Factors Associated with Unmet Need for Modern Contraception in Post-Conflict Liberia

Allison P. Pack, Donna R. McCarraher, Mario Chen, Chinelo C. Okigbo, Lisa Marie Albert, Sam Wambugu

Abstract

We examined the association between intimate partner violence and unmet need for modern contraception in post-conflict Liberia. This is a secondary analysis of data collected using the Priorities for Local AIDS Control Efforts (PLACE) method. Data from 499 sexually experienced young women (aged 14-25) in Montserrado County, Liberia were examined. Intimate partner violence (55.7%), unintended pregnancy (83.2%), and abortion (45.3%) were pervasive in the study population. An estimated 35.9% of respondents had an unmet need for modern contraception. However, multivariate logistic regression results did not reveal an association between intimate partner violence and unmet need (OR 1.11; 95% CI 0.70-1.75). Among covariates examined, only contraceptive use at sexual debut (26.1%) was significantly associated with unmet need (OR 0.27; 95%  CI 0.140.52). Liberian youth need information about and access to modern contraceptive methods besides condoms.  Interventions to identify and treat victims of violence are also needed. Afr J Reprod Health 2014; 18[2]: 58-67).

 

Key words: Intimate partner violence, unintended pregnancy, abortion, unmet need for contraception, adolescents, Liberia  

Résumé

 

Nous avons étudié l'association entre la violence du partenaire intime et le besoin non satisfait de la contraception mo derne au Liberia de post- conflit. Il s'agit d'une analyse secondaire des données recueillies à travers  la méthode des priorités pour les efforts  locaux du contrôle du SIDA (PELCS). Nous avons étudié les données de 499 jeunes femmes (âgées de 14-25)   dans le comté de Montserrado, Libéria, qui étaient sexuellement expérimentées.  La violence du partenaire intime (55,7, les grossesses non désirées (83,2 %)  et l'avortement (45,3 %) étaient très communs dans la population étudiée. On estime que 35,9 % des répondants ont un besoin non satisfait de la contraception moderne. Cependant, les résultats multivariés de la régression logistique n'ont pas révélé une association entre la violence du partenaire intime et les besoins non satisfaits (OR 1,11, IC 95% 0,70 à 1,75). Parmi les co-variables examinées, seule l'utilisation des contraceptifs au premier rapport sexuel (26,1%) était significativement associée à des besoins non satisfaits (OR 0,27, IC 95% 0,14 au 0,52). La jeunesse libérienne a besoin d'informations sur l'accès aux méthodes contraceptives modernes à part les préservatifs. Les interventions qui visent à identifier et à traiter les victimes de violence sont également nécessaires. Afr J Reprod Health 2014; 18[2]: 58-67).

 

Mots clés: violence conjugale,  grossesses non désirées, avortement,  besoins non satisfaits en matière de la contraception,

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References

WJ. Family planning: the essential link to achieving all eight Millennium Development Goals. Contraception 2010;81(6):460-1.

Singh SD, Jacqueline E. Adding It Up: Costs and Benefits of Contraceptive Services Estimates for 2012. New York: Guttmacher Institute and United Nations Populations Fund (UNFPA),, 2012.

Reynolds HW, Janowitz B, Wilcher R, Cates W. Contraception to prevent HIV-positive births: current contribution and potential cost savings in PEPFAR countries. Sex Transm Infect 2008;84 Suppl 2:ii49-53.

Liberia Institute of Statistics and Geo-Information Services. Liberia Demographic and Health Survey 2007. Monrovia: Liberia Institute of Statistics and Geo-Information Services, 2008.

Pallitto CC, Campbell JC, O'Campo P. Is intimate partner violence associated with unintended pregnancy? A review of the literature. Trauma Violence Abuse 2005;6(3):217-35.

Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, et al. Unsafe abortion: the preventable pandemic. Lancet 2006;368(9550):1908-19.

Johnson BR, Ndhlovu S, Farr SL, Chipato T. Reducing unplanned pregnancy and abortion in Zimbabwe through postabortion contraception. Stud Fam Plann 2002;33(2):195-202.

Cleland J, Bernstein S, Ezeh A, Faundes A, Glasier A, Innis J. Family planning: the unfinished agenda. Lancet 2006;368(9549):1810-27.

Williamson LM, Parkes A, Wight D, Petticrew M, Hart GJ. Limits to modern contraceptive use among young women in developing countries: a systematic review of qualitative research. Reprod Health 2009;6:3.

