Contraceptive Decision-Making Among Young College Men and Women in Ethiopia: Results of the Qualitative Study
Authors: Lemma Nebiyat , Sendo Endalew Gemechu , Abebe Workinesh Sineshaw 
Published: May 2023

There is a scarcity of research on contraceptive decision-making and use among Ethiopian students in higher education institutions. As young college students are more exposed to sexual encounters and premarital sex, it is imperative to look at their contraception decision-making and use. This qualitative study aimed to explore the experiences of young college men and women in sexual relationships regarding the decision-making for contraceptive use at Addis Ababa University, Ethiopia. A Phenomenological qualitative study design was employed for this study. The participants were recruited using purposeful sampling. Twenty eligible study participants [10 female and 10 men] were interviewed face-to-face. To be selected for the study, participants had to be in a relationship for at least 6 months after joining the university, attending a regular program, and were able to offer detailed information about their sexual encounters and contraceptive decision-making and use. Data were analyzed at the same time as data were collected from February 2 through March 15, 2022. Thematic analysis was done for the study, which comprises 3 stages: data reduction, data display, and data conclusion. Both a priori codes (from the query guide) and emerging inductive codes were used in the study. The data analysis from the in-depth interviews revealed 3 overarching themes consistent with the study’s aims, including: types of relationships, level of communication, contraceptive decision-making with a partner, and contraception use. In this study’s analysis, the first emerged theme was the types of relationships, which may be divided into 2 categories: dating/causal and intimate partnerships. Participants described their relationship with their partner as intimate and exciting. According to our data, men and women in intimate relationships reported emotional closeness and connectedness. Mostly they make an open discussion about different things including contraception use and made decisions together, they spent a good time together and have mutual trust. They also mentioned that mostly their discussion involves issues about having a happy future life together. On the contrary, however, participants in the causal relationship claimed that while they now spend time together and enjoy themselves, they lack open communication and trust in their relationship. There is less commitment and accountability, and the majority of them do not have a relationship goal, according to their reports. The second theme that emerged during the analysis of the in-depth interview was the level of communication and decision-making with the partner regarding contraception. Within the theme, there is 2 categories communication with partner and decision-making about contraception use. The study participants felt comfortable discussing their sexuality and contraception use in the current study. Most discussions were believed to be initiated by the male partner, and the majority of the decisions were made jointly, according to our findings. The degree of intimacy with their partner in a relationship, their partner’s desire, and contraceptive-related concerns are all factors that impact contraception use decision-making, according to the study’s findings. The majority of male and female interview participants stated that the length of a relationship was an important consideration when deciding whether or not to use contraception. Participants in stable long-term relationships were more likely to choose protection than those in short-term relationships. The usage of contraception, which encompasses 5 linked categories, emerged as the third theme from the in-depth interview analysis: types of contraception used, concerns and doubts about adverse effects of contraception use, reasons for contraception use, trust between partners determines contraception use, barriers to contraception use. The findings of this study demonstrated that communication and using contraception is a common practice and is accepted as a positive thing on campus, mostly to prevent unexpected pregnancy. The major obstacles to using contraception are believed to be a lack of available contraceptives on campus and cost-related concerns. Most male partner access and bring contraceptives from private drug stores for their girlfriends. The university administration and other interested stakeholders need to pay close attention to efforts to increase the use of contraceptives among high-risk young university women while helping guide actions to involve young men in making contraceptive decisions on campus.