Cultural taboos and low sexual and reproductive health literacy among university students in Magway city, Myanmar.

University students in Myanmar experience a high prevalence of sexual and reproductive health (SRH) problems including unintended pregnancies and sexually transmitted infections. These are compounded by pervasive cultural taboos surrounding sex and sexuality. Sexual and reproductive health literacy is crucial to addressing these problems. Four focus group discussions with 33 university students revealed how cultural taboos act as barriers across five SRH literacy subdomains: accessing, comprehending, criticising and applying SRH information, and communicating with healthcare providers. Students primarily relied on online health information rather than face-to-face discussions. Many students considered SRH information to be 'dirty' and experienced feelings of shame, guilt and fear of being blamed or disrespected while seeking healthcare. They therefore hesitated to visit healthcare providers and sought SRH services only in urgent medical situations. Additionally, all SRH literacy subdomains were influenced by cultural taboos surrounding sex: societal denial towards youth premarital sex, and the perception of sexual matters as embarrassing and inappropriate. Advocacy is needed to promote positive societal attitudes towards sexual matters and youth premarital sex, signalling the value of culturally tailored digital SRH literacy interventions using vernacular language. Healthcare providers should offer non-judgemental youth-centred services to promote SRH literacy among students.