Bridging knowledge and practice: Adolescent sexual reproductive health in Northern Vietnam's mountainous ethnic communities.

This study examines adolescent sexual and reproductive health (ASRH) awareness, confidence, and lived experience in a mountainous area of Northern Vietnam, focusing on the impact of cultural factors and local norms. A qualitative study using semistructured interviews and focus group discussions with adolescents aged 12-18 from ethnic minority groups in two communes of Thuan Chau district and four wards of Son La city. The interviews explored their knowledge and confidence in practicing ASRH, perceptions of ASRH services, and barriers to accessing care. Data were analyzed thematically to identify key trends in ASRH awareness and behaviors. The findings reveal a critical gap between knowledge and action: although many participants knew where to access contraceptives, they lacked the confidence to use them, driven by fear of judgment from family, peers, and healthcare providers. This gap is widened by deeply ingrained cultural norms, including traditional gender roles and expectations of early childbearing, which severely limit the decision-making autonomy of adolescents, particularly girls from ethnic minority communities. Addressing ASRH challenges in this context requires interventions that move beyond simple information dissemination. Efforts must focus on building adolescent confidence by developing youth-friendly, confidential ASRH services and implementing community-level interventions aimed at transforming the restrictive cultural beliefs and social stigma that hinder safe ASRH practices.