Identify Key Determinants of Contraceptive Use for Sexually Active Young People: A Hybrid Ensemble of Machine Learning Methods

Abstract

Sexually active young people face an increasing public health burden of unintended pregnancies and sexually transmitted diseases due to improper contraception. However, environmental and social factors related to young people’s contraception remain unclear. To identify the key factors, we applied ensemble machine learning methods to the data of 12,280 heterosexual Chinese college students who reported sexual intercourse experience in the National College Student Survey on Sexual and Reproductive Health in 2020 (NCSS-SRH 2020). In the order of variable importance, convenient access to contraceptives, certain attitudes towards sex, sexual health knowledge level, being an only-child, and purchasing a bachelor’s or master’s degree were positively associated with a high frequency of contraceptive use. In contrast, smoking, free access to contraceptives, a specific attitude towards marriage, and negotiation with a sexual partner were negatively associated with a higher frequency of contraceptive use. Our analysis provides insights into young people’s contraceptive use under a typically conservative culture of sexuality. Compared to previous studies, we thoroughly investigated internal and external factors that might impact young people’s decision on contraception while having sex. Under a conservative culture of sexuality, the effects of the external factors on young people’s contraception may outweigh those of the internal factors.

Modern Contraceptive Use in Adolescent and Young Women: A Systematic Literature Review

“…The sample in the study was female adolescents aged 10-24 years, with participants married,( 9) , ( 10) , (11) married and unmarried, (12) and not specified. ( 5) , ( 13) , ( 14) , ( 15) -( 9) , (16) The number of samples in each study varies, but most use large samples of more than 300 samples because they use datasets from various secondary data sources, while those that use small samples are in qualitative research. .…”

“…The world's birth rate for adolescent girls aged 10-14 years in 2022 is estimated at 1.5 per 1000 girls. (3) Meanwhile, the birth rate or Age-Specific Fertility Rate (ASFR) [15][16][17][18][19] in Indonesia in 2022 will reach 22.8 and this figure has not yet reached the target of 21.(1) This means that in one year an average of 0.023 babies will be born 23 births for every 1000 women). (4) Pregnancies that are too young, too many, too close and too old are one of the causes of the still high maternal mortality ratio (MMR) in Indonesia.…”

“But can chatbots understand sex?” Attitudes towards artificial intelligence chatbots amongst sexual and reproductive health professionals: An exploratory mixed-methods study

“…[3][4][5] Several risk-prediction tools, supported by AI, have also shown to be capable of predicting user risk of HIV, syphilis, gonorrhoea and chlamydia, as well as predicting contraceptive use amongst young people. [6][7][8] Thus, AI models could inform clinical decisions, predict trends in the utilisation of SRHS and support resource allocation.…”

Effects of Sibship Size and Birth Order on Sexual and Reproductive Health among Sexually Active Young People in China

“…Studies investigating the determinants of SRH in China mainly focused on sexual knowledge, attitudes towards sex, socioeconomic status, and lifestyles. These finding based on all Chinese young people may not be applicable to sexually active populations at high risk for sexual and reproductive health [ 13 , 17 , 39 , 40 , 41 ]. In addition, the one-child policy of China is world-renowned, and only children are more common among the teenage generation of today than ever before.…”

“…Therefore, the objective of this study was to analyze the relationships between sibling numbers, being an only child, and birth order with SRH among Chinese young people, which will allow us to better promote SRH among young Chinese people. More importantly, we extended the sibling effect on SRH to sibship size and birth order, while the current literature has largely focused on and considers one-child status as a dichotomous construct [ 39 , 42 , 43 ].…”