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Published in: BMC Medicine 1/2007

Open Access 01-12-2007 | Research article

Contraception use and pregnancy among 15–24 year old South African women: a nationally representative cross-sectional survey

Authors: Catherine MacPhail, Audrey E Pettifor, Sophie Pascoe, Helen V Rees

Published in: BMC Medicine | Issue 1/2007

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Abstract

Background

Adolescent reproductive health has not continued to receive the attention it deserves since the start of the HIV epidemic. In South Africa, high numbers of adolescent women report pregnancies that are unwanted and yet few have accessed available termination of pregnancy services. Enabling contraception use is vital for meeting the goals of HIV prevention.

Methods

A nationally representative survey of South African 15–24 year olds was undertaken. Participants completed a questionnaire on sexual behaviour and provided an oral fluid sample for HIV testing. Analysis of the data was restricted to women (n = 6217), particularly those who reported being sexual active in the last 12 months (n = 3618) and was conducted using svy methods in the program STATA 8.0 to take account of sampling methods. Univariate and multivariate analyses were conducted to explore factors associated with contraceptive use.

Results

Two thirds of all women reported having ever been sexually active and among these 87% were sexually active in the past 12 months. Among women who reported currently being sexually active, 52.2% reported using contraceptives. There was evidence of association between contraceptive use and being employed or a student (vs unemployed); fewer sex partners; type of last sex partner; having talked to last partner about condom use and having ever been pregnant.

