From adolescents own perspectives: Perceptions of contraceptives and contraceptive use : A qualitative study in Arusha, Tanzania

Abstract

Introduction: Adolescents represent a large and fast growing demographic group where sexual activity brings serious consequences for today's generation of adolescents. In Tanzania, 5.1 % of the adult population (>15)is living with HIV, and 23% of girls (15-19) have begun childbearing. Increased use of modern contraceptive can be one important factor among others, in terms of improving adolescents' sexual and reproductive health in Tanzania.

Research aim: The aim of this study was to explore adolescents' perceptions of contraceptives and contraceptive use in Tanzania.

Methods: This study entailed 22 individual interviews and 4 focus group discussions with unmarried boys and girsl aged 15-20. Most of the participants were secondary highs school students, both from an urban and a rural area. The data obtained was analysed using Systematic Text Condenstation.

Findings: The participants perceive modern contraceptives as family planning methods, with the word "family planning" taking on a literal meaning. Unmarried adolescents using contraceptives are stigmatized, and as consequence they have problems with accessing contraceptive health service. Adolescents have basic knowledge of modern contraceptives, and know they are effective in terms of protecting against unwanted pregnancies. However, use seems to be limited by misconceptions, especially fear of intertility. Uncertainty related to condoms' effectiveness exists, and the perception that condom use is not "sweet" seems to have established itself as a truth regardless of personal condom experience. Adolescents are worried about teenage pregnancies, but do not seem to be worried about getting HIV or other STIs. Strong cultural norms and religious beliefsinfluence adolescents' perceiptions of contraceptives, and gender imbalances make young girls vulnerable to HIV and unwanted pregnancies. Talking about sexuality and contraception is regarded as taboo, and critical socialization institutions, such as families and schools, seem to focus on discouraging the use of contraceptives and tell them abstaining is the right "method" to use. Adolescents seem to desire more comprehensive sexual health education, and all the participants want a small family size in the future.

Conclusion: Increasing the use of modern contraceptives requires cultural-sensitive and youth-friendly interventions that focus on what adolescents are concerned with. In addition, adolescents need more information to counter negative perceptions.