">Hacettepe University Institute of Population Studies, United Nations Population Fund (UNFPA). Turkey youth survey: sexual health, reproductive health and child, early and forced marriages among youth. Ankara: UNFPA; 2023. Available at: https://turkiye.unfpa.org/en/2023_TR_Youth_Research_Key_Findings#:~:text=The%20findings%20highlight%20the%20need,from%20diverse%20backgrounds%20across%20T%C3%BCrkiye</mixed-citation>
                    </ref>
                                    <ref id="ref30">
                        <label>30</label>
                        <mixed-citation publication-type="journal">Charlton BM, Hatzenbuehler ML, Jun HJ, et al. Structural stigma and sexual orientation-related reproductive health disparities in a longitudinal cohort study of female adolescents. J Adolesc. 2019;74:183-187. doi:10.1016/j.adolescence.2019.06.008</mixed-citation>
                    </ref>
                                    <ref id="ref31">
                        <label>31</label>
                        <mixed-citation publication-type="journal">World Health Organization. HIV/AIDS: addressing stigma and discrimination. Available at: https://www.emro.who.int/asd/asd-infocus/hiv-basic-knowledge-and-stigma-reduction-in-health-care-settings.html. Accessed February 27, 2025</mixed-citation>
                    </ref>
                                    <ref id="ref32">
                        <label>32</label>
                        <mixed-citation publication-type="journal">Hindin MJ, Christiansen CS, Ferguson BJ. Setting research priorities for adolescent sexual and reproductive health in low- and middle-income countries. Bull World Health Organ. 2013;91(1):10-18. doi:10.2471/BLT.12.107565</mixed-citation>
                    </ref>
                                    <ref id="ref33">
                        <label>33</label>
                        <mixed-citation publication-type="journal">Singh S, Sedgh G, Hussain R. Unintended pregnancy: worldwide levels, trends, and outcomes. Stud Fam Plann. 2010;41(4):241-250. doi:10.1111/j.1728-4465.2010.00250.x</mixed-citation>
                    </ref>
                                    <ref id="ref34">
                        <label>34</label>
                        <mixed-citation publication-type="journal">Nmadu A, Mohamed S, Usman N. Adolescents’ utilization of reproductive health services in Kaduna, Nigeria: the role of stigma. Vulnerable Child Youth Stud. 2020;15(3):246-256. doi:10.1080/17450128.2020.1800156</mixed-citation>
                    </ref>
                                    <ref id="ref35">
                        <label>35</label>
                        <mixed-citation publication-type="journal">Ikiisik H, Ari A, Basibuyuk HF, Biyik K, Erdem AE, Maral I. An assessment of medical students’ level of knowledge about reproductive health and family planning. Anatol Clin J Med Sci. 2019;24(2):147-154. doi:10.21673/anadoluklin.514316</mixed-citation>
                    </ref>
                                    <ref id="ref36">
                        <label>36</label>
                        <mixed-citation publication-type="journal">Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-191. doi:10.3758/BF03193146</mixed-citation>
                    </ref>
                                    <ref id="ref37">
                        <label>37</label>
                        <mixed-citation publication-type="journal">Bakir N, Vural PI, Demir C. Stigmatization in sexual and reproductive health from the perspective of young women. Androl Bul. 2021;23(3):146-153. doi:10.24898/tandro.2021.10438</mixed-citation>
                    </ref>
                                    <ref id="ref38">
                        <label>38</label>
                        <mixed-citation publication-type="journal">Hall KS, Manu A, Morhe E, et al. Development and validation of a scale to measure adolescent sexual and reproductive health stigma: results from young women in Ghana. J Sex Res. 2018;55(1):60-72. doi:10.1080/00224499.2017.1292493</mixed-citation>
                    </ref>
                                    <ref id="ref39">
                        <label>39</label>
                        <mixed-citation publication-type="journal">Yildiz M, Yildirim MS, Okyar G. Determination of sexual and reproductive health stigmatization levels of young women. Anatol J Fam Med. 2020;3(3):254-259. doi:10.5505/anatoljfm.2020.36349</mixed-citation>
                    </ref>
                                    <ref id="ref40">
                        <label>40</label>
