The role of social networks in motivating access and use of contraceptives among adolescent girls and young women living in resource-constrained settings in Cape Town, South Africa.

Background: This study explores the role of social networks consisting of parents, romantic and sexual partners and community members related to contraceptive access and use among adolescent girls and young women (AGYW) living in resource-constrained settings in Cape Town, South Africa METHODS: Data were collected through telephonic individual interviews, using a semi-structured interview schedule, with 63 AGYW aged 15-24 years old. All data were transcribed, translated, coded and analysed thematically using NVivo software.

Results: AGYW self-reported that their motivations to access and use contraceptives correctly and consistently were shaped by intersecting networks of parents (specifically mothers), peers, male romantic and sexual partners, and community members. Parents and male romantic and sexual partners either discouraged or encouraged contraceptive use. The support received from parents was described as both direct and indirect. Direct support was active encouragement of contraceptive use, and indirect support was when parents did not challenge AGYW's use of contraceptives. AGYW also reported on parents who directly discouraged contraceptive use, resulting in AGYW hiding their use of contraceptives. As with parents, support from male romantic and sexual partners was not homogeneous, with some partners being supportive of contraceptive use and some not. There were AGYW who considered their partner's support as central to motivating their use of contraceptives and used strategies to convince their partners to understand the importance of using contraceptives. Conversely, some AGYW were indifferent to the support of their partners, holding the view that using contraceptives is a decision that should be made by the young woman themself. Attitudes from community members were reported to be largely discouraging.

Conclusions: AGYW's interpersonal networks play a major role in shaping their attitudes, motivating or demotivating their use of, and access to contraception services. Social networks need to be taken into consideration when designing policies, interventions and programmes to promote contraception services among AGYW.