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Improving the sexual and reproductive health (SRH) of adolescent girls is one of the primary aims of the Sustainable Development Goals (SDGs). Adequate and accurate knowledge, a favorable attitude, safe behavior, and regular practice contribute to adolescent girls&rsquo, SRH, maternal health, and child health. Considering this, this study aims to explore the level of knowledge, attitudes, and practices (KAP) of SRH among college-going older adolescent girls in Chittagong district, Bangladesh. An institution-based cross-sectional study was conducted in four colleges among the older adolescent girl age group of 16&ndash, 17 years old (N = 792) attending a higher secondary grade in Chittagong district. Data were collected using a structured and self-administered questionnaire. Descriptive statistics and multiple linear regression analyses were used to summarize the SRH-related KAP and identify the associated factors, respectively. The level of knowledge about puberty, family planning, maternal health, and HIV/AIDS was not satisfactory among the older adolescent girls. Different myths are common in the rural area with regards to menstruation, which impose several restrictions on adolescent girls and adult women. Standardized coefficients of beta (&beta, ) and p value &lt, 0.05 in linear regression analyses demonstrated that being a student of the science group (&beta, = 0.29, p &lt, 0.001) and reading about or watching SRH issues on media (&beta, = 0.21, p &lt, 0.001) were significantly associated with older adolescent girls&rsquo, high level of knowledge in this regard. Furthermore, being a student of the science group (&beta, = 0.17, p &lt, 0.001), urban residence (&beta, = 0.20, p &lt, 0.001), regular SRH communication (at least once a month) with a mother/sister/friend (&beta, = 0.10, p = 0.003), and reading or watching any SRH content on media (&beta, = 0.22, p &lt, 0.001) appeared as predictors of adolescent girls&rsquo, positive attitude towards SRH issues. Moreover, being a student of the science group (&beta, = 0.07, p = 0.048), urban residence (&beta, 0.001), regular SRH discussions with a mother/sister/friend (&beta, = 0.09, p = 0.005), pre-knowledge on periods before menarche (&beta, = 0.12, p &lt, 0.001), and reading or watching any SRH content on media (&beta, = 0.18, p &lt, 0.001) are the most important factors influencing a regular hygienic practice of SRH. This study suggests strengthening SRH-related comprehensive education programs incorporated into the curriculum, the effective use of mass media, and supplying behavioral change communication materials.

Background: Improving the sexual and reproductive health (SRH) of adolescent girls is one of the primary agenda of the Sustainable Development Goals (SDGs). Adequate and accurate knowledge, favorable attitude, safe behavior, and regular practice contribute to the adolescent girls’ SRH, maternal, and child health. In the background, this study aims to explore the level of knowledge, attitudes, and practices (KAP) of SRH among college-going older adolescent girls in Chittagong district, Bangladesh. Methods: An institution-based cross-sectional study was conducted in four colleges among the older adolescent girls age group of 16-17 (N = 792) attending a higher secondary grade in Chittagong district. Data were collected using a structured and self-administered questionnaire. Descriptive statistics and multiple linear regression analyses were used to summarize the SRH-related KAP and identify the associated factors, respectively. Results: 62% of study participants had the awareness that both physical and psychological changes occur in the adolescence period, while only 36% knew that menstruation is not a disease. Besides, only 30% of adolescent girls were informed about taking birth control has no adverse effect on the sexual relationship of a couple. Moreover, only 40% of students were learned that HIV could not be spread through the mosquito and flea, whereas only 25% knew that transmission of HIV is unlikely from an infected person’s coughing and sneezing. Of older adolescent girls, 35% disagreed perfectly whether sexual education can lead to more sexual activity. Besides, more or less 20% of participants opined that adolescent girls should refrain from going outside even to the school, entering into the kitchen, touching anyone, brushing hair, and see in the mirror. Moreover, 52% of adolescent girls wanted to learn more details about SRH, while 48% felt timid and afraid of their puberty changes. Besides, 62.5% of adolescent girls reported their using cloth during the menstrual cycle instead of the sanitary pad. Standardized coefficients beta (β) and p value < .05 in linear regression analyses explored that adolescent girls’ study of science, urban residence, reading or watching SRH contents on the mass media appeared as the more significant predictors for outcome variables. Conclusion: Many problems related to SRH exist among older adolescent girls in Bangladesh, such as behaviors and social constraints associated with menstruation, myths, and assumptions, recognition of the value of awareness and knowledge of reproductive health. Therefore, strengthening SRH-related comprehensive education programs incorporating into the curriculum, effective use of mass media, and supplying behavioral change communication materials are essential.