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. 2025 Jun 20;22(1):104.
doi: 10.1186/s12978-025-02066-2.

The role of social networks in motivating access and use of contraceptives among adolescent girls and young women living in resource-constrained settings in Cape Town, South Africa

Tsidiso Tolla  1   2 , Kate Bergh  3 , Zoe Duby  3   4 , Nandipha Gana  3 , Catherine Mathews  3   5 , Kim Jonas  3   5
Affiliations

The role of social networks in motivating access and use of contraceptives among adolescent girls and young women living in resource-constrained settings in Cape Town, South Africa

Tsidiso Tolla et al. Reprod Health. .

Abstract

Background: This study explores the role of social networks consisting of parents, romantic and sexual partners and community members related to contraceptive access and use among adolescent girls and young women (AGYW) living in resource-constrained settings in Cape Town, South Africa METHODS: Data were collected through telephonic individual interviews, using a semi-structured interview schedule, with 63 AGYW aged 15-24 years old. All data were transcribed, translated, coded and analysed thematically using NVivo software.

Results: AGYW self-reported that their motivations to access and use contraceptives correctly and consistently were shaped by intersecting networks of parents (specifically mothers), peers, male romantic and sexual partners, and community members. Parents and male romantic and sexual partners either discouraged or encouraged contraceptive use. The support received from parents was described as both direct and indirect. Direct support was active encouragement of contraceptive use, and indirect support was when parents did not challenge AGYW's use of contraceptives. AGYW also reported on parents who directly discouraged contraceptive use, resulting in AGYW hiding their use of contraceptives. As with parents, support from male romantic and sexual partners was not homogeneous, with some partners being supportive of contraceptive use and some not. There were AGYW who considered their partner's support as central to motivating their use of contraceptives and used strategies to convince their partners to understand the importance of using contraceptives. Conversely, some AGYW were indifferent to the support of their partners, holding the view that using contraceptives is a decision that should be made by the young woman themself. Attitudes from community members were reported to be largely discouraging.

Conclusions: AGYW's interpersonal networks play a major role in shaping their attitudes, motivating or demotivating their use of, and access to contraception services. Social networks need to be taken into consideration when designing policies, interventions and programmes to promote contraception services among AGYW.

Keywords: Adolescent girls and young women; Contraception journey; Contraception services; Parents; Romantic and sexual partners; Social networks.

Plain language summary

This study aimed to understand the role of social networks consisting of parents, sexual and romantic partners and community members in motivating adolescent girls and young women (AGYW) to access and use contraceptives. Individual interviews were used to collect data for the study. A total of 63 AGYW between the ages of 15 and 24 years who lived in resource-constrained settings in Cape Town were interviewed. We found that the parents, male sexual and romantic partners, and community members of AGYW played a key role in AGYW’s use of contraceptives. Parents, specifically mothers, who were supportive of AGYW’s use of contraceptives, motivated AGYW to access and use contraceptive services. Like parents, male sexual and romantic partners also either motivated or demotivated AGYW’s access to and use of contraceptives. Unlike parents and sexual and romantic partners, whose influence was either positive or negative, we found that the attitudes of community members mainly demotivated AGYW’s access to and use of contraceptives. We propose that efforts to increase contraception access among AGYW should incorporate a social lens. Doing so may help raise contraception awareness among the social networks of AGYW, which may ultimately lead to increased contraception use among AGYW.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study followed the World Medical Association Declaration of Helsinki Code of Ethics. Ethical approval for the study was granted by the SAMRC Research Ethics Committee (REC), ref: EC044-10/2021. Before conducting any interviews, parents or guardians of AGYW aged 15–17 years granted verbal informed consent telephonically. In addition to parents’ consent, verbal informed consent was obtained telephonically for each AGYW aged 15–17 years. For AGYW aged 18 years and older, verbal informed consent was obtained telephonically. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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