Teen Pregnancy Prevention Research Articles

Mitigating household psychosocial and economic impact of coronavirus pandemic in Mathare slums, Nairobi, Kenya: an initiative by the German doctors in Kenya.

The Psychosocial and Economic Impact of COVID-19 Pandemic in Mathare slums were adverse which necessitated mitigation strategies to be employed to cushion the most vulnerable and help them cope with the new 'state of affairs'. The pandemic was characterized by a surge in the respiratory infections, unemployment, households going hungry, gender-based violence in families, child abuse cases and increased rates of teenage pregnancy. Retrospective case study design was employed; secondary data from hospital departments were extracted for analysis from March 2020 to December 2021. Interventions in focus were health service provision, Gender based and child abuse services, food distribution, wet-feeding program, business grants and house rent grants. The most common burden faced by Mathare residents was food insecurity which was mitigated by giving 9,423 Patients' food baskets while 1,423 patients enrolled to the wet feeding program. Gender Based Violence services provided doubled in the year 2021 with physical and emotional violence being more common than sexual violence which was at 6.2%. Child abuse services were provided more in the year 2020 and 96 teenage mothers were assisted to go back to school. About 158 families received rent grants; which was a 30.4% increase from the year 2020. There was a 75.5% increase in the year 2021 of residents who received business grants. In a pandemic the effects are beyond health hence it is necessary to manage patients comprehensively using a multi-sectorial approach. However it is important to put regulations to avoid overdependence.

Innovation to Impact: Introduction to the Special Issue on Evidence from the Teen Pregnancy Prevention Program Experiment with Innovation

Congress has provided funding for the federal Teen Pregnancy Prevention (TPP) Program since 2009 for spending beginning in Fiscal Year 2010. Designated TPP programs develop, test, and evaluate innovations for reducing teen pregnancy, teen pregnancy disparities, and associated risk factors and for promoting positive youth development. Since its inception, the TPP Program has experimented with multiple uniquely structured cohorts of innovation and demonstration projects, producing critical insights into equitable and effective public health innovation while also serving as a highly productive contributor of evidence-based, TPP innovations for scale. This article briefly documents the innovation history of the TPP Program and its iterations in response to the shifting needs of the field. We then synthesize findings from the fifteen TPP innovators published in this special edition. We highlight emergent priorities of the TPP Program informed by this federal experiment in rigorous adolescent sexual health innovation development, testing, evaluation, and scaling and conclude by discussing how the TPP program adapted and refined its approach for fostering dynamic innovation-to-scale projects over time.

Youth Unemployment in Uganda

This research showcases the difficulties Uganda faces with their increasing youth unemployment, such as school dropouts, teenage pregnancy, and lasting consequences of the Covid-19 outbreak. It compares how different demographics have an augmented risk of dropping out of school and contrasts policies from other east African countries that helped them decrease their youth unemployment. Particularly, Kenya’s and Tanzania’s programs in different sectors, such as Kazi Kwa Vijana and Building a better Youth Initiative for Agriculture businesses. The paper also analyses Uganda’s previous attempts in decreasing youth unemployment and why they remained unsuccessful. Finally, the paper recommends solutions to different drawbacks Uganda faces. One of those suggestions is by making contraceptives more accessible to reduce the teenage pregnancy rates. Furthermore, by having inmates aid in building new infrastructure like schools could help increase jobs that were lost during the 2020 Covid outbreak. Uganda could also implement training facilities to help certify more primary and secondary school teachers, as well as advertising more job opportunities. In addition to that Uganda can carry out a similar program to Tanzania to get more youth interested and competent in agriculture.

An Analysis of the Impact of Religious Affiliation and Strength of Religiosity on Sexual Health Practices of Sexually Active Female College Students.

