An estimated 60% of all adolescent pregnancies in low-income countries are unintended. The present study was carried out at the university hospital in Lusaka, Zambia over a four-month period in 2005. The aim was to explore experiences of pregnancy loss and to ascertain the girl's contraceptive knowledge and use and their partner's involvement in the pregnancy/abortion. Eighty-seven girls aged 13-19 years admitted to hospital for incomplete abortions were interviewed. Of these girls, 53 (61%) had had a spontaneous abortion and 34 (39%) had undergone an unsafe induced abortion. Significantly more girls with an unsafe induced abortion were single, students, had completed more years in school and were in less stable relationships. Girls' overall contraceptive knowledge and use was low and most pregnancies were unplanned. Partners played a decisive role in terminating pregnancy through unsafe induced abortion. Traditional healers, girls themselves and health professionals were the main abortion providers. Young women's health risks due to unprotected sex and lack of contraceptive services should urgently be addressed. The existence of the abortion law and access to emergency contraception should be better publicized in Zambia.

Our aim in this study was to describe adolescent girls' circumstances underlying the decision to resort to unsafe induced abortions. Thirty-four Zambian girls aged 13 to 19 years admitted to University Teaching Hospital (UTH) in Lusaka were interviewed using a semistructured questionnaire with both closed and open-ended questions. Results revealed that most of the girls were single, in school, reached higher grades, mainly nulliparous, and had very low knowledge of contraceptive use. Reasons given for performing unsafe abortions were fear of facing personal shame and social stigma following premarital pregnancies, such as parental disapproval, abandonment by partner, and expulsion from school. A blend of traditional and modern methods and medicines were used to abort. Limited access to contraception and the stigma attached to premarital pregnancies and abortions are likely to continue to compel girls to rely on clandestine abortions if comprehensive adolescent reproductive health services are not provided. The necessity to give adolescent girls more attention and advocacy is obvious.

The role adolescent boys play in premarital sexual activities, gender power relations, and the reproductive health risks they are exposed to, has received little attention in research. This qualitative study has aimed to explore Zambian male adolescents' perceptions and expectations about premarital sexual relationships. Seven focus group discussions were conducted between November 2000 and May 2001, in George and Chimwemwe compounds, with 53 boys aged 15 to 19. The findings reveal that adolescent premarital sexual relationships are common and considered by many boys as a prerequisite to achieving an adult male's autonomy and status. The boys viewed themselves as the privileged gender, with greater freedom than girls, and were the major decision-makers on sexual matters in relationships. The results indicate that traditional values and stereotypical gender roles continue to influence Zambian boys' male identity. However, a sense of ambiguity among the boys on issues of gender imbalance in premarital relationships indicates a potential and preparedness to break with traditional trends - a true challenge for public health priorities and interventions.

Adolescence is a period of transition during which a person is neither considered a child nor an adult. As little is known about adolescent boys' perceptions, norms, role models and gender relations that influence their male identity and behaviour, this qualitative study was conducted. Data were drawn from seven FGDs and twelve mails of adolescent boys (15-19 years old) residing in two townships outside Lusaka and Kitwe in Zambia. Findings show that growing up to a man entails a certain level of ambiguity and contradictory perceptions in terms of supposedly appropriate social and sexual behaviour but indicates a few alternatives. Based on the findings, we recommend that the information gap, misconceptions and anxiety among boys regarding their male identity should be addressed. The respondents suggested that an educational programme that will pay due attention to their needs and answer their questions should be designed and