Prevalence and factors associated with having ever impregnated a teenage girl among young men (15-24 years) in Kampala and their early fatherhood experiences

Prevalence and factors associated with having ever impregnated a teenage girl among young men (15-24 years) in Kampala and their early fatherhood experiences | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence and factors associated with having ever impregnated a teenage girl among young men (15-24 years) in Kampala and their early fatherhood experiences Damalie Mirembe, Simon P.S Kibira, Lydia Nakanjako, Nelson Mukiza, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7111985/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Background Adolescent pregnancy remains a significant public health challenge in sub-Saharan Africa with approximately 7.3 million girls becoming pregnant before the age of 18 annually, a number projected to reach 86 million by 2030. In Uganda, 25% of teenagers become pregnant by age 19, despite declining fertility rates among women aged 15 to 19. The role of young men in adolescent pregnancies remains understudied, with most research focusing on girls. This study assessed the prevalence, associated factors, and lived experiences of early fatherhood among young men (15–24 years) in Kampala, Uganda. Methods A descriptive cross-sectional study design employing mixed methods was conducted among 360 sexually active young men in relationships with adolescent girls in Kampala. Data on sexual behavior, inter-relational factors, and community data were collected using a pre-tested questionnaire uploaded on the Kobo Collect app. In-depth interviews explored the lived experiences of early fatherhood. Poisson regression analysis was used to assess factors associated with ever impregnating an adolescent, while content analysis was used for qualitative data. Results The mean age of participants was 20 (± 2.4) years, and the mean age at first sexual encounter was 15 (± 2) years. The prevalence of ever impregnating an adolescent girl was 45.8% (95%CI: 40.7–51), with 62 (35.6%) of these pregnancies being aborted. The mean age at impregnating an adolescent girl was 17 years (SD 1.6). Factors associated with ever impregnating an adolescent were older age (aPR: 2.09 (1.16 3.75) 2.54(1.43 4.54)), alcohol use (aPR: 1.34 (1.8 1.67)), drug use (aPR: 1.29 (1.04 1.6)), having friends who had ever impregnated an adolescent girl (aPR: 1.73 (1.22 2.45)), and having more than one sexual partner in a year (aPR: 1.54 (1.04 2.3). Qualitative findings revealed four key themes: perception of early fatherhood, support from family and friends, adjustment to fatherhood, and reforming. Conclusion Nearly half of sexually active young men in Kampala have ever impregnated an adolescent girl. Young fathers often face unpreparedness, financial stress, school dropout, and social stigma. Interventions targeting young men, focusing on behavior change, peer education, and reproductive health services, are essential to address adolescent pregnancy effectively. Adolescent pregnancy young men fatherhood risk factors Uganda Background Approximately 7.3 million girls become pregnant before the age of 18 annually, with projections estimating an increase to around 86 million by 2030 ( 1 ). Teenage pregnancy rates are exceptionally high in developing regions, especially in Sub-Saharan Africa, where an estimated 23% of these pregnancies occur, with approximately 105 in 1,000 girls aged 15 to 19 giving birth ( 2 ). Despite ongoing interventions, data from the SDG Indicators Global Database indicate that the number of childbirths to adolescents has not changed, which is attributed to the large and growing population of adolescent girls in developing regions ( 3 ). In Uganda, the Teenage Pregnancy Rate remains high at 25%, showing stagnation over the past decade from 25% in 2006 to the same percentage in 2016, and is currently threatening to rise. In Kampala, the teenage pregnancy rate has risen from 13.4% ( 4 ) to 14.3% in 2021. Several factors influencing this trend have been explored. However, male-specific factors that may increase the risk of teenage pregnancies have not been investigated ( 5 , 6 ). The UN Development Program defines young men as being 10–24 years old and youth as being 15–24 years old. In this context, teen pregnancy or birth for young fathers is defined as pregnancy or birth before age 20, or pregnancy or birth to a female under age 20, for young men aged 15 to 24 years ( 7 ). Research indicates that males aged 20–24 years father a higher proportion of children born to teen mothers than males aged 19 years or younger, particularly in societies with gender inequalities that create power differences between males and females ( 5 , 8 ). This suggests that young men, especially those in their early 20s, need consideration in teen pregnancy research and prevention, particularly in predominantly patriarchal societies. Adolescent pregnancies pose significant challenges to young girls, and early fatherhood also presents a unique set of challenges to young fathers, including school dropout, low education attainment, and unemployment ( 9 ). Young fathers often deny responsibility for the pregnancy