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Citation
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Grundy SJ, Maman S, Graybill L, Phanga T, Vansia D, Nthani T, Tang JH, Bekker LG, Pettifor A, Rosenberg NE. J. Pediatr. Adolesc. Gynecol. 2022; ePub(ePub): ePub. |
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Abstract
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PURPOSE: In sub-Saharan Africa, sexually active adolescent girls and young women (AGYW) experience high rates of intimate partner violence (IPV) and low levels of contraceptive use, but the effect of IPV on contraceptive use is not well understood.
METHODS: In the Girl Power-Malawi study, AGYW age 15-24 were recruited from four health centers in Lilongwe, Malawi and followed for one year. At baseline, AGYW were assessed for IPV using the modified Conflict Tactics Scale. AGYW reported contraceptive method use at 6 and 12 months, characterized as barrier, non-barrier, or any modern method. Modified Poisson regression was implemented to estimate risk ratios (RRs) and 95% confidence intervals (CI) to examine the effect of IPV on contraceptive use.
RESULTS: One thousand AGYW were enrolled, and 954 non-pregnant participants were included. Baseline prevalence of IPV with the most recent partner was 35.5% (physical), 46.2% (sexual), and 76.9% (emotional). Baseline IPV did not affect contraceptive use at 6 months (aRR (95% CI): physical 0.98 (0.91-1.05); sexual 1.00 (0.94-1.07); emotional 1.03 (0.94-1.12)) or 12 months: physical 0.95 (0.89-1.02); sexual 0.96 (0.90-1.02); emotional 0.98 (0.91-1.05)). None of the three IPV categories affected contraceptive use when the outcome was restricted to either barrier or non-barrier methods.
CONCLUSIONS: In this cohort, IPV was not a key driver of contraceptive use in longitudinal analyses. Interventions are needed to address the alarming rates of IPV in this population but addressing IPV alone may be insufficient to address low contraceptive use and multifaceted youth friendly health services (YFHS) may be necessary.
Language: en |