Children's Mercy Hospital, Kansas City, MO, US.
Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, US.
BMC Womens Health. 2023 Mar 27;23(1):137. doi: 10.1186/s12905-023-02268-5.
Adolescents and young adults (AYAs) in Haiti experience a high unintended pregnancy rate, in part due to unmet contraception needs. Little is known about AYA opinions of and experiences with contraception that may explain remaining gaps in coverage. We aimed to describe barriers and facilitators to contraception use among AYAs in Haiti.
We conducted a cross-sectional survey and semi-structured qualitative interviews with a convenience sample of AYA females aged 14-24 in two rural communities in Haiti. The survey and semi-structured interviews assessed demographics, sexual health and pregnancy prevention behaviors and explored contraception opinions and experiences according to Theory of Planned Behavior constructs: attitudes, subjective norms, and perceived behavioral control. We used descriptive statistics to report means and responses to Likert scale and multiple-choice questions. Guided by content analysis, we analyzed interview transcripts through inductive coding and team debriefing.
Among 200 survey respondents, 94% reported any past vaginal sexual activity, and 43% reported ever being pregnant. A large majority were trying to avoid pregnancy (75%). At last sexual activity, 127 (64%) reported use of any contraceptive method; Among them, condoms were the most common method (80%). Among those with previous condom use, most reported use less than half the time (55%). AYAs were concerned about parental approval of birth control use (42%) and that their friends might think they are looking for sex (29%). About one-third felt uncomfortable going to a clinic to ask for birth control. In interviews, AYAs desired pregnancy prevention but frequently noted concerns about privacy and parental, community and healthcare provider judgement for seeking care for reproductive health needs. AYAs also noted a lack of contraception knowledge, evident by frequent misconceptions and associated fears.
Among AYAs in rural Haiti, a large majority were sexually active and desire pregnancy avoidance, but few were using effective contraception due to numerous concerns, including privacy and fear of judgement. Future efforts should address these identified concerns to prevent unintended pregnancy and improve maternal and reproductive health outcomes in this population.
海地的青少年和年轻人（AYAs）经历了较高的意外怀孕率，部分原因是避孕需求未得到满足。人们对 AYA 对避孕的看法和经验知之甚少，而这些看法和经验可能解释了覆盖范围仍然存在的差距。我们旨在描述海地 AYA 使用避孕措施的障碍和促进因素。
我们对海地两个农村社区中年龄在 14-24 岁的 AYA 女性进行了一项横断面调查和半结构式定性访谈。该调查和半结构式访谈评估了人口统计学、性健康和妊娠预防行为，并根据计划行为理论的构建来探讨避孕的看法和经验：态度、主观规范和感知行为控制。我们使用描述性统计数据报告了均值和对李克特量表和多项选择题的回答。根据内容分析，我们通过归纳编码和团队讨论分析了访谈记录。
在 200 名调查参与者中，94%报告有过阴道性交，43%报告曾怀孕。绝大多数人试图避免怀孕（75%）。在上一次性行为中，有 127 人（64%）报告使用了任何避孕方法；其中，避孕套是最常用的方法（80%）。在以前使用过避孕套的人中，大多数人报告使用不到一半的时间（55%）。AYAs 担心父母会批准使用避孕药（42%），担心他们的朋友会认为他们在寻找性（29%）。约三分之一的人觉得去诊所要求避孕很不舒服。在访谈中，AYAs 希望预防怀孕，但经常提到对隐私和父母、社区和医疗保健提供者对寻求生殖健康护理的判断的担忧。AYAs 还指出缺乏避孕知识，这表现为经常存在误解和相关的恐惧。
在海地农村地区的 AYA 中，绝大多数人有性生活，希望避免怀孕，但由于许多担忧，包括隐私和担心被评判，很少有人使用有效的避孕措施。未来的努力应该解决这些已确定的问题，以防止意外怀孕，并改善这一人群的母婴和生殖健康结果。
