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Meta-Analysis
. 2020 Dec 4;99(49):e23368.
doi: 10.1097/MD.0000000000023368.

Contraceptive and reproductive health practices of unmarried women globally, 1999 to 2018: Systematic review and meta-analysis

Meng-Yao Wang  1   2 , Marleen Temmerman  3   4 , Wei-Hong Zhang  3   5   6 , Yu Fan  1   2 , Yi Mu  2 , Si-Ping Mo  1   2 , Ai Zheng  1 , Jin-Ke Li  1
Affiliations
Meta-Analysis

Contraceptive and reproductive health practices of unmarried women globally, 1999 to 2018: Systematic review and meta-analysis

Meng-Yao Wang et al. Medicine (Baltimore). .

Abstract

Background: Premarital sex practices and contraceptive prevalence rate (CPR) among unmarried women worldwide remain unclear, even though unmarried women tend to have multiple sex partners over time, which makes their sexual behaviors particularly important to the sexual and reproductive health of society more broadly.

Methods: We searched the MEDLINE, PubMed, and Google Scholar databases for relevant articles published between January 1, 1999 and December 31, 2018. Data on prevalence of premarital sexual intercourse, use of highly prevalent contraceptive methods, as well as CPR overall and at first sexual intercourse were extracted and estimated using a DerSimonian- Laird random effects model.

Results: Of the 3918 articles identified, 37 covering 19 countries were included. The estimated overall prevalence of premarital sexual intercourse was 41.9% (95%CI 34.2-49.6%). Pooled CPR was 57.0% (95%CI 44.3-69.8%) overall and 57.6% (95% CI 39.5- 75.6%) at first intercourse. The overall prevalence of condom use was 51.2% (95%CI 42.7-59.7%), followed by oral contraceptives (20.5%, 95%CI 13.7-27.3%), withdrawal (12.7%, 95%CI 9.4-15.9%), and rhythm (12.1%, 95%CI 6.7-17.4%).

Conclusion: The findings of this global study indicate worrying trends in unprotected intercourse and contraceptive practices, suggesting the need for greater attention and resources aimed at educating unmarried adolescent women about sexual and reproductive health.

Systematic review registration number: CRD42019132736.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flowchart summarizing the study selection process.
Figure 2
Figure 2
Prevalence of premarital sexual intercourse among unmarried women worldwide.
Figure 3
Figure 3
Contraceptive prevalence rate (CPR) among unmarried women worldwide.
Figure 4
Figure 4
Contraceptive prevalence rate (CPR) at first sexual intercourse among unmarried women worldwide.
Figure 5
Figure 5
Studies on condom use by sexually active unmarried women worldwide.
Figure 6
Figure 6
Studies on oral contraceptive pill use by sexually active unmarried women worldwide.
Figure 7
Figure 7
Studies on use of rhythm by sexually active unmarried women worldwide.
Figure 8
Figure 8
Studies on use of withdrawal by sexually active unmarried women worldwide.
Figure 9
Figure 9
Estimated prevalence of premarital sexual intercourse among women from Africa, Europe, North America, South America, Asia and Oceania (25 studies), 1999 to 2018.
See this image and copyright information in PMC

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References

    1. Kuruvilla S, Bustreo F, Kuo T, et al. The Global strategy for women's, children's and adolescents’ health (2016-2030): a roadmap based on evidence and country experience. Bull World Health Organ 2016;94:398–400. - PMC - PubMed
    1. Chandra-Mouli V, Parameshwar PS, Parry M, et al. A never-before opportunity to strengthen investment and action on adolescent contraception, and what we must do to make full use of it. Reprod Health 2017;14:85. - PMC - PubMed
    1. World Health Organization. Adolescent health. Available at: https://www.who.int/health-topics/adolescents/ (accessed Sep 22, 2018).
    1. Hlongwa M, Mashamba-Thompson T, Hlongwana K. Evidence on factors influencing contraceptive use and sexual behavior in South Africa. Medicine 2018;97:e13774. - PMC - PubMed
    1. Munakampe MN, Zulu JM, Michelo C. Contraception and abortion knowledge, attitudes and practices among adolescents from low and middle-income countries: a systematic review. BMC Health Serv Res 2018;18:909. - PMC - PubMed