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Published by the INFO Project, Center for Communication Programs, The Johns Hopkins University Bloomberg School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202, USA Volume XXXI, Number 2, |
Young Adult Contraceptive UseIn surveyed countries the highest levels of contraceptive use are among unmarried, sexually active women ages 20 to 24; the lowest levels are among adolescent married women (ages 15 to 19). Particularly in sub-Saharan Africa and South Asia, young married women often face cultural expectations and social pressure to “prove” their childbearing abilities to their families and their husbands’ families immediately (73, 82). As a result, few married adolescents use contraception. Conversely, sexually active young unmarried women have strong motivation to avoid pregnancy, and so they tend to use contraception (70). Still others—married or unmarried—may want to use contraception but face barriers to obtaining family planning because of their young age and unmarried status (51, 60, 106). In sub-Saharan Africa married women ages 15 to 19 have particularly low levels of contraceptive use, at about 13% (see Table 10). Among unmarried sexually active adolescents, however, the level of contraceptive use reaches 39%. In the region some 20% of married women ages 20 to 24 use contraception compared with 49% of sexually active unmarried women in the same age group. Unmarried women most often use condoms, while married women most often use OCs or traditional methods. In Latin America and the Caribbean an average of 39% of married women ages 15 to 19 use contraception. By comparison, 60% of sexually active unmarried women this age use contraception. Women ages 20 to 24 are even more likely to use contraception, at 52% of married women and 69% of sexually active unmarried women. Among married women, pills and injectables are the most widely used; among unmarried women, pills, condoms, and traditional methods. In Eastern Europe and Central Asia nearly 30% of married adolescents use family planning, mostly traditional methods. Eight of every 10 unmarried sexually active adolescents use a family planning method; half use condoms. Among married women ages 20 to 24, IUDs and traditional methods are most used, while unmarried women this age rely on condoms as well as traditional methods. Comparable survey data for Asia and for the Near East and North Africa are available only for married youth. In both regions about one-fifth of married adolescent women use contraception, as do nearly one-third of married women ages 20 to 24. Trends in contraceptive use. Contraceptive use among unmarried sexually active young women has increased substantially since 1990, according to repeat surveys in 26 developing countries. Contraceptive prevalence among unmarried women ages 15 to 19 increased by an average of 5 percentage points in sub-Saharan Africa and by 21 points in Latin America and the Caribbean. In particular, sexually active unmarried adolescents were twice as likely to use condoms at the time of the later survey than at the earlier one (see Table 10). Increases in condom use accounted for nearly all of the increase of contraceptive use in sub-Saharan Africa and 61% in Latin America and the Caribbean. Levels of contraceptive use grew 6percentage points among sexually active unmarried women ages 20 to 24 in sub-Saharan Africa and 18 points in Latin America and the Caribbean. Greater condom use was again responsible for most of the increase in contraceptive use in sub-Saharan Africa and 57% in Latin America and the Caribbean. In the face of the HIV/AIDS epidemic, many countries have focused on increasing young people’s access to and use of condoms. In Colombia, for example, the nationwide family planning program PROFAMILIA has increasingly integrated sexual and reproductive health services into their clinics, including focusing on the needs of youth (55). Between 1990 and 2000 condom use in Colombia grew from 3% to 28% among unmarried sexually active adolescent women, and from 4% to 28% among unmarried sexually active women ages 20 to 24 (see Table 10). Similarly, in Senegal condom use increased from 15% to 29% among unmarried sexually active adolescent women and from 7% to 41% among such women ages 20 to 24 between the 1992–93 survey and the 1997 survey. Recently, Senegal has made substantial efforts to promote condom use among young people (4). (For more information on HIV/AIDS among young people, see Population Reports, Youth and HIV/AIDS: Can We Avoid Catastrophe?, Series L, No. 12, Fall 2001.) |
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