and are rarely involved in the child’s life, leading to stereotypes such as predators, absent, and selfish men ( 10 ). However, previous studies have also shown that father absence, low education level, and poverty are risk factors for young men impregnating adolescent girls, perpetuating a cascade of this problem ( 9 ). Measures to decrease teenage pregnancy rates in Uganda include enacting laws to protect teenagers, ensuring the availability and accessibility of high-quality education, and providing sexual education. Additionally, policies, approaches, awareness campaigns, and educational efforts led by the Ministry of Gender and Labor and Social Development, in collaboration with organizations affiliated with the "GIRLS NOT BRIDES" alliance and UN agencies, share a common objective of addressing adolescent childbearing ( 11 ). However, these efforts have not reduced the teenage pregnancy rates, possibly due to global strategies overwhelmingly focusing on adolescent girls while neglecting the unique prevention needs of young men and the opportunities to engage them as partners in prevention. Young men significantly contribute to conception and play a vital role in the reproductive health outcomes of teenage pregnancies. For instance, male partner involvement in contraceptive decision-making increases the use of effective pregnancy prevention methods ( 12 ). Therefore, documenting and exploring the role young men play in teenage pregnancies is crucial for reinforcing current interventional efforts. Since research towards teen pregnancy prevention is biased towards young girls and little is known about the interplay between the characteristics of young men who engage in sex with teenage girls and the occurrence of teenage pregnancy within this risk group, this study aimed to investigate and understand the prevalence and factors associated with impregnating adolescent girls by young men and to explore their life experiences of early fatherhood. The findings from this study will help to focus public attention on young men’s involvement in teenage pregnancies and provide baseline information for designing the much-needed interventions targeting men as contributors to the burden of teenage pregnancy. Materials and Methods Study design and setting We conducted a concurrent mixed methods design for this study as quantitative and qualitative data collection and analyses were done separately during a single phase of the research. The study was conducted in Kampala which is the capital and largest city of Uganda. It is divided into 5 administrative divisions namely; Kawempe division, Nakawa Division, Rubaga Division, Kampala Central Division, and Makindye Division. Kampala is neighboring Mukono district and Lake Victoria in the east, Buikwe in the south, and Wakiso district in the west and north ( 13 ). It is estimated to have a population of 1.75 million people of which 51% are female and 49% are male, with a diverse ethnic population drawn from all parts of Uganda and a home to many foreigners. The majority of the population works in the informal sector as traders and transportation businesses (taxis and boda-boda) and urban agriculturalists ( 13 ). Study Participants and Eligibility The study included all young men between 15 to 24 years living in the areas of Kampala who had sexual relationships with adolescent girls including those who were “culturally married or cohabiting” during the study period and consented to be part of the study. Intoxicated young men including those who had slurred and incoherent speech from alcohol at the time of the interview were excluded. The qualitative arm of the study considered young men who had impregnated an adolescent girl and birthed a baby. Sample Size and Sampling Procedure The sample size for the quantitative study was 360 sexually active young men, calculated using the Kish-Leslie (1965) formula for a descriptive objective in a single population proportion. It is given by; n = Z α 2 *P (1 - P)/d 2 , where: Z α is 1.96, the critical value of 95% level of confidence at α = 0.05; P is the proportion of self-reported impregnating of a teenage girl, assumed to be 0.225, based on a 22.5% prevalence reported in a study in Uganda ( 14 ); d is 0.05 (5%), the margin error of estimation. A multistage mixture of probability and non-probability cluster sampling was utilized, with five parishes selected randomly from each division in Kampala, recruiting 18 young men from each parish. Participants were then purposively sampled from the hot spots for young men for instance sports betting parlors, boda boda stages, bars, markets, and churches among others. Qualitatively, the study employed a purposive sampling strategy, and solicitations were made on a personal level within the quantitative sample. Five young men with a known history of impregnating an adolescent girl, resulting in the birth of a baby, were recruited. Data Collection Tools and Procedures Before the study, all research assistants (RAs) participated in a one-day training through the principal investigator (PI) on study procedures, data collection tools, and conducting qualitative interviews. The questionnaire and audio recorders were pretested, and necessary