Communicatie patronen en sociale cognities bij het gebruik van orale anti conceptie onder adolescente meisjes in de Dominicaanse Republiek

This research is about the high number of teen pregnancies, sexual acitivity and low use of contraception in the Dominican Republic. This research shows which cultural and psychological factors play a role in predicting the intention to use contraceptives (condoms and oral contraception) of Dominican girls. De cultural factors investigated were: living together, childwish, machismo and communication patterns (about contraception). The psychological factors consisted of the social cognitions from the Theory of Planned Behavior and the extra social cognitions of; response efficacy, vulnerability and severity and knowledge about oral contraception. To conduct the research a questionnaire was used. 202 Dominican girls in the age of 13 to 22 filled out the questionnaire. The average age was 18. 58% of the respondents were found in schools in and around Cabarete, 42% of the respondents were aquired in (poor) neighbourhoods in Cabarete. Sexual activity and teen pregnancies: Dominican girls start fairly early with sex. Before they reach the age of 15 13% has had sex. Before they reach the age of 18 this is 48%. Of all sexually active girls 51% had her first sexual encounter before the age of 16. 27% of all the respondents had been pregnant at least once. Of all sexually active girls this was 45%. From the age of 16 they generally they start to get pregnant. 24% of the 16 year old girls have been pregnant, whereas only 3% of the girls of 15 and younger have been pregnant. On the age of 19 more than half of the girls have been pregnant (53%). The use of oral contraception was a lot higher with girls that are living together (44%) then with sexually active girls that are not living together with their boyfriend (17%). Even so there are a lot more girls in the living together group that are pregnant or have been pregnant then in the not living together group. This is because the girls that are living together are constantly being exposed to the risk of getting pregnant. As you can see by these numbers, teenpregnancies are a common problem in the Dominican Republic and can be partly explained by the early sexual activity and living together on an early age. Oral contraception: Childwish and machismo don’t play an explaining role in the intention to use oral contraception. Positive communication patterns abour oral contraception from the mother are very important for the intention to use oral contraceptives. It also correlated with the other social cognitions about oral contraception. The influence of postive communication with the mother is indirect through the social cognitions. Of the social cognitions about oral contraception only self efficacy and social norms play a significant role in explaining intention to use oral contraception. Both are being influenced by the positive communication of the mother about oral contracepton. Together they explain 23% of the intention to use oral contraception. In explaining the actual use of contraception only knowledge about oral contraception and attitudes about oral contraception play a significant role. Knowledge is working indirectly though attitudes. They explain 12% of the actual use Condom use: Girls that are living together use a condom a lot less (only 14%) then sexually active girls that are not living together (28%). The childwish doesn’t have a significant influence on intention to use condoms. Machismo has, against all expectations, a significant positive influence on intention to use condoms. The reason is not clear, a reason might be that there is another variable at work that hasn’t been measured. Communication patterns don’t play a role in explaining intention to use condoms. Of the social cognitions about condom use only social norms play a significant role in the intention to use condoms. Together with machismo social norms explain 14% of the intention to use condoms. Prevention has to be aimed at 3 levels, the society level for posponing the age that girls start to live together, the community level where especially to mother has to be stimulated to talk more about contraception with her daughter and improving social norms and the personal level to improve skills like self efficacy and knowledge about contraception.