00217 Adolescent pregnancy and current contraceptive use among adolescent and young women aged 16-24 years in Durban and Soweto, South Africa

Reference Article

Malgorzata Beksinska, Kalysha Closson, Jenni Smit et al. Adolescent pregnancy and current contraceptive use among adolescent and young women aged 16-24 years in Durban and Soweto, South Africa, 13 May 2021, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-514539/v1]

Abstract

High rates of adolescent pregnancies in South Africa continues to be a pressing public health concern. This study examines (1) the prevalence of current contraceptive use; and (2) the independent association between adolescent pregnancy and effective contraception use.

This study uses baseline cross-sectional data from a youth-centered sexual and reproductive health (SRH) cohort study among youth (aged 16–24) in Soweto and Durban (2011–2017). Among 207/253 females reporting consensual sexual activity, crude and adjusted logistic regression examine associations between ever having an adolescent pregnancy (aged 15–19) or pregnancy at age 20–24 (ref no pregnancy) and effective contraception use (barrier and/or hormonal methods) in the last 6 months.

Over one-third (34.3%, n = 71) of females reported a history of adolescent pregnancy and 13.0% (n = 27) had a pregnancy at age 20–24. Nearly all (95.9%, n = 94) first pregnancies were unintentional. Current effective contraceptive use was reported by 74.6% (n = 53) with an adolescent pregnancy, 66.6% (n = 18) of those pregnant at 20–24 years, and 46.8% (n = 51) of never pregnant females (p < 0.001). All effective contraceptive users pregnant at 20–24 years and 83% (n = 44) of the adolescent pregnancy group reported using hormonal methods vs. 52.9% (n = 27) of never pregnant females. In the adjusted model, a history of adolescent pregnancy was associated with 3.45 (95%CI = 1.75–6.82) times greater odds of effective contraceptive use (vs. no pregnancy).

The results suggest that adolescent females are accessing effective methods of contraception including hormonal methods only after a pregnancy event, highlighting the need for earlier provision of youth-friendly SRH services.