Relationship dynamics and teenage pregnancy in South Africa
Relationship dynamics and teenage pregnancy in South Africa
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DOI：
10.1016/s0277-9536(00)00177-5
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发表时间：
2001-03-01
影响因子：
5.4
通讯作者：
Jordaan, E
中科院分区：
文献类型：
--
作者：
Jewkes, R;Vundule, C;Jordaan, E
少女怀孕在南非极为普遍。虽然它的“问题”本质是一个有争议的话题，但它反映了一种性活动模式，使青少年面临感染艾滋病毒的风险。目前，五分之一的怀孕少女感染了这种病毒。这就产生了一种新的迫切需要去理解少女怀孕和高风险性活动的模式，这是其后果之一。这是一项探索性研究，旨在调查城市和城郊性活跃青少年中与青少年怀孕相关的因素。该研究采用匹配病例对照设计。191例病例和353个年龄匹配的学校或社区对照。研究对象年龄在19岁以下，从开普敦的乡镇地区招募。使用了一份结构化问卷，以获取有关社会经济因素、避孕知识和使用以及性行为的信息。采用条件logistic回归分析青少年怀孕与调查因素之间的关系。研究结果集中在关系动态及其与怀孕风险的关系上。两组青少年的平均约会时间为两年半，其中约一半仍与他们的第一次性伴侣在一起。怀孕少女的伴侣明显年龄较大，上学的可能性较小，也不太可能有其他女朋友。怀孕的青少年明显更有可能经历强迫的性启蒙，并且经常被殴打。当她们发现男友还有其他女友时，她们不太可能去质问他。多个模型显示，被迫开始性行为和不愿面对不忠伴侣都与怀孕密切相关，而且彼此之间也有关联。我们认为，这种联系是通过不平等的权力关系来调解的，而这种不平等的权力关系又被暴力所强化。我们进一步讨论了怀孕青少年关系中更亲密的指标，这可能表明更多的怀孕是想要的，而不是建议的。这两个结论都对健康促进者提出了严峻的挑战。2001爱思唯尔科学有限公司版权所有。
Teenage pregnancy is extremely common in South Africa. Whilst its 'problematic' nature is a subject of debate, it reflects a pattern of sexual activity which puts teenagers at risk of HIV. Currently one in five pregnant teenagers is infected with the virus. This creates a new imperative to understand teenage pregnancy and the pattern of high risk sexual activity of which it is one consequence. This was an exploratory study undertaken to investigate factors associated with teenage pregnancy amongst sexually active adolescents in an urban and peri-urban context. The study used a matched case control design. with 191 cases and 353 school or neighbourhood, age-matched controls. Subjects were under 19 rears and recruited from township areas of Cape Town. A structured questionnaire was used to obtain information on socio-economic factors, contraceptive knowledge and use, and sexual behaviour. Conditional logistic regression was used to analyse the relationship between teenage pregnancy and the factors investigated. The results presented focus on relationship dynamics and their association with the risk of pregnancy. Both groups of teenagers had been dating for a mean of two and a half years and about half were still with their first sexual partner. The partners of the pregnant teenagers were significantly older, less likely to be in school and less likely to have other girlfriends. The pregnant teenagers were significantly more likely to have experienced forced sexual initiation and were beaten mon often. They were much less likely to have confronted their boyfriend when they discovered he had other girlfriends. Multiple modelling shows that both forced sexual initiation and unwillingness to confront an unfaithful partner are strongly associated with pregnancy and also related to each other. We argue that the associations are mediated through unequal power relations within the relationship which are reinforced by violence. We further discuss indicators of greater intimacy within relationships of the pregnant teenagers which may suggest that more of the pregnancies were wanted than was suggested. Both of these conclusions pose critical challenges for health promoters. (C) 2001 Elsevier Science Ltd. All rights reserved.