Despite great strides in the development of contraceptive technologies, the United States has one of the highest teen pregnancy rates in the world. Religion and associated values may shape the sexual health behaviors of college students, as prior studies have aimed to determine how social factors may influence the use of contraception amongst college students. Thus, we sought to examine the differences in current contraceptive methods and the age of first contraceptive usage among sexually active female college students with different religious affiliations and strengths of religiosity. It was hypothesized that there would be no difference in current contraceptive methods among different religious affiliations and strengths of religions and that there would be a difference in the age of first contraceptive usage among different religious affiliations and strengths of religiosity. Two hundred and twenty-four college-aged females completed a 20-question survey about sexual health and religious practices. Chi-squared tests were implemented to determine the frequencies of responses across religious affiliations and strengths of religiosity. Significant differences in the frequency of responses for the age of first contraceptive usage were observed across different strengths of religiosity (p = 0.016) and for the self-perceived impact of religion on sexual health across different religious affiliations (p = 0.033) and strengths of religiosity (p = 0.005). All other differences were found not to be statistically significant. It was determined that increased strengths of religiosity resulted in delayed onset of contraceptive usage and that both different religious affiliations and greater strengths of religiosity lead to different self-perceived impacts of religion on sexual health despite low levels of current practice.

Community bylaws concerning sexual and reproductive health and rights in Machinga District, Malawi: to what extent are they responsive to young people’s needs?

BackgroundCommunity bylaws are commonly accepted mechanisms to influence behaviour change to achieve better health and development outcomes in sub-Saharan Africa. However, the uses, benefits, and potential downsides of community bylaws are largely unclear, especially regarding sexual and reproductive health and rights (SRHR) of young people. The objective of this study was to determine the extent to which community bylaws in Machinga District in southern Malawi are responsive to young people’s realities and SRHR needs.MethodsIn Phase 1 of this qualitative study, 35 community members were interviewed, including 14 young people (15–24 years), five parents, five traditional leaders, and eleven key informants. Based on findings from Phase 1, eleven members from local youth groups co-created a drama performance that covered issues concerning bylaws and young people’s SRHR (Phase 2). The drama was performed in the community, after which young women (18–24 years), young men (17–24 years), female and male parents discussed on what they saw in the drama, focusing on young people’s SRHR, in four focus group discussions (Phase 3). All transcripts were coded and thematically analysed and narratives were written on main themes.ResultsThree community SRHR bylaws, related to teenage pregnancy, child marriage, and sexual harassment and rape were identified and commonly accepted in the community. While these bylaws intend to reduce SRHR-related issues among young people, they are often not involved in bylaw formulation. The bylaws were associated with protection of girls, and a good reputation for boys, young men and traditional leaders. Bylaw enforcement faced problems, as fines were not in line with national laws, and wealthy offenders could avoid them through bribes. Effects of bylaws on teenage pregnancy rates seemed limited, while some positive effects on school readmission, prevention of child marriage, and reporting sexual harassment were reported.ConclusionsThe study revealed that community bylaws were accepted but not owned by young people, and had different effects on the rich versus the poor, and girls versus young men. Bylaws were associated with punishment in terms of money, which seemed to overpower their potential to promote rights and address social norms underlying SRHR issues of the youth.

Socioeconomic inequality in teenage pregnancy in Papua New Guinea: a decomposition analysis

BackgroundTeenage pregnancy is a global public health issue, and it poses a serious threat to the health and socioeconomic status of mothers and their newborn children. Although Papua New Guinea has recorded one of the highest teenage pregnancy rates among Asia-Pacific countries, few studies have conducted research on the related inequality in the country. Therefore, this study aimed to assess socioeconomic inequality in teenage pregnancy and its contributing factors in Papua New Guinea.MethodsData for this cross-sectional study were obtained from the 2016–2018 Papua New Guinea Demographic and Health Survey. The analytical sample consisted of 2,864 girls aged 15–19 years. We employed Erreygers normalized concentration index (ECI) and concentration curves to measure and depict socioeconomic inequality in teenage pregnancy. Decomposition analysis was likewise performed to identify the contributions of determinants to the observed inequality.ResultsWeighted ECI for teenage pregnancy was − 0.0582 (P < 0.001), thereby indicating that teenage pregnancy in Papua New Guinea is disproportionately concentrated among poor girls. Decomposition analysis suggested that education level (65.2%), wealth index (55.2%), early sexual debut (25.1%), region (8.5%), and sex of household head (4.1%) are the main determinants explaining the pro-poor socioeconomic inequality in teenage pregnancy.ConclusionsA pro-poor socioeconomic inequality of teenage pregnancy was present in Papua New Guinea. This inequality may be alleviated by such interventions as ensuring that teenage girls receive education; implementing poverty alleviation projects, eliminating child, early, and forced marriages; strengthening promotion for household head to support teenagers in accessing sexual and reproductive health education; improving geographical accessibility to health facilities on contraceptive services, and taking necessary precautions and responses to sexual misconduct.

