Contraceptive literacy among school-going adolescents in Botswana

Aim To examine adolescent contraceptive literacy and condom knowledge in Botswana. Background In Botswana, adolescent HIV infection rates remain high and unintended pregnancies are the predominant reason girls drop out of school. Despite a national mandate for comprehensive sexuality education and youth-friendly health services, access to accurate sexual and reproductive health information for adolescents remains limited. Methods Two hundred forty adolescents attending secondary schools in Maun, Botswana, completed cross-sectional surveys in 2020. Bivariate and logistic regression examined factors associated with contraceptive literacy and self-reported condom knowledge. Findings Although 90% of students were aware of one or more forms of contraception, only 67% could name a method for which they knew a source and only half of sexually active respondents had used birth control during their last sexual experience. Respondents reported that teachers and family members were the most important sources of information; only 8.2% of respondents identified health professionals in that role. Adolescents who consulted nurses had eight times greater odds of reporting correct condom-use knowledge than those who consulted teachers. Implications for Nursing Policy The positive association between adolescents' condom-use knowledge and nurses as information resources supports a call to expand nurses' role in health education in secondary schools and clinics in Botswana. Education and training programs for health professionals that build communication skills for working with adolescents should be promoted as an essential step in youth-friendly service provision. Conclusion Contraceptive literacy among adolescents in Botswana is low and may contribute to risk behaviors that drive rates of HIV and pregnancies in this population. Interventions to reduce adolescent HIV risk behaviors and unintended pregnancy may prove more effective if they involve nurses as communicators and educators.