Predictors of contraceptive use among adolescent girls and young women (AGYW) aged 15 to 24 years in South Africa: results from the 2012 national population-based household survey

BACKGROUND: Despite a variety of contraceptives being available for women in South Africa, a considerable number of adolescent girls and young women still face challenges in using them. This paper examines socio-demographic and behavioral predictors of using contraceptives among adolescent girls and young women (AGYW) aged 15 to 24 years. METHODS: A secondary data analysis was conducted based on the 2012 population-based nationally representative multi-stage stratified cluster randomised household survey. Multivariate backward stepwise logistic regression model was used to examine socio-demographic and behavioural factors independently associated with contraceptive use amongst AGYW aged 15 to 24 years in South Africa. RESULTS: Out of 1460 AGYW, 78% (CI: 73.9-81.7) reported using some form of contraceptives. In the model, contraceptive use was significantly associated with secondary education [OR = 1.8 (1.2-2.7), p = 0.005], having a sexual partner within 5 years of their age [OR = 1.8 (1.2-2.5), p = 0.002], and sexual debut at age 15 years and older [OR = 2.5 (1.3-4.6), p = 0.006]. The likelihood of association decreased with other race groups-White, Coloured, and Indians/Asians [OR = 0.5 (0.3-0.7), p = 0.001], being married [OR = 0.4 (0.2-0.7), p = 0.001], never given birth [OR = 0.7 (0.5-0.9), p = 0.045], coming from rural informal [OR = 0.5 (0.3-0.9), p = 0.010] and rural formal settlements [OR = 0.5 (0.3-0.9), p = 0.020]. CONCLUSIONS: Evidence suggest that interventions should be tailor-made to meet the needs of AGYW in order to, promote use and access to contraceptives. The results also suggest that family planning interventions should target those who had not given birth in order to reduce unplanned and or unintended pregnancies and associated risk factors. These findings contribute to public health discourse and reproductive health planning for these age groups in the country.