Reproductive aspirations, contraception use and dual protection among adolescent girls and young women: the effect of motherhood and HIV status

Abstract Background The importance of contraception use is immense for young girls of age 15–24 years. In literatures, there were significant attempts made to study factors associated with adolescent and young women contraception use in Africa. Despite the resulting interventions followed those studies, the contraception uses among youth population in Africa remained below average. Thus, this study is aimed to assess individual and community-level factors associated with contraceptive use in Ethiopian context to support further interventions. Methods Our analysis was based on the secondary data from Ethiopia Demography and Health Survey (EDHS) 2016. Adolescent girls and young women (AGYW) aged 15–24 years were the target population. Means, standard deviations, and proportions were used to describe the study population. To control for the variations due to the differences between clusters, a series of multilevel logistic regression modeling steps were followed and determinants of contraceptive use were outplayed. All variables with bivariate p-value < 0.25 were included in the models and p-value < 0.05 was used to declare associations. Results The prevalence of modern contraceptive use among AGYW in Ethiopia was 34.89% [95% CI, 0.32, 0.36]. Married adolescents were 2.01 times [AOR = 2.01, 95% CI = 1.39,3.16], having work was 1.36 times [AOR = 1.36, 95% CI = 1.06,1.71], living in urban areas was 1.61 times [AOR = 1.61, 95% CI = 1.16,2.45], being in middle wealth status was 1.9 times [AOR = 1.90, 95% CI = 1.32,2.65], being in rich wealth quintile was 1.99 time [AOR = 1.99, 95% CI = 1.35,2.68], and having TV exposure was 1.61 times [AOR = 1.6, 95% CI = 1.17,2.20] more likely associated with modern contraceptive uses. Conclusion The use of modern contraception among AGYW in the country remained appealing and factors like region, residence, marital status, wealth index, religion, working status, parity, husband desire children, ever aborted AGYW, and the television exposures were attributed for the poor improvements. Therefore, the enhancements that consult those factors remained remarkable in improving contraception use, while further increasing in educational engagement, access to health services, and economic empowerment of the AGYW might be the good advantages for the improvements.

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Dual-Contraception Use Among Adolescent Girls and Young Women Before and After Implementation of the Affordable Care Act

Journal of Obstetric Gynecologic & Neonatal Nursing ◽

10.1016/j.jogn.2019.04.214 ◽

2019 ◽

Vol 48 (3) ◽

pp. S127

Author(s):

Tiffany M. Montgomery ◽

Alisa J. Stephens-Shields ◽

Marilyn M. Schapira ◽

Aletha Y. Akers

Keyword(s):

Adolescent Girls ◽

Young Women ◽

Affordable Care Act ◽

Contraception Use ◽

Before And After ◽

The Affordable Care Act

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Common mental disorders and HIV status in the context of DREAMS among adolescent girls and young women in rural KwaZulu-Natal, South Africa

BMC Public Health ◽

10.1186/s12889-021-10527-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Nondumiso Mthiyane ◽

Guy Harling ◽

Natsayi Chimbindi ◽

Kathy Baisley ◽

Janet Seeley ◽

...

Keyword(s):

Mental Health ◽

South Africa ◽

Hiv Prevention ◽

Mental Disorders ◽

Adolescent Girls ◽

Young Women ◽

Common Mental Disorders ◽

Hiv Status ◽

Kwazulu Natal ◽

Hiv Acquisition

Abstract Background HIV affects many adolescent girls and young women (AGYW) in South Africa. Given the bi-directional HIV and mental health relationship, mental health services may help prevent and treat HIV in this population. We therefore examined the association between common mental disorders (CMD) and HIV-related behaviours and service utilisation, in the context of implementation of the combination DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) HIV prevention programme in rural uMkhanyakude district, KwaZulu-Natal. DREAMS involved delivering a package of multiple interventions in a single area to address multiple sources of HIV risk for AGYW. Methods We analysed baseline data from an age-stratified, representative cohort of 13–22 year-old AGYW. We measured DREAMS uptake as a count of the number of individual-level or community-based interventions each participant received in the last 12 months. CMD was measured using the validated Shona Symptom Questionnaire, with a cut off score ≥ 9 indicating probable CMD. HIV status was ascertained through home-based serotesting. We used logistic regression to estimate the association between CMD and HIV status adjusting for socio-demographics and behaviours. Results Probable CMD prevalence among the 2184 respondents was 22.2%, increasing steadily from 10.1% among 13 year-old girls to 33.1% among 22 year-old women. AGYW were more likely to report probable CMD if they tested positive for HIV (odds ratio vs. test negative: 1.88, 95% confidence interval: 1.40–2.53). After adjusting for socio-demographics and behaviours, there was evidence that probable CMD was more prevalent among respondents who reported using multiple healthcare-related DREAMS interventions. Conclusion We found high prevalence of probable CMD among AGYW in rural South Africa, but it was only associated with HIV serostatus when not controlling for HIV acquisition risk factors. Our findings highlight that improving mental health service access for AGYW at high risk for HIV acquisition might protect them. Interventions already reaching AGYW with CMD, such as DREAMS, can be used to deliver mental health services to reduce both CMD and HIV risks. There is a need to integrate mental health education into existing HIV prevention programmes in school and communities.