Conclusion

Specific emphasis must be placed on encouraging young women to use contraceptive methods that offer protection against pregnancy and STIs/HIV. Our consistent finding of a relationship between discussing condom use with partners and condom use indicates the importance of involvement of male partners in women's contraceptive decisions.
Literature
1.
go back to reference Alan Guttmacher Institute: The role of reproductive health providers in preventing HIV. Issues in Brief. 2004, Washington DC: Alan Guttmacher Institute Alan Guttmacher Institute: The role of reproductive health providers in preventing HIV. Issues in Brief. 2004, Washington DC: Alan Guttmacher Institute
2.
go back to reference Kaufman CE, de Wet T, Stadler J: Adolescent pregnancy and parenthood in South Africa. Stud Fam Plan. 2003, 32: 147-160. 10.1111/j.1728-4465.2001.00147.x.CrossRef Kaufman CE, de Wet T, Stadler J: Adolescent pregnancy and parenthood in South Africa. Stud Fam Plan. 2003, 32: 147-160. 10.1111/j.1728-4465.2001.00147.x.CrossRef
3.
go back to reference Garenne M, Tollman S, Kahn K: Premarital fertility in rural South Africa: a challenge to existing population policy. Stud Fam Plan. 2000, 31: 47-54. 10.1111/j.1728-4465.2000.00047.x.CrossRef Garenne M, Tollman S, Kahn K: Premarital fertility in rural South Africa: a challenge to existing population policy. Stud Fam Plan. 2000, 31: 47-54. 10.1111/j.1728-4465.2000.00047.x.CrossRef
4.
go back to reference Reynolds H, Janowitz B, Homan R, Johnson L: Cost-effectiveness of two interventions to prevent HIV-positive births. Proceedings of the XVI International AIDS Conference, Bangkok, Thailand. 2004 Reynolds H, Janowitz B, Homan R, Johnson L: Cost-effectiveness of two interventions to prevent HIV-positive births. Proceedings of the XVI International AIDS Conference, Bangkok, Thailand. 2004
5.
go back to reference Anonymous: The benefits of investing in sexual and reproductive health. Issues Brief (Alan Guttmacher Inst). 2004, 4: 1-4. Anonymous: The benefits of investing in sexual and reproductive health. Issues Brief (Alan Guttmacher Inst). 2004, 4: 1-4.
6.
go back to reference Rani M, Lule E: Exploring the socioeconomic dimension of adolescent reproductive health: a multicountry analysis. Int Fam Plan Pers. 2004, 30: 110-117. 10.1363/3011004.CrossRef Rani M, Lule E: Exploring the socioeconomic dimension of adolescent reproductive health: a multicountry analysis. Int Fam Plan Pers. 2004, 30: 110-117. 10.1363/3011004.CrossRef
7.
go back to reference Pettifor A, Rees H, Kleinschmidt I, Steffenson A, MacPhail C, Hlongwa-Madikizela L, Vermaak K, Padian N: Young people's sexual health in South Africa: HIV prevalence and sexual behaviours from a nationally representative household survey. AIDS. 2005, 19: 1525-1534. 10.1097/01.aids.0000183129.16830.06.CrossRefPubMed Pettifor A, Rees H, Kleinschmidt I, Steffenson A, MacPhail C, Hlongwa-Madikizela L, Vermaak K, Padian N: Young people's sexual health in South Africa: HIV prevalence and sexual behaviours from a nationally representative household survey. AIDS. 2005, 19: 1525-1534. 10.1097/01.aids.0000183129.16830.06.CrossRefPubMed
8.
go back to reference Pettifor A, Rees H, Steffenson A, Hlongwa-Madikizela L, MacPhail C, Vermaak K, Kleinschmidt I: HIV and Sexual Behaviour Among Young South Africans: A National Survey of 15–24 Year Olds. 2004, Johannesburg, South Africa: Reproductive Health Research Unit, University of the Witwatersrand Pettifor A, Rees H, Steffenson A, Hlongwa-Madikizela L, MacPhail C, Vermaak K, Kleinschmidt I: HIV and Sexual Behaviour Among Young South Africans: A National Survey of 15–24 Year Olds. 2004, Johannesburg, South Africa: Reproductive Health Research Unit, University of the Witwatersrand
9.
go back to reference Centre for African Family Studies: Determinants and consequences of adolescent pregnancies in Cameroon. CAFS News. 1996, 6: 8. Centre for African Family Studies: Determinants and consequences of adolescent pregnancies in Cameroon. CAFS News. 1996, 6: 8.
10.
go back to reference Pecoraro AG, Robichaux FB, Theriot JG: Teen pregnancy: effect on family well-being. J Home Econ. 1987, 79: 27-30.PubMed Pecoraro AG, Robichaux FB, Theriot JG: Teen pregnancy: effect on family well-being. J Home Econ. 1987, 79: 27-30.PubMed
11.
go back to reference Varga CA: How gender roles influence sexual and reproductive health among South African adolescents. Stud Fam Plan. 2003, 34: 160-172. 10.1111/j.1728-4465.2003.00160.x.CrossRef Varga CA: How gender roles influence sexual and reproductive health among South African adolescents. Stud Fam Plan. 2003, 34: 160-172. 10.1111/j.1728-4465.2003.00160.x.CrossRef
12.
go back to reference Cunningham PW, Boult BE: Black teenage pregnancy in South Africa: some considerations. Adolescence. 1996, 31: 691-700.PubMed Cunningham PW, Boult BE: Black teenage pregnancy in South Africa: some considerations. Adolescence. 1996, 31: 691-700.PubMed
13.
