From ‘sugar daddies’ to ‘sugar babies’: exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South Africa
MetadataShow full item record
Background: Adolescent pregnancy has been linked to adverse outcomes. Most studies proposing risk pathways for adolescent pregnancy in South Africa are qualitative, hypothesising links among age-disparate relationships, reduced condom use and higher pregnancy rates. No known South African studies have quantitatively explored pathways to adolescent pregnancy. Objectives: This study aimed to: (i) identify the factors associated with adolescent pregnancy and (ii) explore a pathway of risk by assessing whether condom use mediated the relationship between age-disparate sexual relationships and adolescent pregnancy. Methods: A cross-sectional survey of 447 sexually active girls aged 10–19 years was undertaken in six health districts of South Africa. Multivariate logistic regressions controlled for confounders. Mediation tests used bootstrapping. Results: Consistent condom use (ß = –2.148, odds ratio (OR) = 8.566, P = 0.001) and school enrolment (ß = –1.600, OR = 0.202, P = 0.001) were associated with lower pregnancy rates. Age-disparate sex (ß = 1.093, OR = 2.982, P = 0.001) and long-term school absences (ß = 1.402, OR = 4.061, P = 0.001) were associated with higher pregnancy rates. The indirect effect of age-disparate sex on adolescent pregnancy through condom use was significant, irrespective of age, age at sexual initiation, poverty and residential environment (B = 0.4466, s.d. = 0.1303, confidence interval: 0.2323–0.7428). Conclusion: This survey supports hypotheses that inability to negotiate condom use in age-disparate sexual relationships may drive adolescent pregnancy. Interventions addressing these relationships, facilitating condom use and increasing access to sexual health services among adolescents might avert unwanted pregnancies.
Showing items related by title, author, creator and subject.
Sex differences between parental pregnancy characteristics and nonalcoholic fatty liver disease in adolescentsAyonrinde, Oyekoya; Adams, L.; Mori, T.; Beilin, L.; de Klerk, N.; Pennell, C.; White, S.; Olynyk, John (2018)Nonalcoholic fatty liver disease (NAFLD) is a complex chronic liver disorder. Examination of parental pregnancy-related characteristics may provide insights into the origins of risk of NAFLD in offspring. We examined ...
Sex, Condoms and Sexually Transmissible Infections: A Qualitative Study of Sexual Health in Young Australian MenSmith, Jennifer; Fenwick, Jennifer; Skinner, R.; Hallett, Jonathan; Merriman, Gareth; Lewis, M. (2012)Young males have a key role in shaping contraceptive use in a sexual relationship, yet often remain the invisible partner in safe sex promotion. This article describes a conceptual model of STI risk and condom use based ...
Young males' perspectives on pregnancy, fatherhood and condom use: Where does responsibility for birth control lie?Smith, Jennifer; Fenwick, Jennifer; Skinner, R.; Merriman, Gareth; Hallett, Jonathan (2011)Background: To improve our understanding of males’ role in contraceptive practices, this paper explores the relationship between young males’ perspectives on pregnancy and fatherhood and their attitudes, beliefs and ...