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Reproductive Health
Published in: Reproductive Health 1/2018

Open Access 01-12-2018 | Research

Reproductive health problems in rural South African young women: risk behaviour and risk factors

Authors: Hashini Nilushika Galappaththi-Arachchige, Siphosenkosi G. Zulu, Elisabeth Kleppa, Kristine Lillebo, Erik Qvigstad, Patricia Ndhlovu, Birgitte Jyding Vennervald, Svein Gunnar Gundersen, Eyrun Floerecke Kjetland, Myra Taylor

Published in: Reproductive Health | Issue 1/2018

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Abstract

Background

South African young women continue to be vulnerable, with high prevalence of teenage pregnancy, HIV, sexually transmitted infections (STIs) and female genital schistosomiasis (FGS). This study seeks to examine the underlying factors that may be associated with these four adverse reproductive health outcomes.

Methods

In a cross-sectional study of 1413 sexually active of young women, we explored these four adverse reproductive health outcomes by considering socio-demographic factors, socio-economic factors, sexual risk behaviour, substance abuse and knowledge about reproductive health by using a questionnaire. Consenting participants were asked about previous pregnancies and were tested for HIV, STIs and FGS. Multivariable regression analyses were used to explore the factors associated with these four reproductive health outcomes.

Results

1.
Early pregnancy: Among the young women, 44.4% had already been pregnant at least once. Associated factors were hormonal contraceptives, (adjusted odds ratio (AOR): 17.94, 95% confidence interval (CI): 12.73–25.29), and sexual debut < 16 years (AOR: 3.83, 95% CI: 2.68–5.47). Living with both parents (AOR 0.37, 95% CI: 0.25–0.57) and having a steady partner (AOR: 0.43, 95% CI: 0.24–0.76) were identified as protective factors against pregnancy.
 
2.
HIV: HIV prevalence was 17.1%. The odds of having HIV were higher in intergenerational (AOR: 2.06, 95% CI: 1.05–4.06) and intragenerational relationships (AOR: 1.51 95% CI: 1.06–2.15), compared to age-homogenous relationships. Other associated factors were: condom use (AOR: 1.60, 95% CI: 1.16–2.20), number of times treated for an STI (AOR: 1.32, 95% CI: 1.02–1.71), and total number of partners (AOR: 1.14, 95% CI: 1.03–1.28).
 
3.
STIs: Participants who had at least one STI (40.5%) were associated with total partner number (AOR 1.17, 95% CI: 1.06–1.30), and testing HIV positive (AOR: 1.88, 95% CI 1.41–2.50).
 
4.
FGS: FGS prevalence (19.7%) was associated with previous anti-schistosomal treatment (AOR: 2.18, 95% CI: 1.57–3.05).
 

Conclusion

There is a high prevalence of pregnancy, HIV, STIs and FGS among sexually active young women in rural KwaZulu-Natal. Multidisciplinary approaches are urgently needed for educational and health literacy programs prior to sexual debut, and health care facilities, which should be made accessible for young women.
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Metadata
Title
Reproductive health problems in rural South African young women: risk behaviour and risk factors
Authors
Hashini Nilushika Galappaththi-Arachchige
Siphosenkosi G. Zulu
Elisabeth Kleppa
Kristine Lillebo
Erik Qvigstad
Patricia Ndhlovu
Birgitte Jyding Vennervald
Svein Gunnar Gundersen
Eyrun Floerecke Kjetland
Myra Taylor
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2018
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-018-0581-9

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