go back to reference Tanga TT, Uys lR: The social support system of unmarried pregnant adolescents in the Transkei with particular reference to parents. Curationis. 1996, 19: 50-54.PubMed Tanga TT, Uys lR: The social support system of unmarried pregnant adolescents in the Transkei with particular reference to parents. Curationis. 1996, 19: 50-54.PubMed
14.
go back to reference Makiwane MB: Adolescent pregnancy and reproductive health in Transkei (rural South Africa). Afr J Reprod Health. 1998, 2 (1): 41-48.PubMed Makiwane MB: Adolescent pregnancy and reproductive health in Transkei (rural South Africa). Afr J Reprod Health. 1998, 2 (1): 41-48.PubMed
15.
go back to reference South African Department of Education: Monitoring and Evaluation Report on the Impact and Outcomes of the Education System on South Africa's population: Evidence FROM Household Surveys. 2006, Pretoria, South Africa: Department of Education South African Department of Education: Monitoring and Evaluation Report on the Impact and Outcomes of the Education System on South Africa's population: Evidence FROM Household Surveys. 2006, Pretoria, South Africa: Department of Education
16.
go back to reference Calza L, Manfredi R, Chiodo F: Hyperlipidaemia in patients with HIV-1 infection receiving highly active antiretroviral therapy: epidemiology, pathogenesis, clinical course and management. Int J Antimic Ag. 2003, 22: 89-99. 10.1016/S0924-8579(03)00115-8.CrossRef Calza L, Manfredi R, Chiodo F: Hyperlipidaemia in patients with HIV-1 infection receiving highly active antiretroviral therapy: epidemiology, pathogenesis, clinical course and management. Int J Antimic Ag. 2003, 22: 89-99. 10.1016/S0924-8579(03)00115-8.CrossRef
17.
go back to reference Stober DR, Schwartz JA, McDaniel JS, Abrams RF: Depression and HIV disease: prevalence, correlates and treatment. Psych An. 1997, 27: 372-377.CrossRef Stober DR, Schwartz JA, McDaniel JS, Abrams RF: Depression and HIV disease: prevalence, correlates and treatment. Psych An. 1997, 27: 372-377.CrossRef
18.
go back to reference Maman S, Mbwambo JK, Hogan NM, Kilonzo GP, Campbell JC, Weiss E, Sweat MD: HIV-positive women report more lifetime partner violence: findings from a voluntary counseling and testing clinic in Dar es Salaam, Tanzania. Am J Pub Health. 2002, 92: 1331-1337.CrossRef Maman S, Mbwambo JK, Hogan NM, Kilonzo GP, Campbell JC, Weiss E, Sweat MD: HIV-positive women report more lifetime partner violence: findings from a voluntary counseling and testing clinic in Dar es Salaam, Tanzania. Am J Pub Health. 2002, 92: 1331-1337.CrossRef
19.
go back to reference Kruzich LA, Marquis GS, Wilson CM: HIV-infected US youth are at high risk of obesity and poor diet quality: a challenge for improving short- and long-term health. J Am Diet Assoc. 2004, 104: 1554-1560. 10.1016/j.jada.2004.07.031.CrossRefPubMed Kruzich LA, Marquis GS, Wilson CM: HIV-infected US youth are at high risk of obesity and poor diet quality: a challenge for improving short- and long-term health. J Am Diet Assoc. 2004, 104: 1554-1560. 10.1016/j.jada.2004.07.031.CrossRefPubMed
20.
go back to reference Breheny M, Stephens C: Barriers to effective contraception and strategies for overcoming them among adolescent mothers. Pub Health Nurs. 2004, 21: 220-227. 10.1111/j.0737-1209.2004.021304.x.CrossRef Breheny M, Stephens C: Barriers to effective contraception and strategies for overcoming them among adolescent mothers. Pub Health Nurs. 2004, 21: 220-227. 10.1111/j.0737-1209.2004.021304.x.CrossRef
21.
go back to reference Paukku M, Quan J, Darney P, Raine T: Adolescents' contraceptive use and pregnancy history: is there a pattern?. Obst Gynecol. 2003, 101: 534-538. 10.1016/S0029-7844(02)02717-5. Paukku M, Quan J, Darney P, Raine T: Adolescents' contraceptive use and pregnancy history: is there a pattern?. Obst Gynecol. 2003, 101: 534-538. 10.1016/S0029-7844(02)02717-5.
22.
go back to reference Raine T, Minnis AM, Padian NS: Determinants of contraceptive method among young women at risk for unintended pregnancy and sexually transmitted infections. Contraception. 2003, 68: 19-25. 10.1016/S0010-7824(03)00107-0.CrossRefPubMed Raine T, Minnis AM, Padian NS: Determinants of contraceptive method among young women at risk for unintended pregnancy and sexually transmitted infections. Contraception. 2003, 68: 19-25. 10.1016/S0010-7824(03)00107-0.CrossRefPubMed
23.
go back to reference MacPhail C, Campbell C: 'I think condoms are good but, aai, I hate those things': condom use among adolescents and young people in a southern African township. Soc Sci Med. 2001, 52: 1613-1627. 10.1016/S0277-9536(00)00272-0.CrossRefPubMed MacPhail C, Campbell C: 'I think condoms are good but, aai, I hate those things': condom use among adolescents and young people in a southern African township. Soc Sci Med. 2001, 52: 1613-1627. 10.1016/S0277-9536(00)00272-0.CrossRefPubMed
24.
