Communication self-efficacy and contraceptive use at sexual debut among rural adolescent girls in Ethiopia

Abstract

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 total of 394 adolescent girls between the age of 13 - 17, who self-reported their sexual debut, were included in the analysis. Communication self-efficacy was measured using two items: adolescents who discussed contraceptives with their partners, and adolescents who discussed contraceptives with to 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.