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Factors affecting adolescent reproductive health in Manitoba
Patricia J Martens1, Teresa Mayer, Shelley Derksen
1Manitoba Centre for Health Policy, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, MB. Pat_Martens@cpe.umanitoba.ca
Objectives:
To report teen pregnancy and sexually transmitted infections (STI) rates among Manitoba adolescents, and associated factors including rates of sexual intercourse and contraceptive use.
Methods:
Teen pregnancy rates in females aged 15 to 19 for the fiscal years 1994/95 through 1998/99 were derived from the Population Health Research Data Repository and reported by geographical areas and income quintiles. Premature mortality rate (PMR) and the Socioeconomic Factor Index (SEFI) measured the overall health and socioeconomic well-being of regional populations. Data on sexual activity and contraceptive use were derived from the 1996 National Population Health Survey for males and females ages 15 through 19 years.
Results:
The teen pregnancy rate for Manitoba was 63.2/1000, varying by geography and inversely correlated with income, PMR, and SEFI. 39% (95% CI 33-45) of teens reported sexual intercourse, with higher rates in urban areas (46%, 95 % CI 35-57) and the North (48%, 95% CI 36-60) compared to South Rural (30%, 95% CI 25-34), and in low-income families (68%, 95% CI 53-83) compared with middle/high (33%, 95% CI 26-40). For sexually active females, 42% (95% CI 28-57) used the birth control pill, with higher rates in low-income families (70%, 95% CI 50-90) compared to middle/high income (31%, 95% CI 14-48). Condom use (at last sexual intercourse) was reported by 82% (95% CI 72-92) of adolescents, with trends (though not statistically significant) to lower use in low-income families and the North.
Conclusion:
Reliance on the pill for contraception, combined with low rates of condom use, are public health concerns for adolescents where STI and unintended pregnancy rates are high.