Review Article - (2022) Volume 0, Issue 0
Received: 21-May-2022, Manuscript No. Iphsj-22-12789; Editor assigned: 23-May-2022, Pre QC No. Iphsj-22-12789 (PQ); Reviewed: 06-Jun-2022, QC No. QC No. Iphsj-22-12789; Revised: 11-Jun-2022, Manuscript No. Iphsj-22-12789(R); Published: 18-Jun-2022, DOI: 10.36648/1791-809X.16.S7.952
Introduction: In Colombia, teenage pregnancy has become a public health problem in recent decades due to its tendency to increase in the general population of adolescents. In the country there have been few studies focused on identifying the level of knowledge, use and determinants for the choice of contraceptive methods focused on the prevention of teenage pregnancy.
Materials and Methods: An analytical cross-sectional study was carried out through a questionnaire that was applied to 200 adolescents from a population in a municipality in Colombia.
Results: It was found that oral contraceptives is the method that adolescents know the most and use the most, followed by injections. Avoiding pregnancies, protecting against STIs, and regulating menstrual periods are the most important reasons to use birth control. While the most important reasons for not choosing the pill had to remember its use every day. In the case of the implant, the fear and pain of placing and removing it was the most important reason.
Conclusions: Although effectiveness and long-term use can be very important advantages when choosing a contraceptive method, the fear of pain and insertion make long-lasting methods such as implantation and intrauterine devices less attractive to adolescents.
Contraceptives; Pregnancy; Adolescentes; Pills
According to statistics from the World Health Organization, there are 2 billion women of childbearing age in the world, of whom 1.2 billion need family planning. Among these, 870 million use some form of contraception and 300 million have unmet contraceptive needs. [1] Ensuring that all women, especially adolescent girls, have access to the contraceptive method of their choice has strengthened a number of human rights, including the right to life and liberty [2]. Contraceptive use can not only prevent pregnancyrelated health risks for women, especially adolescent girls, but also, when the interval between births is less than two years, the infant mortality rate is 44% higher than when the interval is 2 to 3 years, and 64% higher than when the interval is 4 years or more, so the use of adequate contraception would reduce these figures and also provides many other potential non-health benefits, including providing more educational opportunities for women, as well as providing sustainable population growth and economic development for the country [3].
In the last decade, both in Colombia and in most other Latin American countries, there has been an increase and a greater precocity in the initiation of juvenile sexual activity and therefore an increase in the number of teenage pregnancies, such pregnancies are often unwanted, unforeseen and constitute for all a global public health problem [4].
Youth is a stage where great changes are going through and therefore young people become more vulnerable and feel the need to explore their sexuality, but on the other hand, the ignorance of contraceptive methods means a great public health problem, since it can lead to pregnancies or contagion of sexually transmitted diseases [5, 6].
The combination of sex education and the large number of contraceptives currently available play an important role in the prevention of unwanted pregnancy in adolescents, however different studies show that only about 20%-30% of adolescents report having received some type of sex education or having used some type of contraceptive during their sexual life [6-8]
The objective of this study was to identify those determining factors when selecting a contraceptive method by adolescents and their reasons for choosing or rejecting each of the available methods and their knowledge.
This is an analytical cross-sectional study, carried out in a population of adolescents in a municipality in Colombia, with the availability of a wide variety of contraceptive methods, including oral contraceptives, injectable, subcutaneous implants, copper type T intrauterine device and condoms.
The information was collected through a questionnaire specially designed for this purpose. Participants were asked to mark on a scale of 1 to 5 (with 1, the least important and 5 being the most important), the reasons for choosing a contraceptive method. They were asked to say the most important reasons why they would choose each of the methods indicated and the reasons why they would not choose it. They were informed of the study and asked for informed consent ensuring confidentiality and anonymity of the data. Other variables studied were: Schooling, age, marital status, activity, whether they had initiated sexual activity or not and the use of contraceptives.
Sociodemographic data
In the present research carried out with adolescents from a municipality in Colombia, the following characterization of the sample was found: 100% of the surveyed population corresponded to the female sex, with ages between 17 and 20 years, with a predominance of 20 years (40%), followed by 17 years (30%), 18 years (20%) and 19 years (10%); thus considered a sample of late adolescents and young adults [9].
