Navigating digital: A community engagement study of young adults, mobile phones and sexual and reproductive health in Bangladesh and Colombia

Abstract

Abstract Background Sexual and reproductive health (SRH) is considered taboo for young adults in many countries, but digital technologies are changing access. The Digital Health and Rights Project (DHRP) consortium was developed to study how young adults use digital technologies for health in low- and middle-income countries (LMICs), including Bangladesh and Colombia; and experiences of benefits and risks. This study compares findings from two different religious and cultural contexts, enabling cross-regional learning to inform digital health governance. Methods Researchers used a Community Engagement Study (CES) approach, engaging participants aged 18–30 years old and civil society throughout the study. In Bangladesh, research focused primarily on young men, including young LGBTQ + people. In Colombia, research focused on young adults living with and affected by HIV, including transgender women. Both research teams collaborated within the frame of a broader 5-country study. They reviewed relevant laws and polices, conducted digital ethnography in social media sites; and held focus group discussions (FGD), in-depth interviews (IDI), and key informant interviews (KII) with 158 participants in multiple sites. Results While Bangladesh and Colombia have significant differences, including in religious and cultural norms, they face some shared challenges in the digital transformation. Both countries have predominantly young populations who need SRH information and services. In both countries, intersectional digital divides and punitive laws, stigma and taboos create barriers to accessing SRH services in person. Rather, study participants use online tools to circumvent stigma and taboos. Social media content creators (“knowledge entrepreneurs”) play a significant role in both countries, providing health information and acting as intermediaries with the formal health sector. Participants described diverse views regarding online security. Conclusions Stigma, discrimination and taboos impede access by individuals to the formal health sectors in diverse cultural and religious contexts. This is especially true for sexual minorities, and for young women, due to gender norms in both contexts. Digital tools can empower young people in their diversity, giving them access to SRH information; but accurate information from legitimate sources, robust data protection and online security remain concerns.