Peer-reviewed article
A qualitative study of risks and protective factors against pregnancy among sexually-active adolescents in Soweto, South Africa
Edna N. Bosire, Katharine Chiseri, Dawn L. Comeau, Linda Richter, Aryeh D. Stein et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This qualitative study examined why some sexually-active adolescents in Soweto became pregnant before age 18 while others did not. Researchers interviewed 24-year-old women who had early sexual debut, comparing those who had early pregnancy with those who avoided it. Common risk factors included peer pressure to have sex, family instability, and lack of conversations about sexuality, while protective factors involved family support and access to information about contraception.
Key points
- Both groups reported similar predisposing risks including peer influence to engage in early sex, unstable family relationships, and limited conversations about sex
- Family emerged as a key institution supporting adolescents' decisions regarding sexual behavior and choices
- Access to information, including sex education and contraceptives, was identified as important for pregnancy prevention
- The study used purposive sampling comparing 10 women who did not become pregnant before 18 years with 10 who did
Limitations
The study is retrospective, relying on recall from women aged 24 reflecting on adolescent experiences years earlier, which may introduce memory bias. The small sample size of 20 women from one location limits generalizability beyond Soweto.
Abstract
Risky sexual behaviors contribute to increased risk of adolescent pregnancy. This qualitative study sought to understand risks and protective factors against pregnancy amongst sexually-active adolescents in Soweto, South Africa. We used purposive sampling to recruit women at age 24 years from Soweto, who self-reported having sexual debut by age 15 years. Twenty women were recruited: (i) women who did not become pregnant before 18 years (n = 10) and (ii) women who became pregnant before 18 years (n = 10). In-depth interviews were conducted to understand their family backgrounds, conversations about sex, sexual behaviors, and initiatives taken (or not) during adolescence to prevent pregnancy. Both groups of women reported predisposing risks to early pregnancy including influence from peers to engage in early sex, unstable family relationships and limited conversations about sex. We found that the family is a key institution in supporting adolescents' decisions regarding their behaviors and choices, as are peers and exposures to information. Community Youth Centers, high schools and Youth Friendly Health Services should ensure that adolescents have access to relevant information, including sex education and contraceptives.