This study assessed functional health literacy among family planning clinic clients and whether this was associated with sexual health knowledge and behaviors. It also evaluated the readability of patient leaflets.

Five hundred five female family planning clinic attendees aged 16–35 were interviewed about their sexual behavior and knowledge. Their reading age was assessed using a validated test (REALM). The readability of leaflets on contraception supplied to clinic users was measured.

All respondents had a reading age of 12 years and above, 221 between 12 and 14 years, and 284 more significant than 14 years. Those in the lower literacy group were significantly more likely to have been aged under 16 years at the time of first sexual intercourse, and considerably less likely to know the most fertile time of the menstrual cycle, to identify sexually transmitted infections, and to know that sexual diseases can be transmitted through oral and anal sex. The reading age of information leaflets in the clinics ranged from 11 to 17 years. Thus, clients with a reading level of 12–14 years would have difficulty understanding some of the leaflets.

The study concluded that functional health literacy is related to sexual behavior and knowledge. Written information should be prepared with this in mind and other routes of communication considered.