In sub-Saharan Africa, adolescent girls and young women (AGYW) have high levels of unmet need for contraception, particularly those who are unmarried or nulliparous. Conversations with partners, peers, and family members influence AGYW contraceptive decision-making yet little is known about conversation content and impact or how they vary by relationship status and parity. This paper draws on qualitative data from 60 AGYW (aged 15–24) participating in a sexual and reproductive health study in Malawi to examine contraceptive conversation patterns among participants and their social ties. AGYW's relationship status and parity influenced whether they talked about contraceptives, who they talked to about contraceptives, and the type of contraceptives that were endorsed during conversations. Unmarried and nulliparous AGYW were less likely to discuss contraceptives with all social ties and when conversations occurred, norms and misinformation regarding nonbarrier methods were reinforced, and condoms were largely prescribed. Conversations with intimate partners often provided permission for contraceptive use while conversations with peers and older women in the family provided information on contraceptive methods. Our results highlight the unique roles that social ties play in AGYW contraceptive decision-making and suggest that existing contraceptive conversation patterns might exclude unmarried, nulliparous AGYW from accurate and comprehensive contraceptive information and options.

中文翻译：

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马拉维利隆圭少女和年轻妇女及其伴侣、同龄人和老年女性家庭成员之间的避孕对话：定性分析

在撒哈拉以南非洲地区，少女和年轻女性 (AGYW) 的避孕需求未得到满足的程度很高，特别是那些未婚或未婚的女性。与伴侣、同伴和家庭成员的对话会影响 AGYW 避孕决策，但人们对对话内容和影响以及它们如何因关系状态和奇偶性而变化的情况知之甚少。本文利用参与马拉维一项性健康和生殖健康研究的 60 名 AGYW（15-24 岁）的定性数据来研究参与者之间的避孕对话模式及其社会关系。AGYW 的关系状态和均等性影响了他们是否谈论避孕药具、与谁谈论避孕药具以及在谈话中认可的避孕药具类型。未婚和未生育的 AGYW 不太可能与所有社会关系讨论避孕药具，并且当对话发生时，有关无障碍方法的规范和错误信息会得到加强，并且很大程度上会使用避孕套。与亲密伴侣的对话通常会提供避孕药具的使用许可，而与同龄人和家庭中老年妇女的对话则提供有关避孕方法的信息。我们的研究结果强调了社会关系在 AGYW 避孕决策中发挥的独特作用，并表明现有的避孕对话模式可能会将未婚、未生育的 AGYW 排除在准确和全面的避孕信息和选择之外。