The social stratum found ranges between level 1 and 4, most between 1 and 2 with 45% and 20% respectively; With respect to the health affiliation system, it was found that 60% are from the contributory regime, and either because they work or are beneficiaries or the rest are subsidized [10-14] (Table 1).
| Variable | Categorias | N | % |
|---|---|---|---|
| Age | 17 | 60 | 30 |
| 18 | 40 | 20 | |
| 19 | 20 | 10 | |
| 20 | 80 | 40 | |
| Social Class | 1 | 90 | 45 |
| 2 | 40 | 20 | |
| 3 | 36 | 18 | |
| 4 | 34 | 17 | |
| Regime | Subsidized | 80 | 40 |
| Contributory | 120 | 60 |
Table 1. Sociodemographic data
The results correspond to 200 adolescents who agreed to participate in the study and completed the questionnaire, the average age was 15 years (95% CI: 15.0-16.5). 90% had already initiated sexual activity. 90% were students at the time of the study and the average schooling achieved was 9.5 years (95% CI: 9.0-10.0). [15-18].
Contraceptive use
The contraceptive pill and the monthly injectable were the most used contraceptive methods (80% and 45%), while condom use reached 60%. The use of sub dermal implant and IUD 10% [19- 21] (Figure 1).
Figure 1: The use of sub dermal implant and IUD 10%.
Determinants in adolescents in choosing a contraceptive method
The most important determining factors when choosing a contraceptive method were: Effectiveness in avoiding pregnancies 90%, protection against sexually transmitted diseases 70%, regulating menstruation 50%, not producing acne 30%, not having to remember its use (Figure 2).
Figure 2: Determinants in adolescents in choosing a contraceptive method.
Determining factors when choosing a type of contraceptive method by adolescents
The adolescents when choosing a contraceptive method took into account the fact that it did not need to be remembered (40%) prioritizing in this case the use of the implant and IUD, safety to avoid pregnancies (30%) highlighting the implant, regulates menstruation (60%) highlighting contraceptive pills [22,23] (Figure 3).
Figure 3: Determining factors when choosing a type of contraceptive method.
Determining factors for not choosing any of the different types of contraceptive method by adolescents
Among the determining factors for not using a type of contraceptive is the fear of pain in 80% highlighting the use of injections and implant, development of acne in 60% for contraceptive pills, gain weight in 60% prioritizing pills in the same way and irregular bleeding in 65% highlighting the use of IUDs [24] (Figure 4).
Figure 4: Determining factors for not choosing any of the different types of contraceptive method by adolescents.
In our country a large number of women from 15 to 20 years of age are sexually active regardless of their marital status. There are many barriers to the use of family planning services, in addition to the use of contraceptives that include fear, shame, cost and lack of knowledge. A study conducted in Argentina found that adolescent girls have enough information about sexual health; however, it was evident that they lacked guidance. In another study conducted in Mexico, it was found that adolescents mostly use ineffective contraceptive methods, because they are only governed by the desire to avoid an unwanted pregnancy, but do not have extensive knowledge of the use of adequate contraceptive methods [25].
In this study it was observed that the contraceptive methods best known by adolescents are pills, injections, condom, IUD and implant, data that agree with the findings made in the national demographic survey in health in 2010, The contraceptive pill and the monthly injectable were the contraceptive methods most used by adolescents evaluated in our study, In the same way, certain determining factors were found when choosing a contraceptive method, among which the effectiveness in avoiding pregnancies and protection against sexually transmitted diseases stood out [26].
Despite the fact that a significant percentage of the population studied had extensive knowledge about the different contraceptive alternatives available, a low percentage used them, among them the sub dermal implant, it is important to note that the fear of insertion pain, the possibility that they could gain weight or acne establishes limitations in the population.
Bleeding is another side effect that limits the use of these, especially in methods such as injection, implantation and IUD, which significantly contributed to its discontinuation and for which there are currently various management schemes but are not perceived as effective by adolescents.
The safety, duration and reliability provided by long-term contraceptives makes them a great alternative as a method to avoid teenage pregnancies, but the fear of pain and insertion make these methods such as implantation and intrauterine devices less used by adolescents. It is necessary a professional accompaniment by professionals very well trained considering the fears and contraceptive needs of each adolescent so that they can choose the best contraceptive method according to their needs.
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Citation: Cordero JFB, Triana CCL, Moncada JPG, Álvarez ASH, Gomez MCS, et al. (2022) Determining Factors For The Choice Of A Contraceptive Method In An Adolescent Population In Colombia. Health Sci J. Vol. 16 No. S7: 952
