Yesterday marked the Third Annual World Contraception Day (WCD). Held each year on September 26th, this worldwide campaign aims “to improve awareness of contraception to enable young people to make informed decisions on sexual and reproductive health.” WCD is sponsored by the pharmaceutical company Bayer HealthCare, the maker of numerous birth control pills and other methods such as the intrauterine contraceptive, Mirena. The campaign is supported by a coalition of international NGOs, including International Planned Parenthood Federation, Marie Stopes International, and USAID as well as scientific and medical societies such as the Asian Specific Council on Contraception, the European Society of Contraception and Reproductive Health, and the International Federation of Pediatric and Adolescent Gynecology.
In honor of the event, Bayer conducts a survey of young people around the world to assess their knowledge and use of contraceptive methods. For this year’s survey, “Clueless or Clued-Up: Your Right to Be Informed About Contraception,” researchers from GFK Healthcare interviewed a total of 6,026 young people between the ages of 15 and 24 in 29 countries. Depending on the location, interviews were conducted online, by phone, or face-to-face.
The findings are not surprising but they are alarming as the survey confirms that young people worldwide lack information about and access to contraception and as a result are having unprotected sex quite frequently.
- Young people around the world are sexually active. The majority of young people surveyed were sexually active, including 82 percent in the United States, 80 percent in Russia, 75 percent in Chile, 66 percent in Sweden, and 6 percent in Kenya. The average age that young people in most countries had sex for the first time was 17 except in African countries where the age was closer to 20. Egypt, however, was not included in these findings because in that country researchers only interviewed married young people who were at least 22. Instead of the standard question, these participants were asked “At what age did you get married and have sex?”
- Young people are not using contraception. Over half of the young people surveyed in China, Estonia, Kenya, Korea, Norway, and Thailand reported having had unprotected sex with a new partner at least once, as had 40 percent of young people in Australia, Chile, Colombia, Great Britain, Indonesia, Lithuania, Mexico, Poland, Singapore, Sweden, and Turkey, and as many as 62% of young people in Thailand.
Unfortunately, the problem is getting worse. Many countries saw increases when compared to the WCD survey of 2009; France increased 111 percent (from 19 to 40 percent), the United States increased 39 percent (from 38 to 53 percent), and Great Britain increased 19 percent (from 36 to 43 percent).
- Young people worldwide lack access to contraception. Between 21 percent and 38 percent of young people said they did not use contraception because they did not have any available to them at the time. Many of these young people attributed this to difficulties in obtaining contraception, though this number varied widely from region to region with only 11 percent of Europeans saying they have had problems accessing contraceptives compared to 21 percent in Asia Pacific countries, 25 percent in Kenya, and 31 percent in Uganda.
When probed further, many young people said they were afraid to access contraception because their parents or relatives might find out. This was echoed by 53 percent of respondents in Italy and India, 52 percent in Thailand, 47 percent in Singapore, 46 percent in Brazil, and 41 percent in Uganda (though the authors point out that because of sub-groups, the sample size for this question was small in all of these countries).
Another common reason for not accessing contraception involved the embarrassment of talking to a health care provider. Specifically, 39 percent of males and 43 percent of females in African countries who had experienced difficulty obtaining contraception cited embarrassment about talking to a healthcare professional as did 42 percent of males and 43 percent of females in Asia Pacific countries, 25 percent of males and 32 percent of females in Europe, 24 percent of males and 31 percent of females in Latin America, and 28 percent of males and 20 percent of females in North America.
- Lack of access is not the only reason they don’t use contraception. Young people also aren’t using contraception because they don’t like, they think their partners don’t like it, it’s not cool, and they were drunk. Many young people said they didn’t use contraception simply because they didn’t like it. This dislike was reported by 26 percent of respondents in Latvia, 24 percent in Italy, 19 percent in Thailand, and 18 percent in Singapore, for example.
Even more common in some areas (including the United States) was the feeling that their partner preferred not to use contraception which was reported by 36 percent of respondents in Singapore, 31 percent in Indonesia, and 20 percent in Egypt. Respondents in Asia Pacific countries also said that they felt using contraception was “not cool;” including 4 percent in China, 6 percent in Indonesia, 12 percent in Singapore, and 14 percent in Korea.
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Of course, other respondents admit that they didn’t use it because they were drunk and forgot. This includes 13 percent of young people in the United States which is up from 6 percent in 2009.
- Young people also lack access to information about contraception. When it comes to sex education there is great disparity between countries and regions. While 78 percent of respondents in Latin America, 76 percent in Asia Pacific countries, and 74 percent in the United States say they received sex education only 55 percent of European young people said they had. In some countries, like Egypt sex education is quite rare with only 12 percent of respondents having received it.
And, having received sex education is no guarantee that young people have the information they need to make good decisions about pregnancy prevention. Across the globe, young people report that they learned information from their teachers about contraception that they later realized was inaccurate or untrue. This was true of 29 percent of respondents in Colombia, 18 percent in Estonia, 16 percent in Korea, and 14 percent in both Great Britain and Mexico.
It is not unexpected then that many of the young people surveyed had incorrect knowledge about contraception and believed common myths. For example 36 percent of men and women in Egypt and 19 percent in Singapore believe that having a bath or a shower after sex would prevent a pregnancy. Similarly, 28 percent of young people in Thailand and 26 percent in India believed that having sex during menstruation is an effective form of contraception.
As I said earlier these results are alarming but not surprising. Worldwide we have to do a better job of ensuring that young people have access to accurate information about contraception and to the methods themselves. At the same time, we have to help young people think critically about their sexual decision making so that things like embarrassment and fear of being uncool do not get in the way of their reproductive health. Until we do that, we can’t be shocked when survey results reveal that more than half of respondents in the Kenya (60 percent), Uganda (56 percent), Latin America (55 percent), and the United States (54 percent) report that a close friend or family member experienced an unplanned pregnancy in the last few years.