Condoms, Withdrawal & Abstinence: Oh My!
This study examines sexual activity, contraceptive dynamics and unmet need among young women aged 18–24 in Eswatini, using bi-weekly data collected over one year from a mobile phone survey. Although most participants expressed a strong desire to avoid pregnancy, only one in four used contraception consistently. Findings revealed distinct profiles of women with unmet need for family planning (44%) - more likely to spend time away from home, be in school and be nulliparous - compared to peers with met need. Using hybrid within-between regression models, we found the probability of contraceptive use increased slightly when a woman was more sexually active. Participants who were parous and worked also had higher probability of use. These results offer new insight into the situational nature of contraceptive behavior and suggest that among this population with sporadic sexual activity, unmet need is often brief and preceded by abstinence.
Dr. Abigail (Abba) Greenleaf is a public health demographer whose research focuses on collecting data in low- and middle-income countries where using cell phones to survey populations is an increasingly viable methodology. In the United States, phone-based surveys have been common since the 1980s. In areas such as Africa, until recently there was not sufficient cell phone ownership to create valid phone-based health estimates, and researchers like Dr. Greenleaf have been assessing the reliability of this increasingly popular approach to data collection. Dr. Greenleaf currently works with ICAP's Population-Based HIV Impact Assessment (PHIA) project. Carried out under the leadership of national ministries of health, PHIA data benchmark a country's progress towards controlling the HIV epidemic.
