Primary Submission Category: Health behaviors
Barriers and Enablers Associated with Adolescent Sexual and Reproductive Health Behaviors in Western Kenya: A Theory-Informed Approach
Authors: Nema C.M. Aluku Carolyne Mabeya Catherine Muteithia Yvonne Wanjiru Abigail A. Lee William T. Story
Presenting Author: Abigail Lee*
Background: Young women in western Kenya are becoming pregnant before they want, leading to detrimental health outcomes. Little is understood about the root beliefs that leave girls at risk of young pregnancy. This study aims to elucidate the barriers to and enablers of delayed sexual initiation and condom use among adolescents in western Kenya.
Methods: This study is part of a larger sexual and reproductive health (SRH) program called Stepping Up!. We conducted a rapid assessment of the determinants of delayed sexual initiation and condom use known as Barrier Analysis, which is based on the Health Belief Model and the Theory of Reasoned Action. For each behavior, we interviewed 120 boys and girls (ages 15-24 years) divided evenly between those who practice the behavior (“doers”) and those who do not (“non-doers”). We analyzed the data and identified significant differences (p<0.05) between the “doers” and “non-doers” for each behavior.
Results: For delayed sexual initiation, differences were observed for self-efficacy and social norms related to delaying sex. Compared to doers, non-doers (especially boys) found it difficult to delay sex (p=0.027); however, they were aware that delaying sex would prevent early pregnancy (p=0.012). Non-doers also felt they would be the “odd one out” and their friends would be disappointed if they delayed having sex (p=0.022). For condom use, differences were observed for social norms, negative consequences, and cues to action. Compared to doers, non-doers indicated that most people do not approve of condom use (p=0.017); girls indicated partners do not approve (p=0.013). Non-doers also mentioned discomfort/irritation of condoms during sex (p=0.040) and found it difficult to remember to use a condom correctly (p=0.022).
Conclusion: This study demonstrates that self-efficacy, social norms, negative consequences, and cues to action are key determinants of adolescent SRH in western Kenya and should be addressed in future interventions.