Abstract
CONTEXTAlthough an association between gender equality and contraceptive use has been confirmed among adult samples, few studies have explored this relationship among adolescents. An examination of whether adolescents’ contraceptive use is more prevalent in countries with higher levels of gender equality is needed to fill this gap.METHODSNationally representative data from 33 countries that participated in the 2013–2014 Health Behaviour in School‐Aged Children study and country‐level measures of gender equality—using the 2014 Global Gender Gap Index—were analyzed. Multilevel multinomial logistic regression analyses were employed to assess associations between gender equality and contraceptive use (condom only, pill only and dual methods) at last intercourse as reported by 4,071 females and 4,110 males aged 14–16.RESULTSIncreasing gender equality was positively associated with contraceptive use among both males and females. For every 0.1‐point increase on the equality scale, the likelihood of condom use at last intercourse rose (odds ratio, 2.1 for females), as did the likelihood of pill use (6.5 and 9.6, respectively, for males and females) and dual method use (2.1 and 5.6, respectively). Associations with pill use and dual use remained significant after national wealth and income inequality were controlled for. Overall, associations were stronger for females than for males.CONCLUSIONSMore research is needed to identify potential causal pathways and mechanisms through which gender equality and adolescents’ contraceptive use may influence one another.
Highlights
A full understanding of the patterns of contraceptive use among adolescents requires an ecological approach, involving an examination of individual and contextual variables, at different levels, and their interaction.[7]
The current study revealed that societal gender equality is positively associated with contraceptive use among adolescents, especially pill use
Even when national wealth and income inequality were taken into account, the association between gender equality and pill use remained significant
Summary
A full understanding of the patterns of contraceptive use among adolescents requires an ecological approach, involving an examination of individual and contextual variables, at different levels, and their interaction.[7]. The first showed that young women—but not young men—are less likely to be sexually experienced in countries with more conservative cultural norms regarding sexuality than in those with more liberal norms.[6] The second demonstrated that country-level indicators, including the Human Development Index, national wealth and income inequality, the predominant national religion and the national prevalence of HIV, are related to condom use among young Europeans.[16] the latter study controlled for very few variables at the individual level and may have overestimated associations with macro-level covariates. Other studies examining associations between contextual variables and adolescents’ contraceptive use have been conducted primarily in the United States[17] or in developing countries.[18] A comprehensive analysis of
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