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Evaluation of Pre-Exposure Prophylaxis for High Risk Adolescent Girls and Young Women

Case Medical Research ◽

10.31525/ct1-nct04044235 ◽

2019 ◽

Author(s):

Keyword(s):

High Risk ◽

Adolescent Girls ◽

Young Women ◽

Exposure Prophylaxis

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Analisis Penatalaksanaan Fluor Albus Pada Remaja Putri Kelas X Di MA Al-Fatimah Bojonegoro Tahun 2016

Jurnal Ilmu Kesehatan MAKIA ◽

10.37413/jmakia.v7i1.42 ◽

2020 ◽

Vol 7 (1) ◽

Author(s):

Fela Putri Hariastuti ◽

Andin Ajeng Rahmawati

Keyword(s):

Qualitative Research ◽

Adolescent Girls ◽

Young Women ◽

Sexual Development ◽

Primary Data ◽

Physiological Changes ◽

Hormonal Activity ◽

Research Subjects ◽

Teenage Girls ◽

The Central Nervous System

ABSTRAK Masa remaja mengalami perkembangan fisiologis, psikososial, kognitif, moral dan perkembangan seksual. Perubahan fisiologis pada masa remaja merupakan hasil aktivitas hormonal dibawah pengaruh sistem saraf pusat. Menarche pada umumnya menjadi masalah bagi remaja, hal ini terjadi karena remaja masih belum tahu tentang apa itu menstruasi dan bagaimana menanganinya, sehingga kebersihan daerah genetalia tidak terjaga dan dapat menimbulkan terjadinya keputihan (Soetjiningsih, 2007). Penelitian ini bertujuan untuk mengetahui penatalaksanaan flour albus pada remaja putri kelas X di SMA AL-Fatimah Bojonegoro tahun 2016. Jenis penelitian ini adalah kualitatif yaitu penelitian expose facto (mengungkap fakta) dengan pendekatan pengukuran secara langsung dengan menggunakan data primer. Subjek penelitian semua remaja putri kelas X yang mengalami keputihan di MA AL- Fatimah Kecamatan Bojonegoro Kabupaten Bojonegoro tahun 2016 yang berjumlah 30 responden. Hasil penelitian yang didapatkan sebanyak 25 responden remaja putri sudah bisa melaksanakan penatalaksanaan pada flour albus. Kata Kunci : flour albus, remaja putri ABSTRACT Adolescence develops physiological, psychosocial, cognitive, moral and sexual development. Physiological changes in adolescence are the result of hormonal activity under the influence of the central nervous system. Menarche is generally a problem for teenagers, this is because teenagers still do not know what menstruation is and how to handle it, so that the cleanliness of the genetalia area is not maintained and can lead to whitish (Soetjiningsih, 2007).This study aims to determine the management of flour albus in adolescent girls of class X in SMA AL-Fatimah Bojonegoro in 2016. The type of this research is qualitative research that is expose facto (revealing fact) with approach of measurement directly by using primary data. Research subjects of all teenage girls of class X who experienced whiteness in MA Al-Fatimah Bojonegoro District Bojonegoro District in 2016, amounting to 30 respondents.The results obtained as many as 25 female teenage respondents have been able to implement management on flour albus. Keywords: flour albus, young women

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Correction: Vulnerability profiles and prevalence of HIV and other sexually transmitted infections among adolescent girls and young women in Ethiopia: A latent class analysis

PLoS ONE ◽

10.1371/journal.pone.0236910 ◽

2020 ◽

Vol 15 (7) ◽

pp. e0236910

Author(s):

Carly A. Comins ◽

Katherine B. Rucinski ◽

Stefan Baral ◽

Samuele A. Abebe ◽

Andargachew Mulu ◽

...

Keyword(s):

Latent Class Analysis ◽

Sexually Transmitted Infections ◽

Adolescent Girls ◽

Young Women ◽

Latent Class ◽

Class Analysis ◽

Sexually Transmitted

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Policy considerations for scaling up access to HIV pre‐exposure prophylaxis for adolescent girls and young women: Examples from Kenya, South Africa, and Uganda

The International Journal of Health Planning and Management ◽

10.1002/hpm.3252 ◽

2021 ◽

Author(s):

Jeff Lane ◽

Audrey Brezak ◽

Pragna Patel ◽

Andre R. Verani ◽

Irene Benech ◽

...

Keyword(s):

South Africa ◽

Adolescent Girls ◽

Young Women ◽

Scaling Up ◽

Exposure Prophylaxis

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The Community PrEP Study: a randomized control trial leveraging community-based platforms to improve access and adherence to pre-exposure prophylaxis to prevent HIV among adolescent girls and young women in South Africa—study protocol

Trials ◽

10.1186/s13063-021-05402-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Andrew Medina-Marino ◽

Dana Bezuidenhout ◽

Sybil Hosek ◽

Ruanne V. Barnabas ◽

Millicent Atujuna ◽

...