Effect of COVID-19 lock down on teenage pregnancies in Northern Uganda: an interrupted time series analysis

BackgroundPregnancy and childbirth complications are the leading cause of death among girls aged 15–19 years globally, with low- and middle-income countries (LMICs) accounting for 99% of global maternal deaths of women aged 15–49 years. Despite teenage pregnancies declining in many developing countries in recent years, the COVID-19 period intensified the problem and altered the trend for most countries. We determined the effect of the COVID-19 lockdown on the teenage pregnancy trend in Pakwach district, Uganda, to understand its magnitude in our study population.MethodsUsing interrupted time series analysis (ITS), sometimes known as quasi-experimental time series analysis. We constructed a time series of the first ANC service utilization records for girls aged 10–19 years in Pakwach district, Uganda, and conducted an interrupted series analysis. We compared the two periods of March 2019 to March 2020 and March 2020 to March 2021. We used Stata 15 to conduct our analysis, performed OLS, and plotted the results.ResultsThe teenage pregnancy trend before the lockdown was decreasing by − 0.203 pregnancies per month, but in the first month after the institution of the lockdown (March 20, 2020), there was an increase in the teenage pregnancy rate of 13.9 pregnancies [95% CI: − 33.6 to 61.5], which corresponds to an increase in the monthly trend in teenage pregnancies (relative to the period before the COVID-19 lockdown trend) of 1.53 girls per month.ConclusionTeenage pregnancies increased during the lockdown. This slight increase depicted the impact of the pandemic on the teenage pregnancy trend associated with the COVID-19 outbreak. The government needs to focus on intervention to reduce this trend and avoid any further increases.

Predictors of teen sexual behavior

PurposeTo identify characteristics and behaviors among teenagers that predict sexual initiation or sexual activity and to evaluate alternative methods for predicting sexual behavior among teenagers. MethodsWe used longitudinal data from an evaluation of the Making Proud Choices! teen pregnancy prevention program. The evaluation, funded by the Office of Population Affairs, assessed academic years 2016–2017 through 2018–2019 and examined 2,138 Grade 9 and 10 students of all genders. We used ordinary least squares (OLS), least absolute shrinkage and selection operator (lasso), and stratified OLS to identify behaviors and characteristics at baseline that predict sexual initiation, recent sex, and sex without a condom. ResultsOLS and lasso regression show that pre-sexual behaviors and substance use are the most powerful predictors of sexual initiation among teens. Lasso additionally identified higher-order interactions between predictors of sexual activity, including variation in predictors’ influence across population subgroups. Stratified OLS regression predicted behavior most accurately for sexual initiation, recent sex, and sex without a condom. However, stratified OLS also reduces the sample size, and therefore precision, for each regression. ConclusionsCurrent behavior, not knowledge or beliefs about sex, best predicts future behavior. It can be difficult to evaluate the impact of programs designed to delay sexual initiation among younger adolescents because sexual behaviors often occur at older ages. Our results suggest that pre-sexual behaviors are strongly predictive of subsequent sexual initiation and having sex without a condom, so these could be used as outcome measures for identifying high-risk students or evaluating interventions among younger adolescents. Additionally, our results show that lasso can be a useful technique to identify subgroup differences in the relationship between predictors and future sexual activity and for prioritizing variables to collect in a survey.

Interventions to prevent unintended pregnancies among adolescents: a rapid overview of systematic reviews

Risks associated with unintended pregnancy include unsafe abortions, poor maternal health-seeking behaviour, poor mental health, and potentially, maternal and infant deaths. Adolescent girls with unintended pregnancies are particularly vulnerable as they are at higher risk of eclampsia, premature onset of labour, and increased neonatal morbidity and mortality. Unintended pregnancy, with the right combination of interventions, can be avoided. Evidence-based decision-making and the need for a robust appraisal of the evidence have resulted in many systematic reviews. This review of systematic reviews focuses on adolescent pregnancy prevention and will seek to facilitate evidence-based decision-making. Two review authors independently extracted data and assessed the methodological quality of each review according to the AMSTAR 2 criteria. We identified three systematic reviews from low- and middle-income countries and high-income counties and included all socioeconomic groups. We used vote counting and individual narrative review summaries to present the results. Overall, skill-building, peer-led and abstinence programmes were generally effective. Interventions focused on information only, counselling and interactive sessions provided mixed results.In contrast, exposure to parenting and delaying sexual debut interventions were generally ineffective. Adolescent pregnancy prevention interventions that deploy school-based primary prevention strategies, i.e. strategies that prevent unintended pregnancies in the first place, may effectively reduce teenage pregnancy rates, improve contraceptive use, attitudes and knowledge, and delay sexual debut. However, the included studies have methodological issues, and our ability to generalise the result is limited.

