Risk factors for teenage pregnancy among sexually active black adolescents in Cape Town. A case control study.

Vundule, C; Maforah, F; Jewkes, RK; Jordaan, E; (2001) Risk factors for teenage pregnancy among sexually active black adolescents in Cape Town. A case control study. South African Medical Journal, 91 (1). pp. 73-80. ISSN 0256-9574

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MOTIVATION: Teenage pregnancy is an important health and social problem in South Africa. So far research on adolescent sexual activity has been almost exclusively descriptive; as a result there is considerable knowledge about practices of adolescents in general and outcomes of their pregnancies, but very limited understanding of factors that place particular adolescents at increased risk of teenage pregnancy. Without this understanding, our ability to intervene effectively to reduce teenage pregnancy rates is limited. OBJECTIVE: To undertake an exploratory study to investigate risk factors for teenage pregnancy among sexually active adolescents in an urban and peri-urban context. METHODS: The study used a matched case-control design, with 191 cases and 353 age-matched controls from the same school or neighbourhood. Subjects were under 19 years of age and were recruited from township areas of Cape Town. A structured questionnaire was used to obtain information on socio-economic factors, contraceptive knowledge and use, and sexual behaviour. Conditional logistical regression was used to analyse the relationship between teenage pregnancy and the factors investigated. RESULTS: Teenage pregnancy was found to be most strongly associated with having frequent sex (risk ratio (RR) 30.81) without reliable contraceptive protection (RR 24.35), forced sexual initiation (RR 14.42), not owning a television set (RR 10.33), larger household size (RR 2.44), not living in a brick house (RR 5.09), not living with the biological father (RR 3.26), talking openly about sex with a boyfriend (RR 4.72), and perceiving most friends to be pregnant (RR 4.38). CONCLUSIONS: The findings suggest associations between the promotion of sexual health among adolescents and broader social development and promotion of gender equality. Although further research is needed, it is likely that important foci for short-term strategies should include developing assertiveness, enhancing decision-making competence, and promoting contraception and condoms as part of comprehensive sexual and reproductive health educational interventions.

Item Type: Article
Keywords: Adolescent, Adolescent Behavior, psychology, Blacks, psychology, statistics & numerical data, Case-Control Studies, Female, Human, Knowledge, Attitudes, Practice, Logistic Models, Needs Assessment, Pregnancy, Pregnancy in Adolescence, psychology, statistics & numerical data, Questionnaires, Risk Factors, Sex Behavior, psychology, statistics & numerical data, Sex Education, Social Change, Socioeconomic Factors, South Africa, epidemiology, Support, Non-U.S. Gov't, Urban Health, statistics & numerical data
Faculty and Department: Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
PubMed ID: 11236303
Web of Science ID: 167289800037
URI: http://researchonline.lshtm.ac.uk/id/eprint/18467


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