Factors associated with and barriers to completeness of sexuality information among young people in the Island Communities of Uganda

 Corresponding author: Kirwana Venantius Bbaale Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution License 4.0. Factors associated with and barriers to completeness of sexuality information among young people in the Island Communities of Uganda Venantius Bbaale Kirwana *, Cyprian Misinde, Patricia Ndugga and Christian Kakuba Department of Population Studies, School of Statistics and Planning, Makerere University. World Journal of Advanced Research and Reviews, 2025, 28(01), 847-864 Publication history: Received on 31 August 2025; revised on 05 October 2025; accepted on 08 October 2025 Article DOI: https://doi.org/10.30574/wjarr.2025.28.1.3474 Abstract Purpose: The completeness of sexuality information (SI) has been ignored by many scholars who focus more on access to SI. Yet, completeness is the critical first step towards achieving Comprehensive Sexuality Education (CSE) for young people (10–24 years). This study examined the determinants and barriers to complete SI among young people in Uganda’s island communities. Methods: This convergent mixed-methods study with surveys collected from 569 young people using structured digital questionnaires, analyzed using descriptives and logistic regression. Qualitative data involved 16FGDs and 20KIIs with parents, teachers, and community leaders, analyzed thematically. Ethical approval, consent, and safeguarding procedures were strictly followed. Findings: The study found very low, 3.7%, SI completeness among young people in Uganda’s island communities, across all eight UNESCO-recommended topics. Living with biological parents was the only significant (aoR=13.684[1.483126.291], p=0.021) determinant of SI completeness at the multivariate level, while being female, a student, a club member, were significantly more likely to have complete SI at the bivariate level, highlighting the importance of gender, schooling, social participation, and parental co-residence. SI was mainly verbal or observational, with limited reading or digital access. Barriers included cultural taboos, parental neglect, gender bias, environmental risks, and digital misinformation, underscoring the need for integrated, context-sensitive interventions. Conclusion: Achieving complete SI requires interventions that enhance parental capacity to deliver context-specific SI, alongside supporting schools and peer networks to reach the out-of-school young people. These efforts should be gender-inclusive and address the challenges of digital misinformation, particularly in isolated and resource-constrained communities. Keywords: Sexuality; Sexuality information; Completeness; Comprehensive sexuality education; Sexual health 1. Introduction Sexuality information (SI) is critical to young people’s development and sexual health outcomes. Some evidence has shown that young people who receive complete and accurate SI are more likely to delay sexual initiation, use contraceptives consistently, and negotiate safer relationships(1–3). Conversely, SI incompleteness has been linked to early marriages, unplanned pregnancies, coercive relationships, and limited health-seeking behaviour(4). Young people, aged 10-24 years, constitute 33.5% of Uganda’s population (5). This demographic structure places SI at the centre of Uganda’s development agenda, since the health and well-being of young people directly affect human capital, productivity, and intergenerational progress. SI refers to the set of knowledge, skills, values, and attitudes that World Journal of Advanced Research and Reviews, 2025, 28(01), 847-864 848 individuals acquire about 1) healthy relationships, 2) values and rights, 3) gender, 4) violence prevention and safety, 5) skills for health and well-being, 6) human body development, 7) sexual and reproductive health, and 8) the sexual lifecycle as recommended by UNESCO(6). This combo is globally known as comprehensive sexuality education (CSE) and can't be achieved without completeness of SI. Completeness of SI, as used in this paper, refers to the coverage of all eight topics as guided by UNESCO. Incomplete SI often manifests as the omission of one or more of the topics, and the consequences of incomplete SI are not trivial, as they translate to misinformation, poorer decision-making, and a higher risk of negative sexual health outcomes(2,7). Despite the international consensus on the importance of CSE, many low-and middle-income countries, including Uganda, face challenges in delivering SI even with a well-laid Uganda National Sexuality Education Framework(8). The implementation of this framework has been uneven and contested, with national debates and