Predictors of contraceptive use among adolescent girls and young women (AGYW) aged 15 to 24 years in South Africa: results from the 2012 national population-based household survey

Abstract

Background: Despite a variety of contraceptives being available for women in South Africa, a considerable number of adolescent girls and young women still face challenges in using them. This paper examines socio-demographic and behavioral predictors of using contraceptives among adolescent girls and young women (AGYW) aged 15 to 24 years.Methods: A secondary data analysis was conducted based on the 2012 population-based nationally representative multi-stage stratified cluster randomised household survey. Multivariate backward stepwise logistic regression model was used to examine socio-demographic and behavioural factors independently associated with contraceptive use amongst AGYW aged 15 to 24 years in South Africa.Results: Out of 1460 AGYW, 78% (CI: 73.9-81.7) reported using some form of contraceptives. In the model, contraceptive use was significantly associated with secondary education [OR = 1.8 (1.2-2.7), p = 0.005], having a sexual partner within 5 years of their age [OR = 1.8 (1.2-2.5), p = 0.002], and sexual debut at age 15 years and older [OR = 2.5 (1.3-4.6), p = 0.006]. The likelihood of association decreased with other race groups-White, Coloured, and Indians/Asians [OR = 0.5 (0.3-0.7), p = 0.001], being married [OR = 0.4 (0.2-0.7), p = 0.001], never given birth [OR = 0.7 (0.5-0.9), p = 0.045], coming from rural informal [OR = 0.5 (0.3-0.9), p = 0.010] and rural formal settlements [OR = 0.5 (0.3-0.9), p = 0.020]. Conclusions: Evidence suggest that interventions should be tailor-made to meet the needs of AGYW in order to, promote use and access to contraceptives. The results also suggest that family planning interventions should target those who had not given birth in order to reduce unplanned and or unintended pregnancies and associated risk factors. These findings contribute to public health discourse and reproductive health planning for these age groups in the country.

Predictors of unmet need for contraception among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa: A multilevel mixed effects analysis

“…However, in SSA, studies on the predictors of unmet need for contraception among AGYW have been done in specific countries like Ethiopia [13], Senegal [26] and South Africa [17]. There has not been any study that has combined specific high fertility countries in SSA together to understand the reasons for the high unmet need for contraception in AGYW who live in those countries.…”

“…Although contraceptives have been considered effective in fertility regulation, their use among AGYW in SSA remains an issue that needs urgent attention [ 12 – 14 ]. Studies have indicated that despite the desire for AGYW in SSA to use contraceptives, a majority of them have challenges with access to contraceptive services [ 15 – 17 ]. A useful measure for of the gap between the desire for and access to contraception is the estimation of unmet need for contraception [ 18 ].…”

Identification of adolescent girls and young women for targeted HIV prevention: a new risk scoring tool in KwaZulu Natal, South Africa

“…Vulnerability to HIV acquisition is driven, in part, by power imbalance in relationships with older male partners 19 , 21 , 22 and may be prevented by the administration of PrEP 23 – 26 . In ongoing efforts to combat the transmission of HIV among AGYW, there is a distinct need for risk assessment tools that capture heterogeneities in AGYW HIV acquisition risk, in addition to the efficient identification of those at high risk of infection 7 , 15 , 20 , 22 , 25 , 26 . Risk assessment tools have successfully predicted HIV acquisition among adult African women 4 , 5 and the development of such prognostic tools for the AGYW population 27 may prove effective in breaking the HIV transmission cycle in South Africa, by directing the administration of PrEP to prevent HIV infection among high-risk AGYW.…”

“…In high-prevalence hyper-endemic settings, such as eastern and southern Africa, adolescent girls and young women (AGYW), aged 14–25 years, are particularly vulnerable to HIV acquisition due to power imbalance in sexual relationships 14 – 19 , particularly those in which HIV is acquired from men over 25 years old 15 , 18 – 21 , and biological factors (i.e., increased genital inflammation) 18 . Despite their elevated risk of infection, AGYW, particularly those under 18 years, underutilize health services for fear of stigmatization 18 , 19 .…”

“…Despite their elevated risk of infection, AGYW, particularly those under 18 years, underutilize health services for fear of stigmatization 18 , 19 . Due to the disproportionate burden of HIV/AIDS among African AGYW, efficient identification of females with high HIV risk and an understanding of AGYW risk heterogeneities is critical for effective targeting of prevention interventions 7 , 15 , 20 – 26 . Specific HIV risk tools have been developed for adult African women 4 , 5 and one tool has been developed for South African AGYW 27 .…”