From ‘sugar daddies’ to ‘sugar babies’: exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South Africa

Background: 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 ha...

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Main Authors: Toska, E., Cluver, L., Boyes, Mark, Pantelic, M., Kuo, C.
Format: Journal Article
Published: C S I R O Publishing 2015
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/38531
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author Toska, E.
Cluver, L.
Boyes, Mark
Pantelic, M.
Kuo, C.
author_facet Toska, E.
Cluver, L.
Boyes, Mark
Pantelic, M.
Kuo, C.
author_sort Toska, E.
building Curtin Institutional Repository
collection Online Access
description Background: 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. Objectives: 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. Methods: 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. Results: Consistent condom use (ß = –2.148, odds ratio (OR) = 8.566, P = 0.001) and school enrolment (ß = –1.600, OR = 0.202, P = 0.001) were associated with lower pregnancy rates. Age-disparate sex (ß = 1.093, OR = 2.982, P = 0.001) and long-term school absences (ß = 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). Conclusion: 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.
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spelling curtin-20.500.11937-385312017-09-13T14:19:01Z From ‘sugar daddies’ to ‘sugar babies’: exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South Africa Toska, E. Cluver, L. Boyes, Mark Pantelic, M. Kuo, C. risk behaviours reproductive health youth Background: 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. Objectives: 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. Methods: 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. Results: Consistent condom use (ß = –2.148, odds ratio (OR) = 8.566, P = 0.001) and school enrolment (ß = –1.600, OR = 0.202, P = 0.001) were associated with lower pregnancy rates. Age-disparate sex (ß = 1.093, OR = 2.982, P = 0.001) and long-term school absences (ß = 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). Conclusion: 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. 2015 Journal Article http://hdl.handle.net/20.500.11937/38531 10.1071/SH14089 C S I R O Publishing fulltext
spellingShingle risk behaviours
reproductive health
youth
Toska, E.
Cluver, L.
Boyes, Mark
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
topic risk behaviours
reproductive health
youth
url http://hdl.handle.net/20.500.11937/38531