Beliefs and misconceptions about contraception and condom use among adolescents in south-east Nigeria

Abstract

Background Misconceptions about the usefulness of condoms and other contraceptives still expose many unmarried adolescents to the risk of unwanted teenage pregnancies and sexually-transmitted infections (STIs). This study explored beliefs and misconceptions about condoms and other contraceptives among adolescents in Ebonyi state, south-east Nigeria. Method A qualitative study was undertaken in six local government areas in Ebonyi state, southeast Nigeria. Data were collected within a period of one month from in and out-of-school adolescents aged 13–18 years using twelve focus group discussions (FGD). The data were analyzed using the thematic framework approach. Result Majority of the adolescents were knowledgeable about methods of contraception, how they are used and their modes of action. They were also knowledgeable about the dual effects of condoms in prevention of pregnancy and STIs. However, some misconceptions that were expressed by some adolescents were that pregnancy could be prevented by the use of (i) hard drugs, (ii) laxatives, (iii) white chlorine, and (iv) boiled alcoholic beverages. Condoms were described by some adolescent boys as reusable. Condoms were also perceived by some adolescents to reduce sexual pleasure, and this opinion was mostly held by boys. Coitus interruptus (withdrawal method) was therefore considered more preferable than condoms for prevention of pregnancy. Conclusion Although majority adolescents have knowledge about contraception and condom use, some misconceptions still persist. These misconceptions put many adolescents at increased risk for pregnancy and STIs which are detrimental to their health and wellbeing. Concerted efforts should be made through educational and behaviour change interventions in schools and within communities to debunk persisting misconceptions about contraception including the use of condom, and properly educate adolescents on safe sex practices. Plain English summary Adolescents engage in unprotected sexual intercourse and other risky sexual behaviours because of some mistaken beliefs and wrong impressions about how to prevent unwanted pregnancy. These risky sexual behaviours predispose adolescents to sexually transmitted infections, unsafe abortion and other reproductive health problems. In this qualitative study, we explored some of these mistaken beliefs about condoms and other methods of preventing pregnancy. During focus group discussions, adolescents identified modern contraceptive methods, and described their modes of action and how they are used. They also discussed their contraceptive preferences and perceived effects of condoms on sexual pleasure. Although some of these adolescents were able to correctly mention various types of contraceptives and their modes of action, there were numerous wrong impressions. Hard drugs, laxatives, white chlorine and boiled alcoholic beverage were listed as emergency contraceptive methods. Emergency pills were perceived to work by flushing away spermatozoa from a girl’s system after sexual intercourse. Male condoms were perceived to be potentially dangerous because they could break and enter into the body of the female sexual partner. Some adolescent boys had the notion that particular brands of male condoms could be washed and reused. Notions about condom use and sexual pleasure varied for girls and boys. Some adolescent girls perceived that condom use during sex increases sexual pleasure because of the assurance of being protected from STIs and pregnancy. Adolescent boys were of the opinion that condoms interfere with the pleasure of direct ‘flesh to flesh’ contact during sex. There was a general belief that contraceptive use in early age reduces fertility prospects for boys and girls. Mistaken beliefs about methods of preventing pregnancy persist among adolescents, and this raises concerns about the quality of information they receive. Concerted efforts should be made to debunk these wrong beliefs and properly educate adolescents on safe sex practices.

Understanding Risky Sexual Behaviour Among Undergraduates

“…It is critical to note that 35 percent of this study participant agrees that condom effectively protects against unplanned pregnancy. This is consistent with the records by Mbachu et al (2021) which revealed mistaken beliefs about methods of preventing pregnancy. These misconceptions will subject unmarried Students to unplanned pregnancies.…”

Riverside Men's Knowledge and Ways of Acting Regarding Condom Use

“…In this dimension, they make judgments in relation to their use, on which a negative evaluation is observed, based on their interference with pleasure 10/14 during the sexual act, evidencing that the participants are not satisfied with condom use in their sexual practices. This representation is also a finding in several studies 21,[25][26][27][28] when they associate men with condom use, in which the vast majority think of them as protection, safety and prevention, but refer to the sexual act using the device as something bad, for it interferes with pleasure.…”

Exploring the why: risk factors for HIV and barriers to sexual and reproductive health service access among adolescents in Nigeria

“…Our study identified that parents in Nigeria had a significant role to play in the sexual risk behaviors of adolescents: Poor parental oversight, and parental approval of romantic partners increases sexual risk behaviour of adolescents [ 68 , 69 ]. On the other hand, parental connectedness reduces sexual risk behavior for both male and female adolescents, and mother–child communication reduces sexual risk behavior for girls [ 70 ].…”