Contraceptive use and associated factors among South African youth (18-24 years): a population-based survey

Despite ongoing campaigns and intervention programmes promoting safe sex, contraceptive use remains a controversial area among South African youth. The aim was to investigate contraceptive use and associated factors among South African youth aged 18 - 24 years who reported having had sexual intercourse. Young South Africans (3 123 subjects aged 18 - 24 years) in four provinces responded to a cross-sectional population-based household survey. Among women who reported to be currently using contraception (89.1%), 9.3% were using the Pill, 5.2% the intra-uterine contraceptive device, 25.6% injectables, 57.6% male condoms, 5.9% female condoms, and 8.9% dual methods; other methods used were the rhythm method (7.0%), withdrawal (11.5%), and emergency contraception (5.5%). In multivariable analysis among women, ease of getting condoms and not having had early sex (below 15 years of age) were associated with contraceptive use. Among men, better knowledge about contraceptives, having talked with the partner about condoms in the past 12 months, loveLife and multimedia programme exposure were associated with contraceptive use in univariate analysis, while none were retained in the multivariable model. Communicating with the partner about condom use, education and being employed were significantly associated with contraceptive use. However, use of contraceptives is still low, and this is substantiated by the high rate of unwanted pregnancies reported. It is clear that more vigorous, effective and meticulous means of promoting contraceptive use need to be explored, enabling youth to take control of their reproductive health and make informed decisions.