local resistance shaping what is actually provided (9). There have been political and social pushbacks with concerns about its inappropriateness to the culture and religion, and fears of promoting promiscuity. The framework also faced several reversals and has, in some instances, narrowed classroom content or led to ambiguous guidance for teachers (10). Some evaluations of school-based CSE programs in Uganda reveal improved knowledge and positive shifts in attitudes among young people, but also reveal persistent gaps in content coverage and teacher comfort with sensitive topics such as contraception, sexual values and rights, and sexual expression (11,12). These implementation realities demonstrate that an official policy or framework is necessary but not sufficient to ensure completeness in SI delivery. These challenges are amplified in geographically and socially marginalised settings, such as island communities on Lake Victoria, where logistical, infrastructural, and cultural barriers often constrain service delivery and educational coverage (13). Island communities in Uganda present a unique case. These communities often lack sufficient schools and health facilities. Transport challenges, poverty, and seasonal mobility linked to fishing livelihoods further limit exposure to structured sexuality education(13). Additionally, strong cultural and religious norms frequently discourage open discussions about sex, leading to silence at the family level and resistance to school-based SI. Young people in these contexts may therefore rely on peers or informal sources of information, which can be incomplete or inaccurate. Studying the completeness of SI in such communities is thus vital for both equity and public health, as these youth are among the most underserved. Existing literature shows that several factors affect the completeness of SI given to young people. First, government policies and school rules play a big role. When national guidelines are clear and backed with resources and follow-up, the lessons are usually more complete. But when policies are unclear, conflicting, or restricted, important topics are often left out. (10) Second, the skills and teaching methods of teachers matter a lot. Teachers who have not been welltrained, or who lack confidence in using interactive approaches, often stick to only biology and warning messages, leaving out issues about relationships, rights, and consent (11,14). Third, community beliefs and parental views also shape what is taught. Parents and religious leaders often act as gatekeepers, and their resistance can make teachers avoid certain topics(15). Fourth, limited resources, such as few teaching materials, little ongoing training, and too many students per teacher, make it harder to cover all important content (16). Lastly, how teaching is monitored also matters. If checks only look at whether something was taught, and not whether the information was broad and of good quality, then missing content goes unnoticed. However, all this is in a school context, which leaves out the out-of-school young people, prominent in Island communities. Many studies have ignored the importance of parents, guardians, and siblings in the provision of SI. The study uses the bioecological theory that navigates the socialization of young people in the five systems: the microsystem comprising family, siblings, and other guardians; the mesosystem that comprises community members; the exosystem, macrosystem, and the chronosystem, where the young people don’t interact directly with the SI sources (17,18). The study also used the social learning theory that explains how young people learn certain behaviors by observing others, imitating actions, and noting outcomes; reinforcement, environment, and cognition shape whether behaviors are adopted, including in SI. Barriers to completeness are particularly salient in settings with compounded marginalization, among them Uganda’s island communities. Islands face amplified logistical constraints such as limited transport, fewer trained teachers, and weaker access to educational materials and health services, which affect both access, quality, and completeness(19). Living in isolated areas often means that traditional or conservative beliefs are stronger, making it harder to talk openly about sexuality. As a result, teachers may skip sensitive or controversial topics. Most research on CSE has focused on cities or mainland rural areas, while island and river communities have been studied less, even though they face unique social and structural challenges that affect how complete the information is(9,20–24). Understanding these local factors is important for designing programs that provide not just access to sexuality education but also