In developing countries, teenage girls have the best chance of succeeding later in life if they avoid unwanted pregnancy and sexually transmitted infections. Both directly impact the health of girls and force them out of school. A new working paper from Cameroon shows evidence that simply talking about HIV can reduce teen pregnancy.
Researchers tested a variety of programs and messages educating girls on preventing HIV infections. They found that three pregnancies were averted for every 100 participants in rural areas with higher birth rates. There was no impact in cities where such information is prevalent and birth rates are lower.
“Our results suggest that simple and short HIV prevention interventions can be effective at reducing the incidence of teen pregnancy in rural areas, where teenage pregnancy is common,” according to the report written by Pascaline Dupas, Elise Huillery and Juliette Seban.
Most notable, the way the information was delivered and the advice was given all had the same impact. Fewer girls became pregnant, whether it was a one-time, one-hour self-administered questionnaire on HIV and sexual behavior or a series of special sessions delivered by school staff. The simple “Abstain, Be Faithful, Use Condoms” (ABC) program worked just as well as the more in-depth lessons.
In other words, providing any information about safe sex stopped some girls from getting pregnant. The researchers are encouraged by the findings because it is a cheap way to prevent unwanted pregnancies. It cost only $430 to avert one pregnancy – a small sum when considering the life-long impact on each girl.
The World Health Organization estimates that 16 million girls between the ages of 15 and 19 give birth each year. The majority live in low- and middle-income countries. Their babies face are 50 percent more likely of dying during birth or within the first few weeks of life as compared to children born to mothers in their early 20s. Babies born to teen mothers are also more likely to suffer from life-long problems associated with low birth weight.
At the same time, young women in sub-Saharan Africa account for roughly 20 percent of the annual 2 million new HIV infections around the world. Unwanted pregnancies and HIV are a dangerous combination for teen mothers and their children. The global response to the problem focuses on reducing marriage in girls younger than 18 years old, increasing access to contraceptives and improving access to quality health care.
While the research from Cameroon showed promising reductions in pregnancies, it did not appear to affect HIV rates. They were unable to test all of the girls for HIV before and after the study. Other limits to the study include a small number of girls participating in the study and the fact that Cameroon has the highest HIV rate among young people in West and Central Africa. The lack of impact on urban schoolgirls may indicate that the information works best in areas suffering from higher teen pregnancy rates.
But there are some promising findings. Girls who took part in the programs were more likely to cite abstinence as their plan for avoiding HIV in the coming year. Attitudes about condoms also improved and girls reported fewer cases of unprotected sex. The researchers say it is the result of the plan-making aspect of the programs that encourage the girls to think in advance about when they want to have sex and how they want to avoid pregnancy.
“It is thus possible that the interventions worked in part by making girls home in on a concrete plan with regards to their future sexual behavior. This would be consistent with the literature suggesting that plan-making helps people overcome several psychological barriers to follow through,” according to the report.
Again, the choices about what information delivered or how it is presented matters less than doing it at all. The self-reported changes and averted pregnancies give reason to continue testing how one-time programs are effective.