Toward an Effective Innovation Framework for Federal Grant-Making: an Exploration into OPA’s Teen Pregnancy Prevention Program

States, local, tribal, and territorial governments received almost 20% of all federal spending in fiscal year 2022, about $1.2 trillion dollars (US Office of Management and Budget, 2023a). For a strong, well-functioning democracy, the federal government must be able to disperse grant funds efficiently and effectively. Rates of teen pregnancy in the USA, while decreasing in recent years, are still consistently higher than that of other western industrialized nations (Centers for Disease Control and Prevention, 2023). The Office of Population Affairs’ (OPA) Teen Pregnancy Prevention program combines cutting edge research with innovative grant distribution to creatively tackle this issue. In this commentary, we explore some of the strengths of OPA’s grant distribution program in the hope that others may emulate best practices from this program. Specifically, the special issue highlights how OPA’s grant program took a customer-centered focus by prioritizing work with end users and community. This evidence-based focus enabled the testing of ideas, which in turn could be iterated and scaled up. Through grantee innovation networks, they created space for external expertise, creative thinking, and diversity of thought. Other programs, policymakers, and their partners may learn from OPA’s success, which arises from three core characteristics: (1) their funding stature allows long-term and flexible allocation of funding toward innovation; (2) OPA focuses on creating and supporting local communities and networks of innovation; (3) OPA emphasizes evidence-based decision-making and rigorous evaluation throughout the grant process. With a fifth of the federal budget being dispersed through grant-making and teen pregnancy still at high rates, OPA offers an exciting avenue for innovation and success in both of these areas. This commentary concludes with some recommendations for future practice.

Prevalence, Trends in and Determinants of Teenage Pregnancies in Rwanda: Analysis of Rwanda Demographic and Health Survey (2010 to 2020)

Background: According to the World Health Organization, roughly 16 million teen mothers aged 15 to 19 give birth annually resulting a 44,000 births per day worldwide. Moreover, the vicious cycle of poverty in sub-Saharan Africa is exacerbated by adolescent pregnancy, this also increases maternal, perinatal, and infant mortality hindering SDG goal 5 and target 3 of ending the child marriage of 2030 to be achieved. This study aimed to identify the prevalence, trends, and determinants of teenage pregnancies in Rwanda between 2010 and 2020. Methods: This study used Rwanda's demographic and health survey data from 2010, 2015, and 2020, and a cross-sectional study design. All data were cleaned and appended to get the final data set for analysis, all analyses were performed using R software package 4.3.1. Moreover, statistical significance was determined at a 5% p-value and 95% Confidence Interval (CI) while not crossing one. Results: The total number of teenagers between 2010 and 2020 was 9,050 and among them, the prevalence of teenage pregnancy was 6.11% (n = 553/9050). By trend, teenage pregnancy in 2010 was 6.22%, in 2015, 7.30%, and in 2015 5.41% in prevalence. After adjusting the variables in a multivariate logistic regression model, the following were found to be potential predictors of teenage pregnancy in Rwanda: Region by Eastern province (AOR: 1.55:95% CI: 1.078,2.24), lack of education and primary school teens (AOR: 2.9:95% CI: 1.22,6.89) and AOR: 1.67:95% CI: 1.25,2.24)respectively, Poorest households AOR: 2.02:95% CI: 1.27,3.12), those with knowledge of contraceptive methods (AOR: 8.70:95% CI: 3.34,23.01), sexually active unmarried women (AOR: 3.50:95% CI: 1.58,7.78), teens who did not access social media (AOR: 2.03:95% CI: 1.41,2.91), and it was protective against family size. Conclusion: These results imply that a combination of social, sociodemographic, and knowledge-related factors, as well as awareness of contraceptive techniques, may impact teenage pregnancy in Rwanda. The provision of contraception education and awareness should be the primary goal of efforts to minimize adolescent pregnancies in Rwanda, particularly in areas where the prevalence is higher. In addition, encouraging family planning and tackling economic inequalities can be effective tactics to lower adolescent pregnancy rates.