complete, accurate, and useful information. World Journal of Advanced Research and Reviews, 2025, 28(01), 847-864 849 Empirical evidence from Uganda and comparable contexts highlights the consequences of incomplete SI. School-based CSE interventions often produce gains in factual knowledge and intentions to delay sex, but effects are weaker or absent for more complex outcomes related to gender norms, negotiation skills, and attitudes to sexual diversity domains frequently least covered in curricula and classroom practice(11,25). Studies of parent–adolescent communication further show that many families do not discuss sexuality topics in detail, leaving adolescents to rely on peers or the internet, where misinformation is common(26,27). Additionally, teacher-facing qualitative syntheses document frequent conflict and moral dilemmas that teachers experience when attempting to deliver CSE, which pushes them towards safer biomedical content and away from relational or rights-based topics(14). Together, these findings show that incomplete SI is both prevalent and consequential, limiting the transformative potential of CSE. This study assessed the level of completeness of SI and examined the determinants and barriers influencing the provision of complete SI among young people in Uganda’s island communities. The study aligns with Uganda’s commitments under the Sustainable Development Goals, particularly SDG 3 on health and SDG 4 on quality education, highlighting the critical importance of delivering comprehensive, accurate, and age-appropriate sexuality information to young people in marginalized and hard-to-reach communities. 2. Methods 2.1. Study design and setting This study adopted a convergent mixed-methods design that integrated both quantitative and qualitative approaches to examine the factors associated with and barriers to between of SI among young people in Uganda’s island communities. Mukono District was randomly selected from the seven island districts of Lake Victoria using the ballot method, where the names of all eligible island districts were written on identical slips of paper, mixed in a container, and one was drawn blindly to ensure fairness and transparency. Within Mukono District, Kkoome Subcounty, the only island subcounty was purposively chosen because of its geographic isolation, diverse youth population, and relevance to the study objectives. From the four parishes that make up Kkoome (Bugombe, Busanga, Lwomolo, and Mubembe), Busanga and Bugombe parishes were selected using the ballot method. The study population comprised young people aged 10–24 years, estimated at 345,000(5), and adults and community actors, including parents, guardians, religious leaders, cultural representatives, community leaders, healthcare workers, and teachers living in the island communities of Lake Victoria. 2.2. Survey data collection and analysis The sample size of young people was determined while using Yamane & Israel, (1967) formula for determining the sample size of a known population to have a representative sample of young people in the Island Communities of Lake Victoria. n=N/(1+Ne^2 )=345,000 /(1+345,000 (0.05)^2))=399.5 ≈ 400 Where: n=Sample Size, N=Size of the Target Population (345,000), e=Margin Error/Level of Precision (which is 0.05). An allowance for the design effect of 1.5 translated the sample to 600, and a control for a non-response rate of 10% realized in the field; the sample size became 660 respondents. Data were collected at a single point in May 2025, following ethical approval from TASO and a research permit (SS3785ES) from the Uganda National Council for Science and Technology, using structured interviewer-administered surveys. A sampling frame of all villages in each of the two parishes was developed in collaboration with the subcounty Community Development Officer, parish officials, and Local Council (LC I) leaders. From each parish, six villages were purposively selected based on three key criteria: (1) presence of a relatively high concentration of young people aged 10–24 years, (2) accessibility during the study period, and (3) representation of both landing-site and inland communities to capture socio-economic and cultural variation. Within each selected village, a household listing was developed with the help of village leaders to identify households with at least one eligible young person, with a target of selecting 60 young people per village, 360 per parish. In households with more than one young person aged 10–24 years, a simple random method specifically drawing numbered slips corresponding to each eligible young person was used to select one respondent. This approach minimized intra-household selection bias. In each village, 60 young people were