The prevalence of sexually
transmitted infections (STIs) and early pregnancy are high among adolescents in
Madagascar.
We applied a qualitative descriptive approach to evaluate
perceptions, attitudes, and misconceptions regarding STIs and contraception
among female and male adolescents ages 15-19 years (n = 43) in
Northern Madagascar in 2014 using focus group discussions with open-ended
questions. Data were coded and analyzed for major themes. Participants were in
the 6th to 12th grade in school; 53% were female.
Despite high levels of awareness,
significant stigma against and misconceptions about STIs, condom use, and
sexual practices existed. Many participants did not know how to use condoms and
felt uncomfortable suggesting condoms with regular partners, despite
acknowledging infidelity as a frequent problem.
Male participants were more
willing to use condoms as contraception for unwanted pregnancy than for
prevention of STIs. Most participants held misconceptions about side effects of
contraceptives, including infertility, cancer, and preventing bad blood from
leaving the woman's body. Systematic and community-wide health education and
formal reproductive health curricula in schools may improve attitudes and
stigma regarding STIs and family planning.
These strategies need to be
developed and employed via collaboration among faith-based, community and
non-governmental organizations, schools, and governmental health and social
service agencies.
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- 1 Department of Internal Medicine , Beth Israel Deaconess Medical Center , Boston , Massachusetts , USA.
- 2 Departments of Population Health and Medicine , New York University School of Medicine , New York , New York , USA.
- Women Health. 2016 Apr 19.
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