The use of condoms and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African countries

Abstract

Background Adolescents in sub-Saharan Africa still face sexual and reproductive health challenges. Contraceptives have been used to address these challenges. Despite efforts at national and global levels, contraceptive uptake among young people in Africa remains a challenge due to personal, societal, and health systems-based barriers. We estimated the prevalence and correlates of condom use and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African (SSA) countries. Methods We conducted a secondary analysis of the Global School-based Student Health Surveys (GSHS) datasets pooled from nine SSA countries. We included a sample of 27,504 school-going adolescents 11 years and younger and 18 years and older. We employed meta-analysis using a random-effects model to estimate the total prevalence of the use of condoms, other birth control methods other than a condom and any birth control method at last sexual intercourse. We conducted complex sample descriptive and logistic regression analyses to determine the characteristics and determinants of not using condoms and other birth control methods among sexually active school-going adolescents in nine sub-Saharan African countries, respectively. Results More than half [n = 4430, 53.8% (43.9–63.8)], two-fifth [n = 3242, 39.5% (33.2–45.9) and two-thirds of adolescents [n = 4838, 65.6% (57.5–73.7)] of sexually active in school adolescents across the nine sub-Saharan African countries used condom, other birth control methods and any form birth control method during their last sexual intercourse, respectively. The non-use of condoms at last sex was associated with being younger (less than 16 years) [AOR = 1.48;95%CI: 1.12–1.94], early sexual debut [AOR = 1.81(1.47–2.22)], having two or more sexual partners [AOR = 1.30(1.06–1.58)] and no/minimal parental support [AOR = 1.54(1.17–2.03)]. The non-use of other birth control methods at last sex was associated with being male [AOR = 1.37 (1.09–1.73)], early sexual debut [AOR = 1.83(1.48–2.27) and having no parental support [AOR = 1.64(1.34–2.00)]. Conclusion Contraceptive need among sexually active school adolescents in the nine sub-Saharan African countries is high. Such a need calls for the development of country-specific and or the review of existing school-based sexual health education and youth-friendly sexual and reproductive health interventions that target risky adolescents and promote adolescent-parent effective communication, connectedness and support.

Prevalence and factors associated with contraceptive use among sexually active adolescent girls in 25 sub-Saharan African countries

“…They pledged to invest in adolescents' youth-friendly reproductive health, and thus provided free family planning services at all public health facilities [31]. The fact that 23 out of the 25 SSA countries studied, or 92% of the sampled countries, had less than 50% contraceptive use among adolescent girls who were sexually active confirms the assertion that adolescents in SSA continue to face significant sexual and reproductive health challenges [26]. Similarly, a previous study of adolescent girls in 32 SSA countries that did not specifically target sexually active adolescent girls found an overall low prevalence of contraceptive use of 18.9% [32].…”

“…At the multi-country level, no attention has been paid to sexually active adolescents’ contraceptive use in SSA. A few multi-country level studies that examined contraceptive use among adolescents in SSA focused only on married/cohabited adolescents [ 24 ], young adult women aged 15 to 24 without disaggregation by adolescent age [ 25 ], and school-going adolescents (excluding out-of-school adolescents) [ 26 ]. The purpose of this study was to fill this void by assessing the prevalence and factors associated with contraceptive use among sexually active adolescent girls in 25 SSA countries, in order to provide empirical evidence for advocacy and comparative policy options.…”

Knowledge and attitudes regarding contraceptive methods and sex education in students and parents of eight Colombian schools 2020–2021: a mixed methods study

“… 22 Other studies state that parents are the first source from which adolescents obtain information. 4 , 21 , 23 , 24 , 25 However, there are barriers to initiating dialogues on sexuality at home, such as shame, ignorance, distrust, denial, fear of legitimizing the initiation of sexual life, religious dogmas, lack of time, and generational gaps, among others. 15 , 22 , 26 For this reason, it is necessary to build relationships based on trust, to start the teaching process from a young age with basic subjects according to age, use appropriate language, transform educational paradigms, and rely on external people who can contribute assertively to the education of children.…”

“…This finding is consistent with the literature, which also adds associations with early sexual intercourse, pregnancy, multiple sexual partners, contraceptive myths, and risky manoeuvres to avoid pregnancy. 18 , 21 , 24 , 25 , 31 , 32 , 33 , 34 …”

Editorial: Multipurpose prevention technologies for HIV, STIs and pregnancies

“…Multipurpose prevention technologies (MPTs) are emerging biomedical interventions to prevent two or more SRH issues simultaneously (Figure 1B) (7,8). Male and female condoms, the only existing MPTs, have drawbacks limiting their consistent use, particularly among the most vulnerable (9)(10)(11). Novel MPTs often integrate drug delivery and medical device functions within a single product to increase adherence and overall effectiveness (7).…”