Communication Self-Efficacy and Contraceptive Use at Sexual Debut Among Rural Adolescent Girls in Ethiopia

INTRODUCTION: Girls with early sexual debuts are exposed to risky sexual behaviours, such as unintended pregnancy and contracting sexually transmitted infections. Communication self-efficacy is vital for protecting girls from unwanted pregnancy by educating them about the use of contraceptives. This study aimed to investigate the relationship between communication self-efficacy and contraceptive use at sexual debut in a rural Ethiopian setting. METHODS: A cross sectional study design was employed to study communication self-efficacy at sexual debut in West Hararghe rural zone, Oromia region of Ethiopia. Adolescent girls between the ages of 13 – 17 were selected with simple random sampling technique and out of these a total of 394 girls who self-reported their sexual debut, were included in the analysis. Data were collected with an electronic data collection system through one to one interviews. Communication self-efficacy was measured using two items: adolescents who discussed contraceptives with their partners, and adolescents who discussed contraceptives with other people. The association between contraceptive use at sexual debut and communication self-efficacy was examined using a multivariable logistic regression model that accounted for a complex sample survey design. RESULTS: The mean age of sexual debut was 14.5 years (95% CI 14.38, 14.69) and the proportion of contraceptive use at sexual debut was 17.37% (95% CI 12.75, 22.95). Contraceptive use at sexual debut was higher among girls who talked to their partner about contraceptives (adjusted odds ratio (AOR) = 1.94, 95% CI [0.98 - 3.8]) and those who discussed contraceptives with others (AOR = 2.45, 95% CI [1.56 - 5.55]. CONCLUSIONS: Contraceptive use at sexual debut was low among young rural adolescent girls. Adolescent girls who had communication self-efficacy were likely to use contraceptives at sexual debut. Life skills interventions that improve communication and negotiation are recommended to enhance contraceptive use.