Sexual activity and contraceptive use among adolescents: A descriptive survey in a Ghanaian municipality

Contraceptive use is essential for reducing unwanted pregnancies and sexually transmitted infections (STIs) among adolescents. Sexual activity during adolescence, particularly in developing countries, remains a major public health concern with significant implications for reproductive health. Adolescents aged 10-19 undergo significant hormonal changes that contribute to heightened sexual drive and an increased likelihood of early sexual activity. However, despite widespread knowledge of modern contraceptive methods, their actual use remains low. This study aims to assess sexual activity and contraceptive use among Senior High School (SHS) adolescents and to identify key predictors of contraceptive uptake. A cross-sectional study was conducted from August to September 2022 involved 330 adolescents selected through simple random sampling. Data were analyzed using frequencies, percentages, Pearson's chi-squared test, and binary logistic regression to examine associations between sociodemographic characteristics (age, sex, class, ethnicity, religion, residential status), sexual activity characteristics (relationship status, multiple sexual partners), awareness of contraceptives, and contraceptive use. Statistical significance was set at p ≤ 0.05 with a 95% confidence interval. Out of the total participants, 290 (87.9%) were within the age range of 15-19 years and the majority were females (n = 196, 59.4%). Approximately half (n = 166, 50.3%) were in an intimate relationship and 126 (38%) had engaged in sexual intercourse. Among sexually active adolescents, over half (n = 65, 51.6%) had their first sexual intercourse between the ages of 10-14 years and 100(79.4%) reported having ever used contraceptive, primarily condoms (n = 66, 66.0%), and pills (n = 43, 43.0%), with IUDs being the least common (n = 2, 2.0%). Sexually active adolescents who were aware of contraceptive (AOR = 6.686, 95%CI = 1.515 - 29.505, p = 0.012) had higher odds of contraceptive use. Early sexual initiation and contraceptive use are prevalent among adolescents. Comprehensive sex education and peer counseling on reproductive health are needed to address the consequences of early sexual activity without contraceptive use.