Pallitto CC, O'Campo P. The relationship between intimate partner violence and unintended pregnancy: analysis of a national sample from Colombia. Int Fam Plan Perspect 2004;30(4):165-73.

Kaye DK, Mirembe FM, Bantebya G, Johansson A, Ekstrom AM. Domestic violence as risk factor for unwanted pregnancy and induced abortion in Mulago Hospital, Kampala, Uganda. Trop Med Int Health 2006;11(1):90-101.

Gomez AM. Sexual violence as a predictor of unintended pregnancy, contraceptive use, and unmet need among female youth in Colombia. J Womens Health (Larchmt) 2011;20(9):1349-56.

Ogunjuyigbe PO, Akinlo, A., Oni, G.O. Violence against women as a factor in unmet need for contraception in Southwest Nigeria. Journal of Family Violence 2010;25(2):123-30.

Wingood GM, DiClemente RJ. The effects of an abusive primary partner on the condom use and sexual negotiation practices of African-American women. Am J Public Health 1997;87(6):1016-8.

Williams CM, Larsen U, McCloskey LA. Intimate partner violence and women's contraceptive use. Violence against women 2008;14(12):1382-96.

Fanslow J, Whitehead A, Silva M, Robinson E. Contraceptive use and associations with intimate partner violence among a population-based sample of New Zealand women. Aust N Z J Obstet Gynaecol 2008;48(1):83-9.

Alio AP, Daley EM, Nana PN, Duan J, Salihu HM. Intimate partner violence and contraception use among women in Sub-Saharan Africa. Int J Gynaecol Obstet 2009;107(1):35-8.

National AIDS Commission Republic of Liberia. National HIV/AIDS Strategic Framework II (2010-2014). Liberia, 2010.

(UNICEF) UNCsF. Knowledge about HIV/AIDS, Attitude towards Persons Living with HIV and Sexual Practices Among Young Persons in Liberia. Monrovia, Liberia, 2005.

Ministry of Health and Social Work. Adolescent Health Study within the Context of Prevention. Monrovia, Liberia, 2009.

Kennedy SB, Atwood KA, Harris AO, Taylor CH, Gobeh ME, Quaqua M, et al. HIV/STD Risk Behaviors Among In-School Adolescents in Post-conflict Liberia. J Assoc Nurses AIDS Care 2012;23(4):35060.

McCarraher DM, Chen M, Wambugu S, Sortijas S, Succop S, Aiyengba B, Okigbo C, Pack A. Informing HIV prevention efforts targeting Liberian youth: A study using the PLACE method in Monrovia. Reprod Health 2013;10:54.

Weir SS, Pailman C, Mahlalela X, Coetzee N, Meidany F, Boerma JT. From people to places: focusing AIDS prevention efforts where it matters most. AIDS 2003;17(6):895-903.

Rutstein SO, Rojas, G. Guide to DHS Statistics. Calverton, Maryland: Demographic and Health Surveys and ORC Macro, 2006.

Gallo MF, Behets FM, Steiner MJ, Hobbs MM, Hoke TH, Van Damme K, et al. Prostate-specific antigen to ascertain reliability of self-reported coital exposure to semen. Sex Transm Dis 2006;33(8):476-9.

Gallo MF, Steiner MJ, Hobbs MM, Weaver MA, Hoke TH, Van Damme K, et al. Predictors of unprotected sex among female sex workers in Madagascar: comparing semen biomarkers and self-reported data. AIDS Behav 2010;14(6):1279-86.

Straus MA. Measuring Intra-family conflict and violence: the conflict tactics scale. Journal of Marriage and Family 1979;41(1):75-88.

Straus MA, Gelles, R. J. Physical violence in American families: Risk factors and adaptations to violence in 8,145 families. 4 ed. New Brunswick, New Jersey: Transaction Publishers, 1990.

StataCorp LP. Stata Statistical Software: Release 10. College Station, Texas, 2007.

Freedman DA, Sekhon, J. S. Endogeneity in probit response models. Political Analysis 2010;18(2):13850.

Jagannathan R. Relying on surveys to understand abortion behavior: some cautionary evidence. Am J Public Health 2001;91(11):1825-31.

Otoide VO, Oronsaye, F., Okonofua, F.E. Why Nigerian adolescents seek abortion rather than contraception: evidence from focus-group discussions. International Journal of Family Planning Perspectives 2001;27(2):77-81.

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