Table 5 Interview Themes and Quotes

Attitudes: Avoiding pregnancy is among biggest health concerns for AYAs

I think people need to use birth control more, because we are living in a country where everything is impossible to afford. Insecurity is all over the country, and healthcare is non-existent. (23 years old)

I am trying not to get pregnant right now, because I have already got a baby and I am still in high school. (19 years old)

I am trying to avoid getting pregnant, because I am still in high school and jobless. In the situation that I am right now, I am surviving not living. (22 years old)

AYAs commonly reported misinformation and concerns about contraception side effects

I have heard using birth control can destroy all your white blood cells, it makes you cough up blood, weight loss. (14 years old)

When I first started using birth control it made me have period(s) non-stop. It gives me short[ness] of breath. (19 years old)

Some of them are scared to use it because they think it can make them develop some diseases. They think most of the nurses aren’t using birth control because they know it isn’t good. (19 years old)

While very few had used a LARC, some noted potential benefits

I like the fact I only have to go there once to have it inserted and don’t worry about going back until I want it to be removed. So, in a way I like the fact people don’t (know) my business, because people always think when you go there very often, it’s because you are looking for birth control. (23 years old)

Subjective Norms

Most AYAs thought their partner’s opinion about contraception was important, however some were concerned about lack of partner’s support.

We share the same opinions because he doesn’t want me to get pregnant. We think condoms are good to use. (18 years old)

My actual boyfriend doesn’t want me to get pregnant right now because we are not ready. (23 years old)

I don’t think he would have agreed for me to use it. (17 years old)

I would want them to play a supportive role.

Some agree, and some disagree for their girlfriends to use [it]. (20 years old)

He had agreed for me to use birth control because he doesn’t want to get pregnant, but he doesn’t really like birth control in general. (25 years old)

AYAs noted concerns about family and community judgement when seeking contraception.

Somehow, I think my parents were the challenges because I couldn’t use any birth control, I wasn’t allowed. (20 years old)

I think [young people are] afraid of what people might think when seeking help about birth control. (16 years old)

[I have concerns about people that see you in PF (i.e., family planning) section, might go and tell your business in your neighborhood. (18 years old)

Perceived Behavioral Control

AYAs commonly reported concerns about health care provider and community judgement.

AYAs desired more information on contraception, preferably given in private from a doctor or nurse at a clinic that was not associated with maternal health care.

I think they worried about what the nurses might say behind their backs. Also, about what people in the neighborhood might say. (18 years old)

I would want a nurse. They usually make (an) educational class with a group of women; I think they need to set aside some privacy time in case I want to ask a question without having other women hearing to what I want to ask or say. (18 years old)

I would want them to advise me how to prevent myself from getting pregnant again. And, how to keep myself in good shape, I would want all of this to be done privately. (19 years old)

I would want them to tell me everything about birth control, their advantages, and disadvantages… in private. (24 years old)