Luthuli Muziwandile Qiniso, Nkala-Dlamini Busisiwe, Nzuza-Moroe Nomfundo
Department of Social Work, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa.
Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa.
Front Reprod Health. 2025 Sep 2;7:1620736. doi: 10.3389/frph.2025.1620736. eCollection 2025.
Adolescent girls and young women (AGYW) across the globe face a high risk of mental health challenges and unintended pregnancies, which are often complex and intertwined within their psychosocial environments. While earlier studies have examined contraceptive use, the influence of mental health conditions and symptoms on a broader range of contraceptive options among AGYW has not been thoroughly investigated.
This scoping review aims to map and synthesize peer-reviewed literature to understand how mental health conditions and symptoms influence contraceptive use among AGYW globally.
This review followed Arksey and O'Malley's framework. Databases searched included PubMed, MEDLINE, PsycINFO, CINAHL, Psychology and Behavioral Sciences Collection, Web of Science, and African Journals Online. We included studies on AGYW aged 10-25 years that addressed how mental health conditions and symptoms influence contraceptive use.
Of the 9,817 records identified, only 17 studies met inclusion criteria. Depression (65%; = 11) was the most frequently studied mental health factor, followed by stress (29%; = 5), proxies for mental distress (24%; = 4, including antidepressants and psychotropic drug use), and anxiety (18%; = 3). Hormonal contraceptives (HCs) (100%; = 17) were the most studied methods. Among the included studies, 71% ( = 12) found that mental health conditions and symptoms, such as depression, anxiety, psychological distress, stress, antidepressants, and psychotropic drug use, were associated with lower odds of HC use. Conversely, 29% ( = 5) found these factors to be associated with higher odds of HC use, particularly oral and non-oral methods. Stress and depression were associated with lower odds of consistent contraceptive use, while anxiety demonstrated mixed effects. Two studies reported no association between mental health factors and contraceptive use. Eleven studies focused on adolescents and six on young adults, showing a bidirectional influence between mental health and contraceptive use, with inconsistent findings across age groups.
Mental health factors affect contraceptive use in different ways. Depression and stress reduce the odds of consistent HC use, especially among non-oral contraceptive users, while anxiety shows mixed outcomes. Findings underscore the complex influence of mental health factors on contraceptive behavior among AGYW and highlight the need for age-specific policies and interventions tailored to this high-priority population.
全球范围内的青春期女孩和年轻女性面临着心理健康挑战和意外怀孕的高风险，这些问题在她们的社会心理环境中往往错综复杂且相互交织。虽然早期研究探讨了避孕措施的使用情况，但心理健康状况和症状对青春期女孩和年轻女性更广泛的避孕选择的影响尚未得到充分研究。
本范围综述旨在梳理和综合同行评审文献，以了解心理健康状况和症状如何影响全球青春期女孩和年轻女性的避孕措施使用情况。
本综述遵循阿克西和奥马利的框架。检索的数据库包括PubMed、MEDLINE、PsycINFO、CINAHL、心理学与行为科学文集、科学网和非洲期刊在线。我们纳入了关于10至25岁青春期女孩和年轻女性的研究，这些研究探讨了心理健康状况和症状如何影响避孕措施的使用。
在识别出的9817条记录中，只有17项研究符合纳入标准。抑郁症（65%；n = 11）是研究最频繁的心理健康因素，其次是压力（29%；n = 5）、心理困扰指标（24%；n = 4，包括抗抑郁药和精神药物的使用）以及焦虑（18%；n = 3）。激素避孕法（HCs）（100%；n = 17）是研究最多的方法。在纳入的研究中，71%（n = 12）发现心理健康状况和症状，如抑郁症、焦虑症、心理困扰、压力、抗抑郁药和精神药物的使用，与使用激素避孕法的较低几率相关。相反，29%（n = 5）发现这些因素与使用激素避孕法的较高几率相关，尤其是口服和非口服方法。压力和抑郁症与持续使用避孕措施的较低几率相关，而焦虑症则显示出混合效应。两项研究报告心理健康因素与避孕措施使用之间无关联。11项研究聚焦于青少年，6项聚焦于年轻成年人，显示出心理健康与避孕措施使用之间的双向影响，不同年龄组的研究结果不一致。
心理健康因素以不同方式影响避孕措施的使用。抑郁症和压力降低了持续使用激素避孕法的几率，尤其是在非口服避孕法使用者中，而焦虑症则显示出混合结果。研究结果强调了心理健康因素对青春期女孩和年轻女性避孕行为的复杂影响，并突出了针对这一高优先级人群制定适合特定年龄的政策和干预措施的必要性。
