{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:53:48Z","timestamp":1782924828102,"version":"3.54.5"},"reference-count":56,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    In South Africa, the fertility rate for adolescents 15\u201319 years old was 51.7 per 1,000 women in 2022, according to World Bank data. To address unintended pregnancies, the South African government offers free, multimodal contraception. We aimed to examine risk behaviors in young women that may contribute to unintended pregnancies; we conducted surveys at the Desmond Tutu Health Foundation Youth Centre (YC) in Cape Town, South Africa. The study adapted the 2017\n                    <jats:italic>U.S. Youth Risk Behavior Questionnaire<\/jats:italic>\n                    with cultural modifications, alongside the London Measure of Unplanned Pregnancy. A convenience sample of adolescents seeking YC services were invited to participate in the survey.\n                  <\/jats:p>\n                  <jats:p>A total of 224 women with median age of 19 years (interquartile range: 18, 21) completed the survey between August 2017 and August 2018; of the respondents, 55 (24.6%) indicated a prior pregnancy. About half of the participants were attending secondary school, 24% reported \u22653 lifetime partners, and 17% reported substance use prior to intercourse. Condom use at the last sex act was 52%. Respondents reported onset of several high-risk behaviors, including smoking and alcohol use, by the end of secondary school. Half of the respondents reported depressive symptoms; 20% considered suicide. Of those who reported history of pregnancy, the majority (83%) indicated it was unplanned. Our findings highlight the significant prevalence of mental health challenges and substance use, emphasizing the need for a comprehensive approach to sexual health interventions\u2014one that goes beyond education alone to address the broader social and psychological factors influencing high-risk behaviors.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0271","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T14:23:29Z","timestamp":1778595809000},"page":"198-202","source":"Crossref","is-referenced-by-count":0,"title":["Key Factors Predicting Teen Pregnancy in South Africa"],"prefix":"10.4269","volume":"115","author":[{"given":"Monalisa Attif","family":"Hassan","sequence":"first","affiliation":[{"name":"Office of Global Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Gill","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael E.","family":"DeWitt","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA;"},{"name":"Department of Biology, Wake Forest University, Winston-Salem, North Carolina, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menna","family":"Duyver","sequence":"additional","affiliation":[{"name":"Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avinash K.","family":"Shetty","sequence":"additional","affiliation":[{"name":"Office of Global Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA;"},{"name":"Department of Pediatrics, Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candice J.","family":"McNeil","sequence":"additional","affiliation":[{"name":"Office of Global Health, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA;"},{"name":"Department of Medicine, Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"J Adolesc Health","first-page":"402","article-title":"The health of young people in a global context","volume":"35","author":"Blum","year":"2004"},{"key":"b2","article-title":"Trends in Maternal Mortality 2000 to 2020: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA\/Population Division.","year":"2023"},{"key":"b3","article-title":"Maternal Mortality.","year":"2023"},{"key":"b4","series-title":"BMC Pregnancy Childbirth","first-page":"256","article-title":"Growing inequities in maternal health in South Africa: A comparison of serial national household surveys","volume":"16","author":"Wabiri","year":"2016"},{"key":"b5","series-title":"Reprod Health","first-page":"195","article-title":"Prevalence and determinants of adolescent pregnancy in Africa: A systematic review and meta-analysis","volume":"15","author":"Kassa","year":"2018"},{"key":"b6","series-title":"PLoS One","first-page":"e0279289","article-title":"HIV incidence and associated risk factors in adolescent girls and young women in South Africa: A population-based cohort study","volume":"17","author":"Lewis","year":"2022"},{"key":"b7","series-title":"PLoS One","first-page":"e0306771","article-title":"High STI burden among a cohort of adolescents aged 12-19 years in a youth-friendly clinic in South Africa","volume":"19","author":"Price","year":"2024"},{"key":"b8","series-title":"J Acquir Immune Defic Syndr","first-page":"270","article-title":"Role of schooling and comprehensive sexuality education in reducing HIV and pregnancy among adolescents in South Africa","volume":"90","author":"George","year":"2022"},{"key":"b9","series-title":"PLoS One","first-page":"e0282996","article-title":"Access to public sector family planning services and modern contraceptive methods in South Africa: A qualitative evaluation from community and health care provider perspectives","volume":"18","author":"Kriel","year":"2023"},{"key":"b10","series-title":"Front Reprod Health","first-page":"984303","article-title":"Adolescent pregnancy in sub-Saharan Africa \u2013 A cause for