A qualitative study of risks and protective factors against pregnancy among sexually-active adolescents in Soweto, South Africa.

• Type of Material: Article
• Authors: Edna N Bosire, University of the Witwatersrand, Johannesburg, South Africa.; Katharine Chiseri, Emory University; Dawn Comeau, Emory University; Linda Richter, University of the Witwatersrand, Johannesburg, South Africa.; Aryeh Stein, Emory University; Shane Norris, Emory University
• Language: English
• Date: 2021
• Publisher: PLOS
• Publication Version: Final Published Version
• Copyright Statement: © 2021 Bosire et al
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pgph.0000044
• Title of Journal or Parent Work: PLOS Glob Public Health
• Volume: 1
• Issue: 11
• Start Page: e0000044
• End Page: e0000044
• Grant/Funding Information: The study was supported by the South African Medical Research Council. DSI-NRF Centre of Excellence in Human Development at the University of the Witwatersrand, Johannesburg, South Africa and the Gates Foundation supported the Birth to Twenty Plus cohort. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
• Keywords: Risky sexual behaviors; adolescents; pregnancy
• Research Categories: Health Sciences, Public Health

Abstract

Risky sexual behaviors contribute to increased risk of adolescent pregnancy. This qualitative study sought to understand risks and protective factors against pregnancy amongst sexually-active adolescents in Soweto, South Africa. We used purposive sampling to recruit women at age 24 years from Soweto, who self-reported having sexual debut by age 15 years. Twenty women were recruited: (i) women who did not become pregnant before 18 years (n = 10) and (ii) women who became pregnant before 18 years (n = 10). In-depth interviews were conducted to understand their family backgrounds, conversations about sex, sexual behaviors, and initiatives taken (or not) during adolescence to prevent pregnancy. Both groups of women reported predisposing risks to early pregnancy including influence from peers to engage in early sex, unstable family relationships and limited conversations about sex. We found that the family is a key institution in supporting adolescents' decisions regarding their behaviors and choices, as are peers and exposures to information. Community Youth Centers, high schools and Youth Friendly Health Services should ensure that adolescents have access to relevant information, including sex education and contraceptives.