Teenage pregnancy and Violence: A current public health problem.

Every year, an estimated 21 million teenage girls aged 15–19 years become pregnant, and at least 777,000 births occur to adolescent girls younger than 15 years in developing countries. 1 Latin America has the world's second highest teenage pregnancy rate, with about 18 % of births to mothers under 20. Each year, one and a half million adolescent women aged 15 and 19 have babies in the region.2 Injuries, Violence, self-harm, and maternal conditions are the leading causes of death among adolescents and young adults. Pregnant teenagers are prime targets of different types of Violence. Violence and adolescent pregnancy are public health problems and risk factors for maternal and fetal morbidity and mortality. The United Nations Sustainable Development Cooperation Framework (UNSDCF) prioritizes ending Violence against girls and child marriage.3,4

Impacts of COVID-19 on Biodiversity Conservation and Community Networks at Kibale National Park, Uganda

Conservation, like all aspects of society, was severely affected by the COVID-19 pandemic. Although there have been projections and speculations about impacts on conservation plans and actions, data about the extent of these impacts are sparse. We contribute evidence from a research field site in Kibale National Park, Uganda. Our analysis shows that many of the fears concerning the negative conservation impacts of COVID-19 were borne out. Long-term research projects were disrupted, affecting employment opportunities in the park. These effects percolated into the local communities, which reported high levels of financial stress and other negative impacts, such as increased rates of teenage pregnancy. People who were permanently employed at the park reported lower levels of financial stress. Also particularly concerning was the increase in poaching in the park due to a lack of food security. This research highlights an important path toward resiliency for research stations in the face of global crises, but it requires changes in funding duration and scope from granting agencies and governments. Operating differently than ecotourism, research field stations provide unique opportunities to build resilient conservation instruments and the results of this research can help guide policies to make research field stations more resilient.

Reducing the Risk of Teen Pregnancy among Middle School Pupils through Experiential Learning Intervention by Midwifery Students

Background: This study aimed to evaluate the impact of an experiential learning intervention among middle school teens by midwifery students to reduce the risk of teen pregnancy. Methods: This research was a controlled pre-and post-test design study aimed to evaluate the impact of experiential learning intervention “Smart Teens Program” among middle school students. The data on knowledge, attitude, and subjective norms were collected during a pre-test and posttest (six weeks for intervention), in a control group (n=70) and an intervention group (n=68). The data were collected from self-administered questionnaires and analyzed using STATA (version 12.0). Results: The results showed a significant impact of the intervention “Smart Teen Program” by midwifery students, where there was a significant increase in the knowledge, attitude, and subjective norms in reducing the risk factors of teen pregnancy (p-value = 0.00). The control group who was not given any treatment showed a decreased value. Conclusions: Interventions through experiential learning by midwifery students were able to improve efforts to prevent teen pregnancy. Bangladesh Journal of Medical Science Vol. 22 No. 04 October’23 Page : 797-803

Addressing Evaluation Barriers with Early Innovation Development for Adolescent-Focused Sexual and Reproductive Health Interventions.

Most evidence-based teen pregnancy prevention programs focus on individual-level sexual health outcomes (e.g., STIs, pregnancy, teen births). To expand program and intervention approaches within teen pregnancy prevention (TPP), the Department of Health and Human Services funded two grantees, Innovative Teen Pregnancy Prevention Programs (iTP3) and Innovation Next (IN) to support and enable early innovation to advance adolescent health and prevent teen pregnancy. The pipeline to support and enable innovation in adolescent health is complex, resulting in barriers and challenges to research and evaluation of novel programs. This paper presents some of the barriers encountered by the grantees. Data for this paper was collected from key personnel and secondary data sources. Focus group participants included seven representatives (n = 7) across the two organizations. Focus group questions assessed barriers related to innovative intervention development and evaluation. Key findings include four barriers to evaluation when fostering innovative adolescent-focused pregnancy prevention interventions. These included (a) funding constraints on evaluation activities, (b) innovation readiness for rigorous testing, (c) evaluation knowledge and expertise on innovation-development teams, and (d) challenges with evaluation requirements. Novel and promising system- and technology-focused interventions with the potential to impact TPP require alternative tools and approaches for evaluation. This would allow research to focus on how systems-level change mechanisms (i.e., policy, access to care) impact sexual risk behaviors and better understand ecological and social determinants of health for the priority population. The advancement of approaches to impact adolescent health identifies the need to expand the focus of evidence-based interventions beyond the adolescent themselves and understand approaches that impact external contexts and environments related to reducing sexual and reproductive health (SRH) risk-taking.