Keyword(s):

South Africa ◽

Adolescent Girls ◽

Young Women ◽

Randomized Control Trial ◽

Community Based ◽

Adherence Support ◽

Randomized Control ◽

Exposure Prophylaxis ◽

Effective Use ◽

Improve Access

Abstract Background HIV incidence among South African adolescent girls and young women (AGYW) remains high, but could be reduced by highly effective pre-exposure prophylaxis (PrEP). Unfortunately, AGYW report significant barriers to clinic-based sexual and reproductive health services. Even when AGYW access PrEP as an HIV prevention method, poor prevention-effective use was a serious barrier to achieving its optimal HIV prevention benefits. Determining the acceptability and feasibility of community-based platforms to increase AGYW’s access to PrEP, and evaluating behavioural interventions to improve prevention-effective use of PrEP are needed. Methods We propose a mixed-methods study among AGYW aged 16–25 years in Eastern Cape Province, South Africa. In the first component, a cross-sectional study will assess the acceptability and feasibility of leveraging community-based HIV counselling and testing (CBCT) platforms to refer HIV-negative, at-risk AGYW to non-clinic-based, same-day PrEP initiation services. In the second component, we will enrol 480 AGYW initiating PrEP via our CBCT platforms into a three-armed (1:1:1) randomized control trial (RCT) that will evaluate the effectiveness of adherence support interventions to improve the prevention-effective use of PrEP. Adherence will be measured over 24 months via tenofovir-diphosphate blood concentration levels. Qualitative investigations will explore participant, staff, and community experiences associated with community-based PrEP services, adherence support activities, study implementation, and community awareness. Costs and scalability of service platforms and interventions will be evaluated. Discussion This will be the first study to assess the acceptability and feasibility of leveraging CBCT platforms to identify and refer at-risk AGYW to community-based, same-day PrEP initiation services. It will also provide quantitative and qualitative results to inform adherence support activities and services that promote the prevention-effective use of PrEP among AGYW. By applying principles of implementation science, behavioural science, and health economics research, we aim to inform strategies to improve access to and prevention-effective use of PrEP by AGYW. Trial registration ClinicalTrials.govNCT03977181. Registered on 6 June 2019—retrospectively registered.

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Wealth-related inequalities in demand for family planning satisfied among married and unmarried adolescent girls and young women in sub-Saharan Africa

Reproductive Health ◽

10.1186/s12978-021-01076-0 ◽

2021 ◽

Vol 18 (S1) ◽

Author(s):

Martin K. Mutua ◽

Yohannes D. Wado ◽

Monica Malata ◽

Caroline W. Kabiru ◽

Elsie Akwara ◽

...

Keyword(s):

Family Planning ◽

West Africa ◽

Adolescent Girls ◽

Young Women ◽

Rate Of Change ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Sexually Active ◽

Sub Saharan ◽

Over Time

Abstract Background The use of modern contraception has increased in much of sub-Saharan Africa (SSA). However, the extent to which changes have occurred across the wealth spectrum among adolescents is not well known. We examine poor-rich gaps in demand for family planning satisfied by modern methods (DFPSm) among sexually active adolescent girls and young women (AGYW) using data from national household surveys. Methods We used recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys to describe levels of wealth-related inequalities in DFPSm among sexually active AGYW using an asset index as an indicator of wealth. Further, we used data from countries with more than one survey conducted from 2000 to assess DFPSm trends. We fitted linear models to estimate annual average rate of change (AARC) by country. We fitted random effects regression models to estimate regional AARC in DFPSm. All analysis were stratified by marital status. Results Overall, there was significant wealth-related disparities in DFPSm in West Africa only (17.8 percentage points (pp)) among married AGYW. The disparities were significant in 5 out of 10 countries in Eastern, 2 out of 6 in Central, and 7 out of 12 in West among married AGYW and in 2 out of 6 in Central and 2 out of 9 in West Africa among unmarried AGYW. Overall, DFPSm among married AGYW increased over time in both poorest (AARC = 1.6%, p < 0.001) and richest (AARC = 1.4%, p < 0.001) households and among unmarried AGYW from poorest households (AARC = 0.8%, p = 0.045). DPFSm increased over time among married and unmarried AGYW from poorest households in Eastern (AARC = 2.4%, p < 0.001) and Southern sub-regions (AARC = 2.1%, p = 0.030) respectively. Rwanda and Liberia had the largest increases in DPFSm among married AGYW from poorest (AARC = 5.2%, p < 0.001) and richest (AARC = 5.3%, p < 0.001) households respectively. There were decreasing DFPSm trends among both married (AARC = − 1.7%, p < 0.001) and unmarried (AARC = − 4.7%, p < 0.001) AGYW from poorest households in Mozambique. Conclusion Despite rapid improvements in DFPSm among married AGYW from the poorest households in many SSA countries there have been only modest reductions in wealth-related inequalities. Significant inequalities remain, especially among married AGYW. DFPSm stalled in most sub-regions among unmarried AGYW.

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