selected, comprising 30 males (10 aged 10–14years, 10 aged 15–17years, and 10 aged 18–24) and 30 females (with the same age stratification). Local Council leaders and other community leaders supported community entry and helped confirm the presence of eligible World Journal of Advanced Research and Reviews, 2025, 28(01), 847-864 850 participants, ensuring inclusivity while maintaining randomness at the household level. Ethical and safeguarding procedures were followed strictly to ensure voluntary participation and the protection of minors. Completeness of SI, the dependent variable, was measured against eight UNESCO (2018) comprehensive sexuality education topics: • Healthy relationships, • Values and rights, • Gender equity, • Privacy and staying safe, • Communication, negotiation and decision-making, • Human body and development, • Sexual and reproductive health. • Sexual lifecycle and response. Independent variables included socio-demographic characteristics, mode of receiving SI, and the sources of SI. Young people’s socio-demographic characteristics included: • Parish of residence, • Age • Sex • Religion • Schooling status • Education level • Employment status • Group/club membership • Living arrangements. The survey also captured the mode of receiving SI: • Verbal, • Observation, • Reading, • Video and gaming. Sources of SI were captured as • Microsystem: parents, siblings, and other guardians; • Mesosystem: friends/confidants, peer educators, teachers, religious leaders, healthcare workers, community leaders, the internet, books, or recordings. • The exosystem: a member of the microsystem being employed and belonging to a club or group; • The macro system: knowledge of laws and cultural practices that promote the provision of sexuality education; and • The chronosystem: major life’s changes. Data confidentiality and anonymity were ensured through pseudonymization with unique IDs, and participants were reassured that their responses would never be traced back to them. Quantitative data were analysed using STATA 18. The analysis was conducted at three levels. Univariate analysis described the distribution of variables using frequencies, percentages, means, and standard deviations. Bivariate analysis employed cross-tabulations and logistic regression to compute crude odds ratios at a 95% confidence level. Variables that were statistically significant at the bivariate level were included in a multivariate logistic regression model, where adjusted odds ratios were computed to control confounding. 2.3. FGD and KII data collection and analysis The qualitative component complemented the survey by exploring the barriers to accessing complete SI. Purposive stratified sampling was used to select participants for focus group discussions (FGDs) and key informant interviews World Journal of Advanced Research and Reviews, 2025, 28(01), 847-864 851 (KIIs). A total of 16 FGDs were conducted, each involving six participants. Eight FGDs were held in each of the two parishes, stratified by sex and age groups of 10–14, 15–17, and 18–24 years. Separate FGDs were also conducted with parents and guardians, disaggregated by sex. In addition, 20 KIIs were conducted, 11 per parish, targeting religious leaders across denominations, cultural leaders, community leaders, healthcare workers, and teachers. This distribution is summarized in Table 1. Table 1 Distribution of the KII and FGD participants Participation Type Participant Group Age Group / Role Sex Bugombe Participation Busanga FGD Young People 10–14 years Male 6 6 FGD Young People 10–14 years Female 6 6 FGD Young People 15–17 years Male 6 6 FGD Young People 15–17 years Female 6 6 FGD Young People 18–24 years Male 6 6 FGD Young People 18–24 years Female 6 6 FGD Parents – Male 6 6 FGD Parents – Female 6 6 KII Religious Leaders – Male 1 1 KII Cultural Leaders – Male 1 1 KII Community Leaders – Male 1 1 KII Healthcare Workers – Male 1 1 KII Community Leaders – Female 1 1 KII Healthcare Workers – Female 1 1 KII Teacher – Male 2 2 KII Teacher – Female 2 2 The FGDs and KIIs were conducted in safe and private spaces using either Luganda or English, depending on the study participants’ preference. Discussions were audio-recorded with consent and supported by notes. Trained facilitators followed a discussion guide designed to probe participants’ experiences, perceptions of risky sexual behaviour, and views on access to SI. Safeguarding protocols were carefully observed, particularly for minors, and participants were reminded of the voluntary and confidential nature of their involvement. This data was transcribed and translated as necessary. Data was cleaned iteratively and imported into NVivo software for thematic analysis. Coding was inductive, allowing new themes to emerge from participants’ narratives. The analysis focused on identifying recurring patterns and relationships between the completeness of SI and contextual barriers within the island communities. Ethical approval for this study was granted by the TASO Research Ethics Committee. A research permit, No. SS3785ES was also obtained from the Uganda National Council of Science and Technology under permit. All participants provided informed consent, while those aged 10–17 years provided assent alongside parental consent. The study strictly adhered to principles of voluntary participation, confidentiality, anonymity, and child safeguarding throughout the research process. 