Strategies to enhance sexual health education for prevention of teenage pregnancy in Vhembe District, Limpopo Province: different stakeholder’s perspectives, a co-operative Inquiry qualitative protocol paper

BackgroundSouth Africa is reporting higher rates of adolescent pregnancy as compared to other countries. There are different types of interventions that are in place to address teenage pregnancy. However, these interventions were developed using top-down strategy without the inclusion of different stakeholders and adolescents which makes it hard to implement those interventions particularly in countries like South Africa. Hence, this study aimed to develop strategies to enhance sexual health education for prevention of teenage pregnancy in Vhembe District, Limpopo Province of South Africa.MethodsThe research design of this study will be Co-operative Inquiry.The study will take place in Vhembe District in Limpopo province of South Africa through collaborating with a Non-governmental Organisation (NGO). The study population will be the teenagers and all the different stakeholders caring for teenagers in their areas of specialization. Purposive sampling will be used to sample the targeted participants of the study. The data collection method will be done in phases and focus group discussions will be used to collect data. Content analysis will be used to analyse data.DiscussionThis study will add to the body of knowledge regarding the strategies that maybe used to enhance sexual health education for prevention of teenage pregnancy.

The impact of funding disruptions on large-scale teen pregnancy prevention research projects

To advance the field of teen pregnancy prevention, new interventions must be developed and tested. The federal Teen Pregnancy Prevention program (TPP) funds the evaluation of promising interventions. We report on a funding disruption to 21 TPP Tier 2B research grantees across the US that was unusual for its ideological causation, sudden timing, severity, and ultimately court decisions compelling the agency to reverse the decision. We address the following question: How did challenges presented by the attempted funding termination impact grantees’ ability to continue with their intended research? Results from grantee surveys in 2019 demonstrate the funding disruption negatively impacted participant recruitment, organizational collaboration, program delivery, research rigor, and compromised grantees’ ability to complete high-quality evaluations. Results also show most projects could continue, with modified research goals, when funding was reinstated. We conclude administrations should avoid arbitrarily and prematurely terminating research projects. However, there is merit in reinstating funds to projects should a disruption occur. Results from this work are particularly relevant as we anticipate how health research projects may manage other disruptions to funding or timetables, such as those caused by COVID-19. Results are relevant to policy makers, researchers, government and private funders, grantees, and technical assistance teams.

Prevalence and factors associated with sexual and reproductive health literacy among youth living with HIV in Uganda: a cross-sectional study

BackgroundAdequate sexual and reproductive health literacy (SRHL) among young people has been linked to informed sexual behaviours. Studies on SRHL have largely been conducted among the general adolescent population. Little is known about youth aged 15-24 years living with human immunodeficiency virus (YLHIV). There is a possible lack of SRHL in this population, considering the high rate of teenage pregnancies and unprotected sex reported by YLHIV. This study aimed to assess the prevalence and associated personal and environmental factors for SRHL among YLHIV at a high-volume urban HIV Clinic in Uganda.MethodsThrough a cross-sectional survey, YLHIV receiving routine HIV care services at Baylor-Uganda HIV Clinic were interviewed using an adapted European Health Literacy Survey (HLS-EU). Using simple random sampling, eligible youth who received HIV care services between August and November 2019 were enrolled in the study. SRHL scores were computed using the HLS-EU index method; and individuals whose scores ranged from 34 to 50 were considered health literate. We used descriptive statistics to determine the prevalence. Potential associated personal and environmental factors (p<0.05) were identified by performing two-step inferential statistics, bivariate analysis and binary logistic regression. Odds ratios were calculated to estimate the likelihood of youth being health literate on sexual and reproductive health (SRH) issues in comparison with the reference categories, and 95% confidence intervals were determined to establish whether the relationships were statistically significant.ResultsOf the 267 YLHIV interviewed at Baylor-Uganda HIV Clinic, 167 (62.5%) were female with a mean age of 18.9 years (SD± 2.8), and the majority (242; 90.6%) were vertically infected with HIV. Only 52 (19.5%) were health literate on SRH issues. At the multivariate level, YLHIV who never had difficulty accessing SRH information were 0.391 times less likely to be health literate on SRH issues than their counterparts with challenges in accessing SRH information (Adjusted Odds Ratio [AOR] = 0.391, 95% CI =0.178 to 0.860; p= 0.019). YLHIV who did not find it easy to access SRH care service points were 2.929 times more likely to be literate in SRH than those who found it easy to access such services (Adjusted Odds Ratio [AOR] = 2.929, 95% CI =1.241 to 6.917; p=0.014). Additionally, YLHIV who did not listen to radio health talks were 2.406 times more likely to be health literate on SRH issues than those who did (AOR = 2.406, 95% CI =1.133 to 5.112; p=0.022).ConclusionsSRHL is an unmet need among YLHIV; only 19.5% were health literate on SRH issues. This could complicate the achievement of the UNAIDS sustainable development goal (SDG) of an HIV/AIDS-free generation by 2030 because low health literacy (HL) skills can affect the efficacy of almost all HIV disease prevention and health promotion efforts. Inaccessible SRH care service points and not listening to radio health talks were positively associated with SRHL, while having access to SRH information was negatively associated with SRHL.

