Contraceptive Use and Method Choice during First Sexual Encounter among Adolescents: Insights from the Teamup Study

Themba Mzembe, African Institute for Development Policy (AFIDEP)
Nurudeen Alhassan, African Institute for Development Policy (AFIDEP)
Naa Dodua Dodoo, African Institute for Development Policy (AFIDEP)
Maame Peterson, African Institute for Development Policy
John A Mushomi, Makerere University
Ernestina Coast, London School of Economics and Political Science (LSE)
Saseendran Pallikadavath, University of Portsmouth
Jacques B. O. Emina, University of Kinshasa
Elizabeth F. Omoluabi, Akena Plus Heath Trust
Francis Dodoo, Pennsylvania State University
Nyovani Madise
Eliya M. Zulu, African Institute for Development Policy (AFIDEP)

Background We aimed to explore contraceptive use and method choice during first sexual encounter among adolescents (ages 15-19) in the TEAMUP Study. Methods TEAMUP (Re-examining Traditional Method Use) was a cross-sectional study conducted in the Democratic Republic of Congo (DRC), Ghana, Kenya, and Nigeria between September 2022 and February 2023. We performed descriptive analyses and used multilevel logistic regression to examine associations between contraceptive use at first sexual encounter and sociodemographic factors among adolescents. Results Overall, 817 (36.1%) adolescents reported ever having sex. Among these, 326 (39.9%) reported using contraception during their first encounter. Of these, 25 (7.7%) used modern and traditional methods concurrently, 210 (64.4%) used modern methods only, 49 (15.0%) used traditional methods only, and 42 (12.9%) used folkloric methods only. Contraception use at first sexual encounter was associated with secondary/higher education (adjusted odds ratio [aOR]: 1.52, 95% confidence interval [CI]: 0.97–2.37) and high household socioeconomic status (aOR: 1.64, 95% CI: 1.02–2.62). Conclusion Our results show persisting inequalities in contraception use during first sexual encounter across countries. Improving access to reproductive health services and sexual health education, especially among disadvantaged adolescents, is crucial in reducing adolescent pregnancies and enhancing reproductive health outcomes.

Keywords: Sexual and Reproductive Health and Rights, Inequality, Disadvantage and Discrimination, Children, Adolescents, and Youth

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