refinements were made to enhance functionality, clarity, and reliability. Upon participants expressing interest in participating, a consent form was read to each participant to ensure comprehension, and allowance was given for all questions and concerns from the participants. A structured questionnaire was used to collect participants’ socio-demographic, individual factors, interpersonal factors, as well as community factors (see Additional file 1). Qualitative data were gathered using an open-ended in-depth Interview Guide. Participants were contacted via mobile phone to set and confirm appointments the day before, and the interviews took place in a private setting chosen by the interviewees. These interviews were conducted by male research assistants. Anonymity and confidentiality were emphasized, and each interview lasted for about 30 minutes. Study Variables The dependent variable was self-reported “ever impregnated an adolescent girl,”. The independent variables included socio-demographic factors such as age, occupation, education level, religion, marital status, alcohol use, and illicit drug use. Behavioral sexual factors comprised age at first sex, number of sexual partners in the last year, lifetime sexual partners, frequency of condom use, having had sex in the last 30 days, condom use at first sex, prevention methods used at last sex, and sex education. Interpersonal variables included peer pressure, parental support, a history of teenage parenthood, father support, and the history of teenage pregnancy in the social network. Community variables included access to information, social norms, cultural beliefs, and religious beliefs. Data analysis and Management Data were collected using the Kobo Collect mobile app and exported to Microsoft Excel for cleaning. The cleaned data were then exported to Stata Version 14 for analysis. Baseline characteristics were summarized as means with standard deviations, medians, and interquartile ranges for continuous variables, while categorical variables were presented as frequencies and proportions. The prevalence of self-reported ever-impregnating an adolescent was expressed as a percentage of the total sample size. The numerator was the number of young men who reported having ever impregnated an adolescent girl in their lifetime. Modified Poisson regression was utilized to test associations between individual, sexual behavioral, inter-relational, and community factors and the occurrence of ever-impregnating an adolescent girl. Variables with a p-value < 0.2 in bivariate analysis and < 0.05 in multivariate analysis were considered statistically significant. Results were presented in tables, including both unadjusted and adjusted prevalence ratios with corresponding 95% confidence intervals (CIs). Qualitatively, audio recordings from in-depth interviews were transcribed and translated by a trained qualitative research assistant, while the principal investigator (PI) cross-checked the transcripts for completeness, accuracy, and correctness using field notes and audio recordings. The PI and experienced qualitative research analysts reviewed the transcripts multiple times to identify themes and sub-themes. Data were coded using an inductive thematic approach with Nvivo software, and key themes were reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. To ensure confidentiality, all completed questionnaires, audio recordings, and consent forms were securely stored under lock and key, accessible only to the PI. Results A total of 360 sexually active young men in sexual relationships with adolescent girls participated in the study. The mean age of the participants was 20 years (±2.4). Most of the young men were single (71.1%), had completed secondary education (48.3%), and did not consume alcohol (64.2%). The average age at their first sexual encounter was 15 years (±2). The majority of the participants reported having multiple sexual partners within a year (80%), using condoms during sexual activity (87.7%), and supporting the idea that adolescent girls should have access to contraceptives (56.6%). However, approximately a quarter of participants had never tested for HIV (26.1%), used condoms at their first sexual encounter (25%), but did not use contraceptives during their last sexual encounter (26.1%). Over half of the young men disclosed feeling pressure to engage in sexual relations (69.7%), knowing friends who had impregnated an adolescent girl (73.1%), having access to contraceptive information in the community (75.8%), and lacking paternal support (50.6%) (Table 4). Prevalence Of Ever Impregnating An Adolescent Girl Out of 360 sexually active young men, 145 (45.8%) reported to have ever impregnated an adolescent girl. Of those that impregnated, 100(57.6%) became young fathers, 62(35.6%) aborted the pregnancy, while 6.9% did not know the outcome of the pregnancy (fig3). The mean age of impregnating an adolescent girl was 17 years (Table 1). Table 1 ; prevalence of impregnating an adolescent girl Mean SD Age at impregnating an adolescent girl 17 1.6 Frequency Percentage 95% CI Ever impregnated an adolescent girl No 195 54.2 49-59.3 Yes 165 45.8 40.7-51 Pregnancy outcome for impregnated teenage