Prevalence, factors associated with adolescent pregnancy by young men (15-24 years) in Kampala and their life experiences of early fatherhood

Abstract

Background: About 21 million adolescent girls still become pregnant each year despite the ongoing interventions focusing on the girl child. In Uganda, 25% of the teenagers experience pregnancy by the age of 19 despite reduced total fertility rates among women aged 15 to 19 year. This is partly due to the under-studied role of men in adolescent pregnancy. There is therefore a need to investigate the young men too as a means of enforcing the current interventional efforts in reducing adolescent pregnancy. Objective: To determine the prevalence and risk factors associated with ever impregnating an adolescent girl by a young man in Kampala district, Uganda and their life experiences of early fatherhood Methods: This study was a descriptive and cross-section design using a mixed methods of data triangulation. A total of 360 sexually active young men determined by Kish Leslie in a relationship with an adolescent girl residing in Kampala were recruited. A pre-tested questionnaire uploaded on the Kobo Collect app via mobile phones was used to obtain sexual behavioral, inter-relational and community data. An in-depth interview guide was used for life experiences of early fatherhood. Poisson regression analysis was used to assess factors associated with ever impregnating an adolescent while content analysis was used for qualitative data. Results: The mean age of the participants was 20 (-+2.4) years, mean age of the first sexual encounter was 15(-+2) years, the prevalence of ever impregnating an adolescent girl was 45.8% (95%CI:40.7-51), 62(35.6%) the pregnancy was aborted and the mean age at impregnating an adolescent girl was 17years (SD1.6). Factors associated with ever impregnating an adolescent were; older age aPR: 2.09(1.16 3.75) 2.54(1.43 4.54) alcohol use aPR: 1.34 (1.8 1.67), drug use aPR: 1.29(1.04 1.6), friends ever impregnated an adolescent girl aPR: 1.73 (1.22 2.45), more than one sexual partner in a year aPR: 1.54 (1.04 2.3) 2(1.33 3.01). Financial responsibility with unmet financial needs leading to many consequences and absent fatherhood were some of the experiences the young fathers endured.

Conclusion: The prevalence of “ever impregnating an adolescent girl” by a sexually active young man in Kampala city, Uganda is high and the factors associated with ever impregnating an adolescent include; - older age, drug use, alcohol use, peer influence and multiple sexual partners. The young fathers were unprepared for pregnancy and early fatherhood and their life experiences included financial hardships, stigma and dropping out of school.