From ‘sugar daddies’ to ‘sugar babies’: exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South Africa
<p><strong>Background:</strong> Adolescent pregnancy has been linked to adverse outcomes. Most studies proposing risk pathways for adolescent pregnancy in South Africa are qualitative, hypothesising links among age-disparate relationships, reduced condom use and higher pregnancy ra...
| Main Authors: | , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
CSIRO Publishing
2015
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| _version_ | 1826271385596461056 |
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| author | Toska, E Cluver, L Boyes, M Pantelic, M Kuo, C |
| author_facet | Toska, E Cluver, L Boyes, M Pantelic, M Kuo, C |
| author_sort | Toska, E |
| collection | OXFORD |
| description | <p><strong>Background:</strong> Adolescent pregnancy has been linked to adverse outcomes. Most studies proposing risk pathways for adolescent pregnancy in South Africa are qualitative, hypothesising links among age-disparate relationships, reduced condom use and higher pregnancy rates. No known South African studies have quantitatively explored pathways to adolescent pregnancy. </p>
<p><strong>Objectives:</strong> This study aimed to: (i) identify the factors associated with adolescent pregnancy and (ii) explore a pathway of risk by assessing whether condom use mediated the relationship between age-disparate sexual relationships and adolescent pregnancy. </p>
<p><strong>Methods:</strong> A cross-sectional survey of 447 sexually active girls aged 10–19 years was undertaken in six health districts of South Africa. Multivariate logistic regressions controlled for confounders. Mediation tests used bootstrapping. </p>
<p><strong>Results:</strong> Consistent condom use (β = –2.148, odds ratio (OR) = 8.566, P ≤ 0.001) and school enrolment (β = –1.600, OR = 0.202, P ≤ 0.001) were associated with lower pregnancy rates. Age-disparate sex (β = 1.093, OR = 2.982, P ≤ 0.001) and long-term school absences (β = 1.402, OR = 4.061, P ≤ 0.001) were associated with higher pregnancy rates. The indirect effect of age-disparate sex on adolescent pregnancy through condom use was significant, irrespective of age, age at sexual initiation, poverty and residential environment (B = 0.4466, s.d. = 0.1303, confidence interval: 0.2323–0.7428). </p>
<p><strong>Conclusion:</strong> This survey supports hypotheses that inability to negotiate condom use in age-disparate sexual relationships may drive adolescent pregnancy. Interventions addressing these relationships, facilitating condom use and increasing access to sexual health services among adolescents might avert unwanted pregnancies.</p> |
| first_indexed | 2024-03-06T21:55:50Z |
| format | Journal article |
| id | oxford-uuid:4ce770fc-4592-4c08-b852-6b34237fae98 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T21:55:50Z |
| publishDate | 2015 |
| publisher | CSIRO Publishing |
| record_format | dspace |
| spelling | oxford-uuid:4ce770fc-4592-4c08-b852-6b34237fae982022-03-26T15:52:12ZFrom ‘sugar daddies’ to ‘sugar babies’: exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South AfricaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:4ce770fc-4592-4c08-b852-6b34237fae98EnglishSymplectic Elements at OxfordCSIRO Publishing2015Toska, ECluver, LBoyes, MPantelic, MKuo, C<p><strong>Background:</strong> Adolescent pregnancy has been linked to adverse outcomes. Most studies proposing risk pathways for adolescent pregnancy in South Africa are qualitative, hypothesising links among age-disparate relationships, reduced condom use and higher pregnancy rates. No known South African studies have quantitatively explored pathways to adolescent pregnancy. </p> <p><strong>Objectives:</strong> This study aimed to: (i) identify the factors associated with adolescent pregnancy and (ii) explore a pathway of risk by assessing whether condom use mediated the relationship between age-disparate sexual relationships and adolescent pregnancy. </p> <p><strong>Methods:</strong> A cross-sectional survey of 447 sexually active girls aged 10–19 years was undertaken in six health districts of South Africa. Multivariate logistic regressions controlled for confounders. Mediation tests used bootstrapping. </p> <p><strong>Results:</strong> Consistent condom use (β = –2.148, odds ratio (OR) = 8.566, P ≤ 0.001) and school enrolment (β = –1.600, OR = 0.202, P ≤ 0.001) were associated with lower pregnancy rates. Age-disparate sex (β = 1.093, OR = 2.982, P ≤ 0.001) and long-term school absences (β = 1.402, OR = 4.061, P ≤ 0.001) were associated with higher pregnancy rates. The indirect effect of age-disparate sex on adolescent pregnancy through condom use was significant, irrespective of age, age at sexual initiation, poverty and residential environment (B = 0.4466, s.d. = 0.1303, confidence interval: 0.2323–0.7428). </p> <p><strong>Conclusion:</strong> This survey supports hypotheses that inability to negotiate condom use in age-disparate sexual relationships may drive adolescent pregnancy. Interventions addressing these relationships, facilitating condom use and increasing access to sexual health services among adolescents might avert unwanted pregnancies.</p> |
| spellingShingle | Toska, E Cluver, L Boyes, M Pantelic, M Kuo, C From ‘sugar daddies’ to ‘sugar babies’: exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South Africa |
| title | From ‘sugar daddies’ to ‘sugar babies’: exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South Africa |
| title_full | From ‘sugar daddies’ to ‘sugar babies’: exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South Africa |
| title_fullStr | From ‘sugar daddies’ to ‘sugar babies’: exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South Africa |
| title_full_unstemmed | From ‘sugar daddies’ to ‘sugar babies’: exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South Africa |
| title_short | From ‘sugar daddies’ to ‘sugar babies’: exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South Africa |
| title_sort | from sugar daddies to sugar babies exploring a pathway among age disparate sexual relationships condom use and adolescent pregnancy in south africa |
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