3. Results Table 2 shows the distribution of socio-demographic characteristics and the mode of SI among young people who participated in the survey. Participants were fairly distributed across age groups, with 31.3% aged 10–14 years, 31.1% aged 15–17 years, and 37.6% aged 18–24 years, with a mean age was 16.43 years and a standard deviation of 3.16 years. World Journal of Advanced Research and Reviews, 2025, 28(01), 847-864 852 Female young people were slightly more at 51.3% compared to 48.7% males. Most young people (83.5%) resided in peri-urban settings, while only 16.5% lived in rural areas and participated in the study. Young people who were Christians were 88.4% while those who were non-Christians comprised 11.6%. The majority (61.0%) were not currently attending school, though 98.2% had attained at least primary education. About 56.2% of young people were not engaged in income-generating activities, while 43.8% reported some form of employment. About 59.4% of respondents belonged to a club or group. Most young people, 40.3%, lived alone, while 17.8% with biological parents, 16.3% with a spouse, and 25.7% lived with other family. Over half of the young people, 65.6%, reported receiving SI verbally, and over three quarters, 75.6%, by observation. However, very few accessed SI through reading (5.5%) or videos/gaming (0.2%). Table 2 Summary of social demographics of study participants and their mode of receiving SI Variables Categories Frequency Percentage Parish Bugombe 280 49.2 Busanga 289 50.8 Age group 10-14years 178 31.3 16.433±3.155 15-17years 177 31.1 18-24years 214 37.6 Sex Female 292 51.3 Male 277 48.7 Residence Rural 94 16.5 PeriUrban 475 83.5 Religion Christian 503 88.4 Nonchristian 66 11.6 Schooling status No 347 61.0 Yes 222 39.0 Education level None 10 1.8 ≥Primary 559 98.2 Employment status No 320 56.2 Yes 249 43.8 Belong to a club/group No 231 40.6 Yes 338 59.4 Living arrangements Alone 229 40.3 Biological Parent 101 17.8 Spouse 93 16.3 Other 146 25.7 Mode of receiving SI Receiving SI verbally No 196 34.5 Yes 373 65.6 Receiving SI by observation No 139 24.4 Yes 430 75.6 World Journal of Advanced Research and Reviews, 2025, 28(01), 847-864 853 Receiving SI by Reading No 538 94.6 Yes 31 5.5 Receiving SI by video or gaming No 560 99.8 Yes 1 0.2 Table 3 shows the distribution of SI sources among young people in Uganda’s island communities, showing strong variation across bioecological system levels. In the microsystem, within the household, only 19.2% of young people reported receiving SI directly from their biological parents or guardians, 15.3% from siblings, and 9.1% from “other guardians” contributed to just 9.1%. A composite household measure, with internal consistency reliability of 0.735, revealed that 43.1% of young people received some SI from within their households. In the mesosystem, outside the household but within the community, young people received information as follows: from teachers (29.9%), from friends/confidants (28.7%), from religious leaders (25.0%), from healthcare workers (20.9%), from community leaders (20.6%), from peer educators (3.3%), from the internet (0.9%), and books or recordings (0.9%). The composite meso-level measure, with internal consistency reliability of 0.751, showed that 61.2% of young people had accessed some SI from these sources directly from the community. Table 3 Actual SI Sources Variables Categories Frequency Percentage Microsystem Biological Parent No 460 80.8 Yes 109 19.2 Brother, Sister, Cousin No 482 84.7 Yes 87 15.3 Other guardian at home No 517 90.9 Yes 52 9.1 Microsystem: The Household: (composite) No 324 56.9 Cronbach's alpha 0.735 Yes 245 43.1 Meso system Friend /confidant No 406 71.4 Yes 163 28.7 Peer Educators No 550 96.7 Yes 19 3.3 Teacher No 399 70.1 Yes 170 29.9 Religious Leader No 427 75.0 Yes 142 25.0 Community leader No 452 79.4 Yes 117 20.6 Healthcare worker No 450 79.1 Yes 119 20.9 World Journal of Advanced Research and Reviews, 2025, 28(01), 847-864 854 Internet No 564 99.1 Yes 5 0.9 Book or recording No 564 99.1 Yes 5 0.9 Mesosystem: