Participation in an HIV prevention intervention and access to and use of contraceptives among young women: A cross sectional analysis in six South African districts

Abstract

ObjectiveThis study investigated whether young women's participation in a combination HIV-prevention intervention was associated with accessing and using condoms and other contraceptives. Study DesignA cross-sectional household survey was conducted from 2017 to 2018 among a representative sample of young women aged 15–24 years old living in six South African districts in which the intervention was implemented. Cross-tabulations and multivariate regression analyses of weighted data were performed to examine access to and use of condoms and other contraceptives. ResultsIn total 4399 young women participated, representing a 60.6% response rate. Of participants, 61.0% (n = 2685) reported accessing condoms and other contraceptives in the past year. Among those who ever had sex (n = 3009), 51.0% used condoms and 37.4% other contraceptives at last sex. Among 15–19 year old, participation in the combination intervention was positively associated with reporting contraceptive use other than condoms at last sex (Prevalence Ratio (PR): 1.36; 95% CI: 1.21–1.53) and reporting use of both condoms and other contraceptives at last sex (PR: 1.45; 95% CI: 1.26–1.68). No associations were observed in the age group 20–24. ConclusionOur findings suggest that combination HIV prevention interventions may lead to increased access and use of condoms and other methods of contraception among adolescent women, but this needs to be confirmed in experimental studies. We need to test different or more intensive interventions to increase contraceptive use in young women aged 20–24. ImplicationsParticipating in combination HIV prevention interventions that are delivered via multiple approaches may promote access to, and use of condoms and other methods of contraceptives among adolescent women, and thereby help reduce unintended pregnancies.