Abstract
BackgroundPrior research has established that an individual’s social environment may influence his or her reproductive behaviors, yet less is known about peer influence on contraceptive use among young people (ages 15–24). In Kenya, the site of this study, 15% of adolescents ages 15–19 have begun childbearing and 45% of sexually active young women report current use of a modern contraceptive method. This highlights the need to better understand what factors influence young people to use contraception. The objective of this study is to explore the relationship between the perception of peers’ use of contraceptives and contraceptive use and method choice among young men and women in Kenya.MethodsThis study utilizes a nationally representative sample of women and men aged 15–24 years from the 2018 and 2019 cross sectional Shujaaz State of the Kenyan Youth annual surveys. Among the sample of sexually experienced young people (59%), multivariable multinomial logistic regression was used to explore the association between the perception of peers’ use of contraceptives and the respondent’s contraceptive method choice: non-user, condom use or use of any other modern method. Results are presented separately for young men and young women.ResultsOur results show that sexually experienced young men and women who perceive that their peers are using contraceptives are more likely to report current use of condoms compared to being a nonuser (RRR = 2.12, p < 0.001, RRR = 2.59, p < 0.001, respectively); they are also more likely to use condoms than another modern method of contraception (RRR = 2.13, p = 0.034, RRR = 1.71, p = 0.014, respectively). Young women are more likely to use another modern method (not including condoms) than be a nonuser when they perceive that their peers’ use contraceptives (RRR = 1.51, p = 0.020).ConclusionsThe results of this study highlight the important role of peer influence on young people’s contraceptive choices. These findings can be used to develop programs that encourage behavior change communication activities in Kenya that focus on normalizing use of a full range of contraceptive methods among peer groups of sexually experienced young people.
Highlights
Prior research has established that an individual’s social environment may influence his or her reproductive behaviors, yet less is known about peer influence on contraceptive use among young people
Plain language summary In Kenya, about 15% of women age 15–19 have already had a birth and approximately one third of these women did not want to have a child at that time
This study focused on a representative sample from Kenya of female and male youth who ever had sex
Summary
Prior research has established that an individual’s social environment may influence his or her reproductive behaviors, yet less is known about peer influence on contraceptive use among young people (ages 15–24). In Kenya, the site of this study, 15% of adolescents ages 15–19 have begun childbearing and 45% of sexually active young women report current use of a modern contraceptive method. This highlights the need to better understand what factors influence young people to use contraception. Unmet need is high among young people in sub-Saharan Africa (SSA) and as a result, approximately 37% of pregnancies among adolescent girls ages 15–19 and 27% of pregnancies among women ages 20–24 in SSA are unintended [1, 2] To address these issues, the global community has recognized the importance of ensuring that the sexual and reproductive health needs of young people are met through enabling access to high quality family planning care for all [3,4,5,6]. Contraceptive use and method mix are often not reported for men, though some studies have shown that young men report using predominantly condoms for dual prevention of pregnancy and sexually transmitted infections [15, 16]
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