Community(composite) No 221 38.8 Cronbach's alpha 0.751 Yes 348 61.2 Exosystem Parent has a workplace No 444 78.0 Yes 125 22.0 Parent belongs to a Club No 533 93.7 Yes 36 6.3 Sibling is employed No 487 85.6 Yes 82 14.4 Sibling belongs to a group No 565 99.3 Yes 4 0.7 Other guardian at home has a workplace No 527 92.6 Yes 42 7.4 Other guardian at home belongs to a group No 543 95.4 Yes 26 4.6 Exosystem (composite) No 311 54.7 Cronbach's alpha 0.752 Yes 258 45.3 Macro system Knowledge of the law promoting SI No 548 96.3 Yes 21 3.7 Knowledge of culture promoting SI No 491 86.3 Yes 78 13.7 Macrosystem: (composite) Cronbach's alpha 0.724 No 470 82.6 Yes 99 17.4 Chronosystem: Ever had major Life changes No 407 71.5 Yes 162 28.5 In the exosystem sources, where young people indirectly get SI through the engagements of their household members were much weaker. Only 22.0% reported that a parent had a workplace, while 14.4% mentioned employed siblings. Very few young people reported their family members’ participation in groups or clubs; siblings, 0.7%; parents, 6.3%; and other guardians, 4.6%. The composite measure of the exosystem, with internal consistency reliability of 0.735, indicated that 45.3% young people had formal engagements at work and in a club or group. Only 3.7% knew laws promoting SI. Awareness of cultural norms was slightly higher, with 13.7% acknowledging cultural practices that promote SI. The macro system composite measure, with internal consistency reliability of 0.724, indicated that only 17.4% of young people reported awareness of laws and cultural practices that promote the provision of SI. World Journal of Advanced Research and Reviews, 2025, 28(01), 847-864 855 Over a quarter, 28.5%, of young people reported having experienced major life changes. This dimension suggested that transitions over time, such as changes in schooling, living arrangements, or family dynamics. Table 4 Completeness of SI Variables Categories Frequency Percentage Topic 1: Healthy Relationships No 275 48.3 Yes 294 51.7 Topic 2: Sexual values, rights, and practices No 416 73.1 Yes 153 26.9 Topic 3: Gender equity No 408 71.7 Yes 161 28.3 Topic 4: Privacy, bodily integrity, and staying safe No 430 75.6 Yes 139 24.4 Topic 5: Communication, negotiation, and decision-making No 354 62.2 Yes 215 37.8 Topic 6: Human Body changes and development No 373 65.6 Yes 196 34.5 Topic 7: Pregnancy, HIV, and STIs No 349 61.3 Yes 220 38.7 Topic 8: Sex, sexual expression, and sexual response No 427 75.0 Yes 142 25.0 Completeness of SI (Cronbach's alpha 0.752) No 549 96.3 Yes 21 3.7 The analysis of SI completeness across the eight topics in Table 5 revealed that over half of respondents (51.7%) reported having received information on healthy relationships, making it the most commonly addressed topic. This was followed by topics on sexual and reproductive health, 38.7%; communication, negotiation, and decision-making, 37.8%; human body changes and development 34.5%; gender equity, 28.3%; sexual values, rights, and practices, 26.9%; sex, sexual expression, and sexual response, 25.0%; and privacy, bodily integrity, and staying safe, 24.4%. A composite variable, with internal consistency reliability of 0.752, from the different topics, indicated that only 3.7% of respondents had received SI that covered the full range of topics considered essential for comprehensive understanding, while 96.3% had incomplete exposure Table 5 Bivariate association of sociodemographic characteristics, mode of receiving SI, and completeness of SI Categories SI Completeness CoR [CI] p-value Incomplete Complete Parish Bugombe 264(94.3) 16(5.7) 1 1 Busanga 284(98.3) 5(1.7) 0.290[0.105, 0.804] 0.017* Age group 16.433±3.155 10-14years 174(97.7) 4(2.3) 1 1 15-17years 167(94.4) 10(5.6) 2.605[0.801, 8.467] 0.111 World Journal of Advanced Research and Reviews, 2025, 28(01), 847-864 862 The study highlights that structural, cultural, and systemic barriers continue to limit the completeness of SI among young people in Uganda’s island communities. Barriers include low awareness of sexuality education policies, minimal prioritization of sexuality topics in schools, and parental discomfort discussing sexual issues. These findings align with national-level studies, which report sociocultural resistance, teacher under-preparedness, and policy ambiguities as persistent obstacles to SI (13,29). The Bioecological theory situates these barriers across multiple layers: at the exosystem level, institutions and schools lack resources and training; macrosystem norms stigmatize open sexual dialogue; and chronosystem shifts, including urbanization and politicization of SI, exacerbating inconsistencies. Similarly, the IMB model shows how gaps in information and low motivation hinder the