Youth Reproductive and Sexual Health - DHS Comparative Reports No. 19

The purpose of this 107-page study is to provide data on key reproductive and sexual health indicators for youth (aged 15-24) in 38 developing countries. It was produced for review by the United States Agency for International Development (USAID) through the MEASURE DHS (Demographic and Health Survey) project. According to the authors, "[s]everal important findings from this study have implications for programs aimed at improving the reproductive and sexual health of youth."

A descriptive analysis is provided of background characteristics; adolescent pregnancy and motherhood; contraception; sexual activity; and HIV/AIDS-related knowledge, attitudes, and behaviours. In addition, associations between these indicators and various individual and household characteristics are examined.

An excerpt from the report follows:

"The findings indicate that adolescent pregnancy is more common in sub-Saharan Africa and in Latin America and the Caribbean than in South/Southeast Asia. More than 20 percent of adolescents age 15-19 have ever been pregnant in 20 of the 26 countries in sub-Saharan Africa and in South/Southeast Asia. Overall, pregnancy terminations are rare in all countries, ranging from less than 1 percent in several countries (Eritrea, Ethiopia, Lesotho, Rwanda, the Philippines, and Morocco) to 4 percent (Congo). Programs need to target adolescent girls in rural areas, those who have lower levels of education, and those who have less exposure to mass media as they are most likely to become pregnant.

Although large proportions of youth in all countries know of one method of contraception, more effort is needed to increase the knowledge of multiple methods among sub-Saharan youth, where smaller proportions of young people have the necessary knowledge. Higher proportions of sexually active, unmarried female youth report current use of modern contraceptive methods than of those who are married. Current use of modern contraceptive methods among married youth is lowest in sub-Saharan Africa. Current use of a modern method is associated with living in an urban area, having more education, and having regular exposure to the media. Unmet need for family planning is higher among sexually active, unmarried young women than currently married young women.

Results also indicate that primary abstinence is more likely to be practiced by young women than young men, and it is more common in South/Southeast Asia and in North Africa/West Asia/Europe than other regions. Primary abstinence among both female and male youth is associated with younger ages, lower levels of education, lack of employment, and lack of media exposure. Among females, living with a nuclear family, living with other youth, having a male head of household, and living with an adult are associated with higher levels of primary abstinence. Among males, primary abstinence is associated with living in a nuclear family and living with another youth. Secondary abstinence is much less common than primary abstinence, and is more common in sub-Saharan Africa than other regions.

Multiple sexual partnerships are most common among young men who reside in an urban area, have higher levels of education, are employed, are regularly exposed to the media, and who live in the wealthiest households. Higher-risk sex among both young women and men is associated with living in an urban area, having more education, being unemployed, living in a joint family, and being a member of one of the highest wealth quintiles. Among married youth, young males are more likely than young females to report extramarital sex in the past 12 months.

Programs need to reach young men, who are more likely than young women to have sex with multiple partners and to have higher-risk sex. Planners and policymakers should also note that among young men, higher-risk sex is the norm; in all but six of the countries studied, more than three-quarters of young men report having higher-risk sex in the past 12 months. In spite of the prevalence of higher-risk sex, condom use at last higher-risk sex is low in most countries, with female youth less likely to report condom use at last higher-risk sex than male youth.

Although the majority of youth have heard of HIV/AIDS and know that abstaining from sex, being faithful to an uninfected, faithful sexual partner, and using condoms can reduce the risk of HIV infection, young men are more informed about prevention measures than young women. In most countries, considerable proportions of female and male youth do not have accepting attitudes toward persons living with HIV; acceptance levels are particularly low in North Africa/West Asia/Europe.

Testing for HIV is rare among youth. In most countries in sub-Saharan Africa and South/Southeast Asia, less than 10 percent of young females and males have ever been tested for HIV. Testing rates are higher in Latin America and the Caribbean than in other regions, and female youth are somewhat more likely than male youth to be tested.

Young females are more likely than young males to report having an STI or symptoms of an STI in the past year. In 16 of 31 countries with data on STIs, 10 percent or more of young females report having had an STI or STI symptoms in the past year.

...Despite the wealth of information in this report, additional research is required to further understand current reproductive and sexual behavior patterns in youth in the developing world..."