Tolla Tsidiso, Bergh Kate, Duby Zoe, Gana Nandipha, Mathews Catherine, Jonas Kim
Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.
School of Public Health, Division of Social and Behavioural Sciences, University of Cape Town, Cape Town, South Africa.
Reprod Health. 2025 Jun 20;22(1):104. doi: 10.1186/s12978-025-02066-2.
BACKGROUND: This study explores the role of social networks consisting of parents, romantic and sexual partners and community members related to contraceptive access and use among adolescent girls and young women (AGYW) living in resource-constrained settings in Cape Town, South Africa METHODS: Data were collected through telephonic individual interviews, using a semi-structured interview schedule, with 63 AGYW aged 15-24 years old. All data were transcribed, translated, coded and analysed thematically using NVivo software. RESULTS: AGYW self-reported that their motivations to access and use contraceptives correctly and consistently were shaped by intersecting networks of parents (specifically mothers), peers, male romantic and sexual partners, and community members. Parents and male romantic and sexual partners either discouraged or encouraged contraceptive use. The support received from parents was described as both direct and indirect. Direct support was active encouragement of contraceptive use, and indirect support was when parents did not challenge AGYW's use of contraceptives. AGYW also reported on parents who directly discouraged contraceptive use, resulting in AGYW hiding their use of contraceptives. As with parents, support from male romantic and sexual partners was not homogeneous, with some partners being supportive of contraceptive use and some not. There were AGYW who considered their partner's support as central to motivating their use of contraceptives and used strategies to convince their partners to understand the importance of using contraceptives. Conversely, some AGYW were indifferent to the support of their partners, holding the view that using contraceptives is a decision that should be made by the young woman themself. Attitudes from community members were reported to be largely discouraging. CONCLUSIONS: AGYW's interpersonal networks play a major role in shaping their attitudes, motivating or demotivating their use of, and access to contraception services. Social networks need to be taken into consideration when designing policies, interventions and programmes to promote contraception services among AGYW.
背景：本研究探讨了由父母、恋爱及性伴侣和社区成员组成的社交网络在南非开普敦资源受限环境中生活的少女和年轻女性（AGYW）获取和使用避孕措施方面所起的作用。方法：通过电话进行个人访谈，使用半结构化访谈提纲，对63名年龄在15至24岁的AGYW进行了数据收集。所有数据都进行了转录、翻译、编码，并使用NVivo软件进行了主题分析。 结果：AGYW自我报告称，她们正确且持续获取和使用避孕措施的动机受到父母（特别是母亲）、同龄人、男性恋爱及性伴侣以及社区成员等相互交织的网络的影响。父母和男性恋爱及性伴侣有的不鼓励使用避孕措施，有的则鼓励。父母给予的支持既有直接的也有间接的。直接支持是积极鼓励使用避孕措施，间接支持是父母不质疑AGYW使用避孕措施。AGYW还提到有些父母直接不鼓励使用避孕措施，导致她们隐瞒自己使用避孕措施的情况。与父母一样，男性恋爱及性伴侣的支持也不一致，有些伴侣支持使用避孕措施，有些则不支持。有些AGYW认为伴侣的支持是促使她们使用避孕措施的关键，并采取策略说服伴侣理解使用避孕措施的重要性。相反，有些AGYW对伴侣的支持漠不关心，认为使用避孕措施是年轻女性自己应做的决定。据报告，社区成员的态度大多是不鼓励的。 结论：AGYW的人际网络在塑造她们对避孕措施的态度、促使或抑制她们使用避孕措施及获取避孕服务方面起着重要作用。在设计促进AGYW避孕服务的政策、干预措施和项目时，需要考虑社交网络的因素。
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