Factors affecting contraceptive use among young people in KwaZulu-Natal.
Although sexual and reproductive health practices among young people are well documented, little is known about the factors that affect their decisions to use contraception. This is of paramount importance particularly in KwaZulu-Natal for two reasons: 1) the increasing number of teenage unplanned pregnancies in KwaZulu-Natal and 2) the inherent implication that unprotected sex can result in the transmission of diseases like sexually transmitted infections, including HIV and AIDS. Additionally, the sexual risk-taking and reproductive health behaviour of young people in KwaZulu-Natal is of extreme interest to researchers and program implementers, particularly since KwaZulu-Natal is the worst HIV affected region in South Africa (World Aids Conference XID, 1999). The aim of this study is to investigate sexual and reproductive health practices and dynamics among males and females between the ages 14 and 22 years in two areas in KwaZulu-Natal, South Africa: Metropolitan Durban and the magisterial district of Mtuzini. It explores a selection of the factors that affect contraceptive use among young people. These include age, race, sex, geographic location, relationship status and perceived risk. The study includes a rural-urban comparison, using focus group discussions and structured interviews from a pre-existing data set. Results were analysed using the Statistical Package for the Social Sciences (SPSS). The method of triangulation was adopted as this offered a more holistic approach to the analysis of both the qualitative and quantitative components of this study. The quantitative analysis was conducted using univariate frequencies, bivariate cross tabulations and multivariate logistic regression. The major [mdings of this study were that there is a strong correlation between contraceptive use and relationship status, age and sex of respondent and geographic location: (i) Both men and women in a steady relationship were more likely to use contraception, with a greater prevalence among those young adults who had previously given birth or fathered a child. (ii) respondents in the 20-22 year old age category exhibited the highest occurrence of safe sex practices, (iii) young women viewed contraception more positively than young men; particularly as a means to avoid or delay pregnancy, (iv) knowledge about contraception, its use and source of supply among both men and women between the ages 14 and 22 years is universal, with almost all having heard of at least one modem method of contraception. However, young people living in urban areas displayed a greater knowledge of the different contraceptive methods, than their rural counterparts.