girl Abortion 62 35.6 28.8- 43.1 Birthed a baby 100 57.5 49.9-64.7 I don't know outcome of the pregnancy 12 6.9 3.9-11.8 F actors associated with ever impregnating an adolescent girl At the bivariate level, age, marital status, alcohol use, drug use, condom use at first sexual encounter, number of sexual encounters in the last 1 year, friends impregnating teenagers, and lifetime number of sexual partners were associated with ever impregnated an adolescent girl and further included in the multivariate analysis (Table 2). At multivariate analysis, independent association with ever impregnating an adolescent girl was found with age, where young men aged 18-20 years and 21-24 years were 2.09 times and 2.54 times more likely to ever have impregnated an adolescent girl compared to those aged 15-17, (aPR:1.23, 95%CI:1.11-1.36, p=0.014) and (aPR:1.16, 95%CI:1.05 1.29, p=0.002) respectively. In regards to alcohol consumption, young men who reported alcohol use were 34% more likely to ever have impregnated an adolescent girl compared to those who did not use alcohol, (aPR:1.34, 95% CI:1.8-1.67, p=0.008). Additionally, men who reported to use drugs were 29% more likely to ever have impregnated an adolescent girl compared to those that do not use drugs, (aPR:1.29, 95% CI: 1.04-1.6, p=0.022). Sexually active young men who had 2 to 5 sexual partners in a year were 54% more likely to ever have impregnated an adolescent girl and those that had more than 5 sexual partners in a year were twice as likely to ever have impregnated an adolescent girl, compared to their counterparts with just one sexual partner, (aPR :1.54, 95% CI:1.04-2.3, p=0.033) and (aPR:2, 95%CI:1.33-3.01, p=0.001) respectively (Table 2). Table 2 ; Bivariate and multivariate analysis of factors associated with ever impregnating an adolescent girl by a young man Ever-impregnating a girl Bivariate Analysis Multivariate analysis Variable name No Yes cO.R (C.I) p value Adj OR (C.I) P value n (%) n (%) Age in completed years 15-17 39(81.2) 9(18.8) 1 1 18-20 76(55.5) 61(44.5) 2.37(1.28-4.41) 0.006 2.09(1.16-3.75) 0.014 21-24 80(45.7) 95(54.3) 2.9(1.58-5.30) 0.001 2.54(1.43-4.54) 0.002 Marital Status Not married 147(57.4) 109(42.6) 1 Married 48(46.2) 56(53.8) 1.26(1.01-1.59) 0.044 Alcohol use No 147(63.6) 84(36.4) 1 1 Yes 48(37.2) 81(62.8) 1.73(1.39-2.14) <0.001 1.34(1.8-1.67) 0.008 Drug use No 165(60.9) 106(39.1) 1 1 Yes 30(33.7) 59(66.3) 1.69(1.37-2.09) <0.001 1.29(1.04-1.6) 0.022 Number of sexual partners in the last 1 year 1 51(73.9) 18(26.1) 1 1 2 to 5 122(55.5) 98(44.5) 1.71(1.12-2.61) 0.013 1.54(1.04-2.3) 0.033 more than 5 22(31) 49(69) 2.65(1.73-4.06) <0.001 2(1.33-3.01) 0.001 Condom use at first sexual encounter No 133(49.3) 137(50.7) 1 Yes 62(68.9) 28(31.1) 0.61(0.44-0.85) 0.004 Lifetime number of sexual partners 1 16(76.2) 5(23.8) 1 2 to 5 100(73.5) 36(26.5) 1.11(0.49-2.51) <0.001 more than 5 79(38.9) 124(61.1) 2.57(1.18-5.56) <0.001 Friends impregnating teenagers No 72(74.2) 25(25.8) 1 1 Yes 123(46.8) 140(53.2) 2.07(1.45-2.95) <0.001 1.73(1.22-2.45) 0.002 Life Experiences Of Early Fatherhood The qualitative arm of the study explored lived experiences of fatherhood from the perspective of young men who have fathered children with adolescent girls. This included 5 in-depth interviews conducted among 5 young men whose ages varied from 16 to 20. Their responses were categorized into four major themes: perception of early fatherhood, Family and friends support, adjustment, and reforming with each theme containing sub-themes and supporting testimonies (Table 3). Table 3 ; Thematic Presentation of life experiences of early fatherhood THEME SUBTHEME CODE THEME 1: Perception of early fatherhood Fear of pregnancy and early fatherhood. “When she told me she was pregnant, I was scared especially because of the responsibility that came with it since I had never dealt with such circumstances. I wanted her to have an abortion because I could not afford to take care of a child but she insisted on having the baby.” [Cohabiting, 20years] fatherly duties “I was happy but I also cried because my child was born when I was not in hospital with them because I had to be at work looking for money.” [Single 2,16years] THEME 2: Family and friends moral and emotional support “I talked to my parents, who then talked to her parents to inform them about what was going on. Both sets of parents were understanding and she carried the pregnancy to term.” [Single 1, 16years] raising the child Single, 19years “ I took the child to my mother since I also couldn’t stay with and take proper care of him all the time. My mother has done a good job of taking care of him and everyone appreciates .” THEME 3: Adjustment to early fatherhood finances and employment “I was now working and doing casual labor activities like digging in people’s farms to earn a living.” [Single,17years] dropping out of school “I dropped out of school when I became a father because I had to fend for my child and take on my responsibility.” [Single, 16years] THEME 4: Reforming criminal activity “Being banished from the village really helped me because it pushed me to move to the city. I didn’t know anyone in the city but I had to come to look for a better