Immaturity in puberty and negative attitudes toward reproductive health among Indonesian adolescents

Complex factors influence adolescents' attitudes. Secondary sexual development and emotional changes are markers of puberty and affect attitudes toward reproductive health (RH). This is especially evident in the society and culture of Indonesia. This study examined the presence of immaturity at puberty and factors associated with negative attitudes toward RH among Indonesian adolescents. We conducted a cross-sectional study with 1040 students (aged 11-16 years) selected using multistage random cluster sampling. Data were collected using a self-administered questionnaire that included the illustrative questionnaire for interview surveys with young people and the pubertal development scale (PDS), modified in accordance with the Indonesian context. Data analysis used descriptive and comparative statistics and logistic regression analyses. Immature pubertal development was higher in boys [22.7%, 95% confidence interval (CI): 14.7%-30.7%] than girls (18.4%, 95% CI: 11%-25.7%). However, negative attitudes were higher in girls (40.6%, 95% CI: 34.3%-46.8%) than boys (37.1%, 95% CI: 29.9%-44.7%). Factors associated with negative attitudes toward RH in both boys and girls were age, RH communication with parents, and pubertal development. Smoking was an additional factor in boys, whereas living in an urban area was an additional factor in girls. High knowledge about RH was associated with less negative attitudes toward RH in both boys and girls. Immaturity and factors that influence negative attitudes toward RH should be explored during puberty. Improving knowledge about RH may help to prevent negative attitudes toward RH, especially for girls in urban areas and boys with smoking habits.