In Kenya, adolescent pregnancy rates are high, contraception utilization is low, and adolescent sexuality is stigmatized. We describe how perceptions of sexuality and pregnancy stigma influence decision-making among adolescents in the informal settlements of Kisumu. We used purposive sampling to recruit 120 adolescent boys and girls aged 15–19 for focus group discussions. A semistructured interview guide was used to elicit social norms and community attitudes about sexual and reproductive health. We analyzed the data using the Framework Approach. The social stigma of adolescent sexuality and the related fear of pregnancy as an unambiguous marker of sexual activity emerged as main themes. This stigma led adolescents to fear social retribution but did not lead to more frequent contraception use due to additional stigma. The intensity of this fear was most acutely expressed by girls, leading some to seek unsafe, sometimes fatal, abortions, and to contemplate suicide. Fear of pregnancy outweighed fear of contracting HIV that was viewed as both treatable and less stigmatized. Our findings illustrate how fear of pregnancy among these adolescents is driven primarily by fears that their community will discover that they are sexually active. Interventions are urgently needed to address adolescent sexual stigma and to prevent negative outcomes.

中文翻译：

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“我们不惧怕艾滋病毒。我们只是害怕怀孕。”：肯尼亚基苏木非正规住区青少年性行为和怀孕污名的定性分析

在肯尼亚，青少年怀孕率高，避孕药具利用率低，青少年性行为受到污名化。我们描述了性观念和怀孕耻辱感如何影响基苏木非正式定居点青少年的决策。我们使用有目的的抽样方法招募了 120 名 15-19 岁的青春期男孩和女孩进行焦点小组讨论。半结构化访谈指南被用来引出社会规范和社区对性健康和生殖健康的态度。我们使用框架方法分析了数据。青少年性行为的社会污名化和对怀孕的相关恐惧作为性活动的明确标志成为主要主题。这种污名导致青少年害怕社会报复，但并没有因为额外的污名而导致更频繁地使用避孕药具。这种恐惧的强度在女孩身上表现得最为强烈，导致一些人寻求不安全的、有时甚至是致命的堕胎，并考虑自杀。对怀孕的恐惧超过了对感染 HIV 的恐惧，后者被认为是可以治疗的，而且不会受到太大的侮辱。我们的研究结果表明，这些青少年对怀孕的恐惧主要是因为担心他们的社区会发现他们性活跃。迫切需要采取干预措施来解决青少年性污名化问题并防止负面结果。我们的研究结果表明，这些青少年对怀孕的恐惧主要是因为担心他们的社区会发现他们性活跃。迫切需要采取干预措施来解决青少年性污名化问题并防止负面结果。我们的研究结果表明，这些青少年对怀孕的恐惧主要是因为担心他们的社区会发现他们性活跃。迫切需要采取干预措施来解决青少年性污名化问题并防止负面结果。