                        <mixed-citation publication-type="journal">Dagli E, Reyhan FA. Stigmatization in women&#039;s sexual and reproductive health: the case of midwifery students. Mersin Univ Fac Med Lokman Hekim J Med Hist Folklor Med. 2024;14(1):141-149. doi:10.31020/mutftd.1358849</mixed-citation>
                    </ref>
                                    <ref id="ref41">
                        <label>41</label>
                        <mixed-citation publication-type="journal">Polat F, Senol DK. Examining the correlation between sexual and reproductive health stigmatization level and gender perception: a case of a university in Turkey—a descriptive cross-sectional study. Sao Paulo Med J. 2022;141(2):146-153. doi:10.1590/1516-3180.2022.0278.03062022</mixed-citation>
                    </ref>
                                    <ref id="ref42">
                        <label>42</label>
                        <mixed-citation publication-type="journal">Hall KS, Morhe E, Manu A, et al. Factors associated with sexual and reproductive health stigma among adolescent girls in Ghana. PLoS One. 2018;13(4):e0195163. doi:10.1371/journal.pone.0195163</mixed-citation>
                    </ref>
                                    <ref id="ref43">
                        <label>43</label>
                        <mixed-citation publication-type="journal">Parker R, Aggleton P. HIV- and AIDS-related stigma and discrimination: a conceptual framework and implications for action. In: Parker R, Aggleton P, eds. Culture, Society and Sexuality. London, UK: Routledge; 2007:459-474. doi:10.4324/9780203966105-42</mixed-citation>
                    </ref>
                                    <ref id="ref44">
                        <label>44</label>
                        <mixed-citation publication-type="journal">Widman L, Choukas-Bradley S, Noar SM, Nesi J, Garrett K. Parent-adolescent sexual communication and adolescent safer sex behavior: a meta-analysis. JAMA Pediatr. 2016;170(1):52-61. doi:10.1001/jamapediatrics.2015.2731</mixed-citation>
                    </ref>
                                    <ref id="ref45">
                        <label>45</label>
                        <mixed-citation publication-type="journal">Grossman JM, Pearce N, Richer AM. The family system of sexuality communication: extended family perceptions of adolescent-family talk about sex, with sibling and non-sibling comparison. Sexes. 2021;2(1):1-16. doi:10.3390/sexes2010001</mixed-citation>
                    </ref>
                                    <ref id="ref46">
                        <label>46</label>
                        <mixed-citation publication-type="journal">World Health Organization. Documents on adolescent health. 2011. Available at: http://www.who.int/maternal_child_adolescent/documents/adolescent/en/. Accessed February 28, 2025</mixed-citation>
                    </ref>
                                    <ref id="ref47">
                        <label>47</label>
                        <mixed-citation publication-type="journal">White A, Boehm M, Glackin E, Bleakley A. How sexual information sources are related to emerging adults’ sex‑positive scripts and sexual communication. Sexuality Cult. 2023;27(4):1224-1245. doi:10.1007/s12119-022-10061-z</mixed-citation>
                    </ref>
                                    <ref id="ref48">
                        <label>48</label>
                        <mixed-citation publication-type="journal">Olawade DB, Asaolu AJ, Adebisi YA, Asaolu FT, Odetayo A, David Olawade AC. The realities of adolescent sexual behaviours in Nigeria: a narrative review. Afr Health Sci. 2024;24(2):273-282. doi:10.4314/ahs.v24i2.30</mixed-citation>
                    </ref>
                                    <ref id="ref49">
                        <label>49</label>
                        <mixed-citation publication-type="journal">Chou WJ, Liu TL, Hsiao RC, Yen CF. Online sexual risk behaviors in adolescents: roles of family relationships, impulsivity, and attention-deficit/hyperactivity disorder. Children. 2024;11(10):1199. doi:10.3390/children11101199</mixed-citation>
                    </ref>
                                    <ref id="ref50">
                        <label>50</label>
                        <mixed-citation publication-type="journal">Kaplan O, Mucuk S. Students’ avoidance of sexuality in relation to sexual topics discussed within the family. Gen Sag Bilimleri Derg. 2024;6(1):57-73</mixed-citation>
                    </ref>
                            </ref-list>
                    </back>
    </article>