go back to reference Hendriksen E, Lee A, Coates T, Rees H, Pettifor A: Predictors of condom use among South African youth age 15–24: the RHRU national survey. Am J Pub Health. 2007. Hendriksen E, Lee A, Coates T, Rees H, Pettifor A: Predictors of condom use among South African youth age 15–24: the RHRU national survey. Am J Pub Health. 2007.
25.
go back to reference Davies SL, DiClemente RJ, Wingood GM, Person SD, Dix ES, Harrington K, Crosby RA, Oh K: Predictors of inconsistent contraceptive use among adolescent girls: findings from a prospective study. J Adol Health. 2006, 39: 43-49. 10.1016/j.jadohealth.2005.10.011.CrossRef Davies SL, DiClemente RJ, Wingood GM, Person SD, Dix ES, Harrington K, Crosby RA, Oh K: Predictors of inconsistent contraceptive use among adolescent girls: findings from a prospective study. J Adol Health. 2006, 39: 43-49. 10.1016/j.jadohealth.2005.10.011.CrossRef
26.
go back to reference Ross JA, Frankenberg E: Findings from Two Decades of Family Planning Research. 1993, New York: The Population Council Ross JA, Frankenberg E: Findings from Two Decades of Family Planning Research. 1993, New York: The Population Council
27.
go back to reference Nichols D, Woods ET, Gates DS, Sherman J: Sexual behaviour, contraceptive practice, and reproductive health among Liberian adolescents. Stud Fam Plan. 1987, 18: 169-176. 10.2307/1966811.CrossRef Nichols D, Woods ET, Gates DS, Sherman J: Sexual behaviour, contraceptive practice, and reproductive health among Liberian adolescents. Stud Fam Plan. 1987, 18: 169-176. 10.2307/1966811.CrossRef
28.
go back to reference Varga CA: Pregnancy termination among South African adolescents. Stud Fam Plan. 2002, 33: 283-298. 10.1111/j.1728-4465.2002.00283.x.CrossRef Varga CA: Pregnancy termination among South African adolescents. Stud Fam Plan. 2002, 33: 283-298. 10.1111/j.1728-4465.2002.00283.x.CrossRef
29.
go back to reference Ehlers VJ: Adolescent mothers' utilization of contraceptive services in South Africa. Int Nurs Rev. 2003, 50: 229-241. 10.1046/j.1466-7657.2003.00187.x.CrossRefPubMed Ehlers VJ: Adolescent mothers' utilization of contraceptive services in South Africa. Int Nurs Rev. 2003, 50: 229-241. 10.1046/j.1466-7657.2003.00187.x.CrossRefPubMed
30.
go back to reference Buchmann EJ, Mensah K, Pillay P: Legal termination of pregnancy among teenagers and older women in Soweto, 1999–2001. S Afr Med J. 2002, 92: 729-731.PubMed Buchmann EJ, Mensah K, Pillay P: Legal termination of pregnancy among teenagers and older women in Soweto, 1999–2001. S Afr Med J. 2002, 92: 729-731.PubMed
31.
go back to reference Dickson KE, Jewkes RK, Brown H, Levin J, Rees H, Mavuya L: Abortion service provision in South Africa three years after liberalization of the law. Stud Fam Plan. 2003, 34: 277-284. 10.1111/j.1728-4465.2003.00277.x.CrossRef Dickson KE, Jewkes RK, Brown H, Levin J, Rees H, Mavuya L: Abortion service provision in South Africa three years after liberalization of the law. Stud Fam Plan. 2003, 34: 277-284. 10.1111/j.1728-4465.2003.00277.x.CrossRef
32.
go back to reference Mokgethi N, Ehlers V, van der Merwe M: Professional nurses' attitudes towards providing termination of pregnancy services in a tertiary hospital in the north west province of South Africa. Curationis. 2006, 29: 32-39.CrossRefPubMed Mokgethi N, Ehlers V, van der Merwe M: Professional nurses' attitudes towards providing termination of pregnancy services in a tertiary hospital in the north west province of South Africa. Curationis. 2006, 29: 32-39.CrossRefPubMed
33.
go back to reference Whaley AL: Preventing the high-risk sexual behaviour of adolescents: focus on HIV/AIDS transmission, uninteneded pregnancy, or both?. J Adol Health. 1999, 24: 376-382. 10.1016/S1054-139X(98)00153-0.CrossRef Whaley AL: Preventing the high-risk sexual behaviour of adolescents: focus on HIV/AIDS transmission, uninteneded pregnancy, or both?. J Adol Health. 1999, 24: 376-382. 10.1016/S1054-139X(98)00153-0.CrossRef
34.
go back to reference Stein Z: Family planning, sexually-transmitted diseases, and the prevention of AIDS: Divided we fail?. Am J Pub Health. 1996, 86: 783-784.CrossRef Stein Z: Family planning, sexually-transmitted diseases, and the prevention of AIDS: Divided we fail?. Am J Pub Health. 1996, 86: 783-784.CrossRef
35.
go back to reference Rutenberg N, Kaufman CE, Mcintyre K, Brown L, Karim A: Pregnant or positive: adolescent childbearing and HIV risk in KwaZulu-Natal, South Africa. Reprod Health Matt. 2003, 11: 122-133. 10.1016/S0968-8080(03)02298-5.CrossRef Rutenberg N, Kaufman CE, Mcintyre K, Brown L, Karim A: Pregnant or positive: adolescent childbearing and HIV risk in KwaZulu-Natal, South Africa. Reprod Health Matt. 2003, 11: 122-133. 10.1016/S0968-8080(03)02298-5.CrossRef
Metadata
Title
Contraception use and pregnancy among 15–24 year old South African women: a nationally representative cross-sectional survey
Authors
Catherine MacPhail
Audrey E Pettifor
Sophie Pascoe
Helen V Rees
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2007
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/1741-7015-5-31

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