development of protective behavioral skills(35). This study extends prior literature by emphasizing the unique challenges of island contexts, including geographical isolation, fishing-related livelihoods, and “camp” environments that deprioritize formal education. Additionally, digital technology introduces new vulnerabilities, as unregulated online content interacts with structural barriers to worsen SI incompleteness. While national policies like Uganda’s National Sexuality Education Framework (2018) exist, poor localization and limited community awareness reduce effectiveness. Unlike urbanfocused studies, these findings reveal how environmental and technological factors intersect with sociocultural barriers, shaping SI access and quality. The study underscores that structural, cultural, and systemic barriers are compounded by ecological and digital realities, highlighting the need for context-specific interventions. Complete SI in island communities requires integrated, multi-level approaches that localize policy, enhance parental and teacher capacity, and incorporate digital literacy to ensure completeness of SI. This study offers valuable insights into the completeness and barriers of SI among young people in Uganda’s island communities. Limitations include reliance on self-reported data, potential social desirability bias, and a cross-sectional design that prevents causal inference. Findings may not generalize to mainland rural or urban settings, where cultural norms, family dynamics, and access to education differ. Strengths include a mixed-methods approach, focus on an under-researched population, and theoretical grounding in ecological and behavioral frameworks. Future research should employ longitudinal or observational designs to track SI acquisition over time, explore parent–school– community interventions, and compare island and mainland young people. Innovative methods, such as participatory diaries, digital tracking, or structural equation modeling, could clarify causal pathways. Practically, the study underscores the importance of integrated, family-centered, school-supported, and community-empowered strategies for delivering complete SI, informing policies and programs that enhance knowledge and choice of behaviour. 5. Conclusion This study set out to examine the completeness of sexuality information (SI) among young people in Uganda’s island communities, focusing on social-demographic characteristics, microsystem influences, and modes of SI delivery. The findings reveal that SI completeness is extremely low, with parental co-residence emerging as the strongest predictor. This underscores the critical role of the microsystem within the broader bioecological context, particularly in geographically isolated settings where schools, peer clubs, and health services are limited or inconsistent. The results suggest that a combination of the Bioecological Model and Social Learning Theory is useful for understanding how microsystem actors, repeated guidance, and observational learning shape SI completeness. They also highlight that current approaches focusing predominantly on schools or peer groups may overestimate their effectiveness, as access alone does not ensure complete SI. The study emphasizes the need for context-specific, integrated strategies that strengthen parental capacity, support inclusive school and peer interventions, and address digital misinformation. Policy-makers, educators, community leaders, and organizations implementing sexual and reproductive health programs can benefit from these insights by designing interventions that recognize the unique challenges of island or remote communities, including gender disparities and ecological constraints. Future research using longitudinal designs, experimental interventions, and comparative studies between island and mainland youth could provide a more nuanced understanding of SI acquisition, the interplay of family and institutional influences, and the effectiveness of integrated, multi-level strategies for improving comprehensive sexuality education. This study contributes to evidencebased planning, guiding policies and programs toward achieving complete, equitable, and context-sensitive SI delivery in marginalized communities. Compliance with ethical standards Disclosure of conflict of interest No conflict of interest to be disclosed. World Journal of Advanced Research and Reviews, 2025, 28(01), 847-864 863 References [1] Lameiras-Fernández M, Martínez-Román R, Carrera-Fernández MV, Rodríguez-Castro Y. Sex education in the spotlight: What is working? systematic review. Vol. 18, International Journal of Environmental Research and Public Health. MDPI; 2021. p. 1–35. 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