Effect of Domestic Violence on Contraceptive Use Among Adolescents in Nicaragua

Background: Nicaragua has the highest adolescent birth rate in the Latin America region despite having one of the highest contraceptive prevalence rates. 70% of women in Nicaragua will experience domestic violence (DV) at least once in their life. Study findings between DV and contraception use vary.

Objective: To evaluate the relationship between DV and contraceptive use among Nicaraguan adolescents.

Methods: AMNLAE, a women’s organization in Nicaragua, conducted a self-administered survey of sexual and reproductive health (SRH) attitudes, knowledge, and practices in 11 towns. 714 respondents filled out the survey.  Pearson’s chi-square, independent samples t-test, and Krushkall-Wallis tests were used to test the relationship between contraceptive use and domestic violence, age, and opinion of a woman who has sex while in a relationship. Regression analysis was used to determine if current contraceptive use could be predicted by age, urban residence, age of first relationship, gender, and/or age of sexual initiation.

Results: Contraceptive use was not related to reports of physical violence, pressure to have sex, or being socially isolated. Respondents who reported that their first sexual encounter was forced were more likely to use contraception. Lower levels of contraceptive use were associated with younger age, being ≤14 at first relationship,  living in a rural area, and having negative views of someone who has sex in a relationship.

Conclusion: Sex education and SRH services should be directed towards younger populations (≤14), especially in rural areas. Decreasing negative opinions around sex in relationships has the potential to improve contraceptive use.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
Evaluate the relationship between domestic violence and contraceptive use in Nicaraguan adolescents. Identify potential factors leading to lower contraceptive use. Demonstrate the need to focus on younger populations and decrease stigma of sex in relationships.

Keyword(s): Domestic Violence, Contraception

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a DrPH student at SUNY Downstate. I hold an MPH from the University of South Florida, and I have been working in the field of public health for 5 years. I currently work with Planned Parenthood Federation of America evaluating international health programs.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4356.0: Exploring the intersections between violence and sexual and reproductive health