concern","volume":"4","author":"Maharaj","year":"2022"},{"key":"b11","series-title":"BMJ Glob Health","first-page":"e009594","article-title":"Impact of the COVID-19 pandemic on access to and utilisation of services for sexual and reproductive health: A scoping review","volume":"7","author":"VanBenschoten","year":"2022"},{"key":"b12","series-title":"Reprod Health","first-page":"122","article-title":"Perceptions of contraception services among recipients of a combination HIV-prevention interventions for adolescent girls and young women in South Africa: A qualitative study","volume":"17","author":"Jonas","year":"2020"},{"key":"b13","series-title":"J Stud Alcohol Drugs","first-page":"194","article-title":"Substance use and the risk for sexual intercourse with and without a history of teenage pregnancy among adolescent females","volume":"72","author":"Cavazos-Rehg","year":"2011"},{"key":"b14","series-title":"PLoS One","first-page":"e0240797","article-title":"Adolescents\u2019 narratives of coping with unintended pregnancy in Nairobi\u2019s informal settlements","volume":"15","author":"Mumah","year":"2020"},{"key":"b15","series-title":"AIDS Behav","first-page":"344","article-title":"\u201cAs a young pregnant girl\u2026 the challenges you face\u201d: Exploring the intersection between mental health and sexual and reproductive health amongst adolescent girls and young women in South Africa","volume":"25","author":"Duby","year":"2021"},{"key":"b16","series-title":"An Analysis of Baseline and Early Data from the PlusPills Study: An Open-label Trial of Pre-exposure Prophylaxis for South African Adolescents.","author":"Gill","year":"2016"},{"key":"b17","series-title":"Am Psychol","first-page":"469","article-title":"Emerging adulthood. A theory of development from the late teens through the twenties","volume":"55","author":"Arnett","year":"2000"},{"key":"b18","series-title":"BMC Public Health","first-page":"1370","article-title":"Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa","volume":"20","author":"Ajayi","year":"2020"},{"key":"b19","series-title":"BMC Public Health","first-page":"1542","article-title":"Impact evaluation of scripted lesson plans for HIV-related content in a life orientation curriculum: Results from two provinces in South Africa","volume":"20","author":"Speizer","year":"2020"},{"key":"b20","year":"2020"},{"key":"b21","series-title":"Reprod Health","first-page":"50","article-title":"Teenage pregnancy rates and associations with other health risk behaviours: A three-wave cross-sectional study among South African school-going adolescents","volume":"13","author":"Jonas","year":"2016"},{"key":"b22","series-title":"PLoS 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South Africa","volume":"22","author":"Sehularo","year":"2020"},{"key":"b26","article-title":"Teenage Pregnancy in Africa: Status, Progress and Challenges 2024."},{"key":"b27","series-title":"BMC Public Health","first-page":"2282","article-title":"Binge drinking and condom negotiation behaviours among adolescent girls and young women living in Cape Town, South Africa: Sexual control and perceived personal power","volume":"23","author":"Singer","year":"2023"},{"key":"b28","series-title":"Health Policy Plan","first-page":"589","article-title":"Determinants of prenatal care use: Evidence from 32 low-income countries across Asia, sub-Saharan Africa and Latin America","volume":"29","author":"Guliani","year":"2014"},{"key":"b1","series-title":"J Adolesc Health","first-page":"402","article-title":"The health of young people in a global context","volume":"35","author":"Blum","year":"2004"},{"key":"b2","article-title":"Trends in Maternal Mortality 2000 to 2020: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA\/Population Division.","year":"2023"},{"key":"b3","article-title":"Maternal Mortality.","year":"2023"},{"key":"b4","series-title":"BMC Pregnancy Childbirth","first-page":"256","article-title":"Growing inequities in maternal health in South Africa: A comparison of serial national household surveys","volume":"16","author":"Wabiri","year":"2016"},{"key":"b5","series-title":"Reprod Health","first-page":"195","article-title":"Prevalence and determinants of adolescent pregnancy in Africa: A systematic review and meta-analysis","volume":"15","author":"Kassa","year":"2018"},{"key":"b6","series-title":"PLoS One","first-page":"e0279289","article-title":"HIV incidence and associated risk factors in adolescent girls and young women in South Africa: A population-based cohort study","volume":"17","author":"Lewis","year":"2022"},{"key":"b7","series-title":"PLoS One","first-page":"e0306771","article-title":"High STI burden among a cohort of adolescents aged 12-19 years in a 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Behav","first-page":"344","article-title":"\u201cAs a young pregnant girl\u2026 the challenges you face\u201d: Exploring the intersection between mental health and sexual and reproductive health amongst adolescent girls and young women in South Africa","volume":"25","author":"Duby","year":"2021"},{"key":"b16","series-title":"An Analysis of Baseline and Early Data from the PlusPills Study: An Open-label Trial of Pre-exposure Prophylaxis for South African Adolescents.","author":"Gill","year":"2016"},{"key":"b17","series-title":"Am Psychol","first-page":"469","article-title":"Emerging adulthood. 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