Elona Toska|Lucie Cluver|Mark Boyes|Marija Pantelic|Caroline Kuo
From ‘sugar daddies’ to ‘sugar babies’: exploring a pathway among age-disparate sexual relationships, condom use and adolescent pregnancy in South Africa
Oxford Policy Management|University of Oxford|University of Oxford|University of KwaZulu-Natal|Groote Schuur Hospital|University of Cape Town|Oxford Policy Management|Curtin University|Oxford Policy Management|University of Oxford|Brown University|Providence College|Groote Schuur Hospital|University of Cape Town|University of KwaZulu-Natal
background adolescent pregnancy linked adverse outcomes studies proposing risk pathways adolescent pregnancy south africa qualitative hypothesising links among agedisparate relationships reduced condom use higher pregnancy rates known south african studies quantitatively explored pathways adolescent pregnancythis study aimed identify factors associated adolescent pregnancy ii explore pathway risk assessing whether condom use mediated relationship agedisparate sexual relationships adolescent pregnancya crosssectional survey 447 sexually active girls aged 1019 years undertaken six health districts south africa multivariate logistic regressions controlled confounders mediation tests used bootstrappingconsistent condom use 2148 odds ratio or8566 p0001 school enrolment 1600 or0202 p0001 associated lower pregnancy rates agedisparate sex 1093 or2982 p0001 longterm school absences 1402 or4061 p0001 associated higher pregnancy rates indirect effect agedisparate sex adolescent pregnancy condom use significant irrespective age age sexual initiation poverty residential environment b04466 sd01303 confidence interval 0232307428this survey supports hypotheses inability negotiate condom use agedisparate sexual relationships may drive adolescent pregnancy interventions addressing relationships facilitating condom use increasing access sexual health services among adolescents might avert unwanted pregnancies