This two-page position paper discusses the growing prevalence of adolescent pregnancy and what can be done to address it. According to the publishers, SAfAIDS, approximately 16 million women aged between 15–19 years give birth each year, which accounts for 11% of all births worldwide. In low and middle-income countries, almost 10% of girls become mothers by age 16, with the vast majority being in sub-Saharan Africa. Adolescent pregnancies are associated with many factors, some of which include lower educational levels, higher rates of poverty, use of drugs and alcohol, lack of education and availability of contraceptive measures, sexual abuse, inter-generational relationships, and peer pressure to have sexual intercourse.
As stated in this paper, the increasing rate of adolescent pregnancies is a growing concern in southern Africa and it has become imperative to examine the various causes of teenage pregnancy in order to comprehensively address this issue. The following are some factors that lead to adolescent pregnancy:
- Adolescent sexual behaviour: Adolescence marks the onset of sexual maturity, and most young people start exploring their sexuality at this stage. In most southern African countries, most young women often experience sexual intercourse for the first time between 15-19 years which is earlier than their male counterparts who often experience it at age 20. This makes the girls vulnerable to pregnancy if they do not have enough sex education and are not aware of the pregnancy prevention measures.
- The role of drug and alcohol abuse: Use of drugs and alcohol may possibly encourage unintended sexual activity. Often when adolescents are intoxicated, they forget to use protection. Young people are twice as likely to have unprotected sex whilst under the influence of alcohol or drugs compared to when they are sober. This often results in the girls becoming pregnant and also exposes them to the risks of HIV infection.
- Peer pressure to have sexual intercourse at a young age: Adolescent girls often face peer pressure from their boyfriends and social networks to engage in sexual intercourse. Early sexual début has become a trend in most societies and this often pressurises adolescent girls to indulge in sexual intercourse because of fear of being stigmatised by their peers.
- Physical and sexual abuse: Adolescent pregnancies also result from sexual abuse of teenage girls perpetrated by their male partners, family members, and criminals. The rate of physical and sexual abuse is high all over the world. Studies have indicated a strong link between early childhood sexual abuse and subsequent teenage pregnancy, especially in developing countries.
According to SAfAIDS, behaviour change communication (BCC) approaches can help reduce adolescent pregnancies and reduce HIV infections in southern Africa. A better understanding of culture and behaviour is essential in promoting positive change among adolescents. The BCC approaches adopted should recognise that presenting facts alone does not ensure behaviour change. Information and education promoting behaviour change is essential to reducing adolescent pregnancies and stemming the HIV pandemic. Interventions that have proven to be more effective in this regard include the following:
- HIV and sexual health education prior to the onset of sexual début can be effective in encouraging abstinence and preventing transmission of HIV.
- Promoting the use of condoms for pregnancy prevention would increase condom use for use for safe sex among young people.
- Mass media and social marketing campaigns are modestly effective in persuading both female and male adolescents to change risky behaviours that may lead to pregnancy and HIV infection. An example of effective social and media campaign is the Love Life campaign which was launched in South Africa in 1999. The campaign has reached youth in South Africa and enabled them to openly discuss sex, sexuality, and the link to HIV.
- Communication between adults and young people about reproductive health information can increase protective behaviours.
In order to reduce adolescent pregnancies in southern Africa whilst at the same time reducing the rate of HIV infections, SAfAIDS recommends that special attention be given to the following issues:
Policy makers and governments:
- Governments should involve young people in health and HIV programming decisions. This can help them understand the risks and prevention strategies.
- There is a need to integrate health services for young people with other issues such as alcohol and drug abuse because of the inter-linkage that exists with adolescent pregnancies. It should be routine for professionals to address sexual health and substance abuse issues simultaneously.
- Governments should involve young people in health and HIV programming decisions. This can help them understand the risks and prevention strategies. They should also develop programmes for out-of-school youth to equip them with life and employment skills.
- Communities need to be involved in shaping a positive social environment that promotes healthy behaviours and safer attitudes among young adults.
- Societies should also help address inequalities that make girls vulnerable to pregnancy and HIV infection because they cannot negotiate safe sex in relationships.
- Civil society needs to advocate for laws to protect adolescents especially the most vulnerable including, street children, migrants, and victims of violence.
Young Women First website on May 13 2013.