Prevalence of Teenage Pregnancy and Associated Factors in Agago District, Uganda: A Community-Based Survey.

Teenage pregnancy remains a common public health and social problem associated with negative health outcomes. We determined the prevalence and factors associated with teenage pregnancy among teenage girls aged 13-17 years in Agago district, Uganda. We conducted a community-based, cross-sectional study between October and November 2020 in Lapono Sub-County, Agago district among teenage girls 13-17 years. Multi-stage sampling technique was used. Parishes, villages, and households were randomly selected (computer generated random numbers were used for household selection). In each household, one participant was randomly selected for interview and pregnancy testing. We collected data on socio-demographic factors using a pre-tested semi-structured questionnaire. All eligible participants were tested for urine human chorionic gonadotropin (hCG). Multivariable logistic regression analysis was done to determine independent predictors of teenage pregnancy, with p<0.05 considered statistically significant. A total of 289 eligible participants, with a mean age of 15.1±1.5 years, were enrolled. Most (n=246, 81.5%) participants had attained primary education, 18 (6.2%) were married, 41 (14.2%) used alcohol, 62 (21.5%) had a history of sexual intercourse and 32 (11.1%) were sexually abused. The prevalence of teenage pregnancy was 2.8% (n=8). Factors significantly associated with teenage pregnancy were alcohol consumption (adjusted odds ratio (aOR): 13.2, 95% Confidence Interval (95% CI): 1.7-100.6, p=0.013) and having secondary/tertiary education (aOR: 10.2, 95% CI: 1.5-71.9, p=0.02). The study findings suggest that teenage pregnancy is still a public health and social problem in Agago district, Uganda. Interventions discouraging alcohol consumption and promoting education among teenagers are key in addressing the burden of teenage pregnancies in the district.

A social semiotic study of public institutional websites focusing on teenage pregnancy in Brazil

Although institutional websites focusing on health matters play an important role in providing information in contemporary society, analysis of the way they use visual communication has received scarce academic attention. This exploratory study seeks to address this neglect through a visual analysis of public institutional websites concerned with the prevention of teenage pregnancy, which, in Brazil, is a serious sociocultural predicament. Drawing on a social semiotic approach to communication, specifically using systemic-functional grammar, Kress and Van Leeuwen’s grammar of visual design ( Reading Images, 2021[2006]) and Van Leeuwen’s (2008) framework of visual social actors, the authors analyse the visual and verbal features used to portray the social actors in images from the selected websites. Results show that pregnant teenagers tend to be visually portrayed in isolation, suggesting a sense of powerlessness. Other relevant social actors such as parents and/or family members, fathers of the babies, medical and educational professionals are usually not represented. In addition, pregnant teenagers are portrayed generically, categorizing them, rather than portraying them as individuals. Teenagers who apparently abstain from sexuality, on the other hand, are shown in naturalistic images, smiling at the viewer and in happy closely-knit groups of friends. The texts also foreground the institutions providing the information, through logos and through typography.