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Open Access Research article

Contraception use and pregnancy among 15–24 year old South African women: a nationally representative cross-sectional survey

Catherine MacPhail1*, Audrey E Pettifor12, Sophie Pascoe3 and Helen V Rees4

Author Affiliations

1 Reproductive Health & HIV Research Unit, Department of Obstetrics and Gynecology, University of the Witwatersrand, Johannesburg, PO Box 18512, Hillbrow 2038, South Africa

2 Department of Epidemiology, CB#7435 McGavran-Greenberg Building, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7435, USA

3 Infectious Disease Epidemiology Unit, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC 1E 7HT, UK

4 Reproductive Health & HIV Research Unit, Department of Obstetrics and Gynecology, University of the Witwatersrand, Johannesburg, PO Box 18512, Hillbrow 2038, South Africa

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BMC Medicine 2007, 5:31  doi:10.1186/1741-7015-5-31

Published: 28 October 2007

Abstract

Background

Adolescent reproductive health has not continued to receive the attention it deserves since the start of the HIV epidemic. In South Africa, high numbers of adolescent women report pregnancies that are unwanted and yet few have accessed available termination of pregnancy services. Enabling contraception use is vital for meeting the goals of HIV prevention.

Methods

A nationally representative survey of South African 15–24 year olds was undertaken. Participants completed a questionnaire on sexual behaviour and provided an oral fluid sample for HIV testing. Analysis of the data was restricted to women (n = 6217), particularly those who reported being sexual active in the last 12 months (n = 3618) and was conducted using svy methods in the program STATA 8.0 to take account of sampling methods. Univariate and multivariate analyses were conducted to explore factors associated with contraceptive use.

Results

Two thirds of all women reported having ever been sexually active and among these 87% were sexually active in the past 12 months. Among women who reported currently being sexually active, 52.2% reported using contraceptives. There was evidence of association between contraceptive use and being employed or a student (vs unemployed); fewer sex partners; type of last sex partner; having talked to last partner about condom use and having ever been pregnant.

Conclusion

Specific emphasis must be placed on encouraging young women to use contraceptive methods that offer protection against pregnancy and STIs/HIV. Our consistent finding of a relationship between discussing condom use with partners and condom use indicates the importance of involvement of male partners in women's contraceptive decisions.