“我会找到最适合我的方法”：探寻南非少女和年轻女性的避孕历程

"I will find the best method that will work for me": navigating contraceptive journeys amongst South African adolescent girls and young women.

作者信息

Duby Zoe, Bergh Kate, Bunce Brittany, Jonas Kim, Slingers Nevilene, Mathews Catherine, Abdullah Fareed

机构信息

Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.

School of Public Health, University of Cape Town, Cape Town, South Africa.

出版信息

Contracept Reprod Med. 2024 Aug 2;9(1):39. doi: 10.1186/s40834-024-00298-4.

DOI:10.1186/s40834-024-00298-4

PMID:39090752

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11295340/

Abstract

BACKGROUND

Given that South Africa has one of the highest rates of pregnancy amongst adolescent girls and young women (AGYW) globally, the provision of contraceptives to this group has been a key focus in recent years. Pregnancy prevention involves an on-going continuum of decision-making around contraceptive method choice, uptake, use, experience, continuation, and discontinuation.

METHODS

This paper presents analysis of data from a cross-sectional survey with 2376 AGYW, as well as qualitative in-depth interviews (IDIs) with 54 AGYW, inclusive of contraceptive journey narratives. We examine the preferences, valued characteristics, choices, beliefs, understandings and experiences of choosing and using contraceptives amongst AGYW in two South African communities characterised by high rates of pregnancy.

RESULTS

These findings shed light on the preferences towards, beliefs about, and experiences of choosing, using and discontinuing contraceptive methods amongst this population, with survey data suggesting that the most popular methods were the injection, followed by the implant, and then the oral pill. Findings illustrate the complexity and dynamic nature of contraceptive decision-making and the varied embodied and lived experiences of contraceptive use, and how these are impacted by contraception service provision.

CONCLUSIONS

Our findings show that contraception experiences of each individual are cumulative, and comprise a continuum of method initiation, use, discontinuation, method switching and on-going circular decision-making influenced by multiple social, structural, contextual and interpersonal factors, combined with shifting preferences, values and needs. To maximise the use of contraceptives amongst South African AGYW, it is necessary to provide responsive contraception service provision to reflect the changing contexts and preferences of users, in order to ensure that pregnancy prevention needs are catered for throughout their reproductive life course.

摘要

背景

鉴于南非是全球青春期女孩和年轻女性（AGYW）怀孕率最高的国家之一，近年来，为这一群体提供避孕药具一直是重点关注的问题。预防怀孕涉及围绕避孕方法选择、获取、使用、体验、持续使用和停用等方面持续不断的决策过程。

方法

本文对2376名AGYW的横断面调查数据以及对54名AGYW进行的定性深入访谈（IDI）进行了分析，包括避孕历程叙述。我们考察了南非两个以高怀孕率为特征的社区中AGYW在选择和使用避孕药具方面的偏好、重视的特征、选择、信念、理解和体验。

结果

这些发现揭示了该人群在选择、使用和停用避孕方法方面的偏好、信念和体验，调查数据表明最受欢迎的方法是注射，其次是植入，然后是口服避孕药。研究结果说明了避孕决策的复杂性和动态性，以及避孕使用中不同的具体体验和生活经历，以及这些如何受到避孕服务提供的影响。

结论

我们的研究结果表明，每个人的避孕经历都是累积性的，包括方法启动、使用、停用、方法转换以及受多种社会、结构、背景和人际因素影响的持续循环决策过程，同时伴随着不断变化的偏好、价值观和需求。为了在南非AGYW中最大限度地提高避孕药具的使用率，有必要提供响应式避孕服务，以反映用户不断变化的背景和偏好，从而确保在她们的整个生殖生命过程中满足预防怀孕的需求。