Sexual and reproductive health needs of young adults with chronic conditions in the USA and Canada: a scoping review.

INTRODUCTION: Young adults with chronic conditions, including epilepsy, congenital heart disease (CHD) and systemic lupus erythematosus (SLE), face unique sexual and reproductive health (SRH) challenges. Limited access to age-appropriate information, inconsistent counselling and systemic inequities contribute to unmet needs and suboptimal reproductive outcomes. Evidence on SRH in this population remains limited. This review maps existing literature and identifies barriers, facilitators and gaps in SRH care across these conditions. METHODS: This review followed Joanna Briggs Institute (JBI) methodology for scoping reviews. A search was conducted in MEDLINE, Embase, CINAHL, PsycINFO, Scopus and grey literature for studies published from inception through October 2025. Using Covidence, three reviewers completed screening. Data on study characteristics, participants, SRH needs, barriers, facilitators and key findings were extracted and synthesised descriptively and narratively. The protocol is registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/5SWTY). RESULTS: 21 studies met eligibility criteria, focusing on young adults aged 10-24 years with epilepsy, CHD or SLE from Canada and the USA. Participants consistently reported unmet SRH needs around contraception, pregnancy planning and reproductive risks, with counselling often delayed or inadequate. Barriers included limited provider guidance, stigma, fear of complications, fragmented care, transition gaps and racial/socioeconomic inequities. Facilitators included young adult-centred education and multidisciplinary care. Males and gender-diverse populations remain underrepresented. CONCLUSION: SRH remains insufficiently addressed among young adults with chronic conditions, requiring inclusive research, equitable policies and integrated clinical approaches.