life. I stopped committing robbery and I also became a Christian and changed my ways.” [Single,17years] contraceptive use “I do not use them but I think my woman uses family planning. She first resisted its use and as a result our second child was unexpected. But she’s probably using family [single, 17years] Perception of early fatherhood The young men had an inherent “fear” of impregnating an adolescent girl and were not ready to become fathers. This fear was not only due to the financial responsibilities but also the stigma, societal perceptions and stereotypes associated with impregnating an adolescent. For example; “When she told me she was pregnant, I was scared especially because of the responsibility that came with it since I had never dealt with such circumstances. I wanted her to have an abortion because I could not afford to take care of a child but she insisted on having the baby.” [Cohabiting, 20years] Despite the fear and uncertainty of early fatherhood due to its inevitable challenges, the young men were happy to be called “father” after the baby was born. Infact, the men decidedly chose to take responsibility of the expectant mother and baby. However, due to societal perceptions associated with fatherhood, the young men also believed that fatherhood meant financial responsibility. For instance, Participant Cohabiting, 20years said, “I was very happy, although I also realized that it came with financial implications.” While participant Single 2,16years “I was happy but I also cried because my child was born when I was not in hospital with them because I had to be at work looking for money.” Family and friends Due to societal perceptions and stereotypes associated with impregnating an adolescent, the young men initially feared their parents’ and friends’ reactions. Despite the disappointment and anger they expressed, the parents and friends provided emotional and moral support for their expectant sons to help them cope with the challenges of pregnancy and fatherhood. For example; Participant Single 2, 16 years said, “Her parents considered arresting me, but my mother managed to talk them out of it because we came from a very humble background since my father passed on when I was 7 years old. The girl’s parents calmed down since I had not denied the pregnancy and I had agreed to take on the responsibility.” Additionally, four of the young men reported that they sent their children to stay with their parents who took on the responsibility to raise their grandchildren. For instance, Participant Single, 19years “I took the child to my mother since I also couldn’t stay with and take proper care of him all the time. My mother has done a good job of taking care of him and everyone appreciates.” Adjustment to early fatherhood Unplanned early fatherhood drastically transformed the young men’s lifestyle trajectories towards education, finances, employment and social life in order to meet their responsibilities as fathers and “husbands”. The young men who had been fully dependent on their parents for all their livelihoods including food, shelter, and all financial provisions had got the same responsibility and had to immediately find ways to support the mother and baby. For example; participant Single,17years said, “ I was now working and doing casual labor activities like digging in people’s farms to earn a living.” In order to fend for the expecting mother and the child, the four young men who were attaining an education made a difficult decision to drop out of school. Such a decision was made to enable them have extra time to work in turn increase their earnings. For example, participant Single, 17years shared that “I dropped out of school when I became a father because I had to fend for my child and take on my responsibility However, despite their new found time consuming responsibilities and the negative societal perception challenges, these young men were determined to resume school and get an education or even to attain a new skill. For instance; Single, 19years said that, “Although I put my studies on hold up to now, but I intend to resume in the future and go to university.” Reforming Fatherhood also became a period of reformation. Choices and lifestyles had to be adjusted for the young fathers to meet their new responsibilities. The young men reported that the birth of their babies inspired them to be better fathers as their actions directly affected the wellbeing of their families. Therefore, they had to reform and distance themselves from friends who were involved in the criminal activities. For example; Participant Cohabiting,20 years said, “I stopped robbery, and I also had to mature mentally. I had to distance myself from the groups I used to hang out with and fend for my child. This happened particularly when I was arrested along with my friends who had murdered someone they were trying to rob. I had to leave my pregnant girlfriend alone in the house for a week. I cried and after I was released, I had to be a better person. I no longer deal with those friends of mine who are still robbers.” Since the young men believed that they impregnated the young girls following inconsistent contraceptive use, they reported consistent condom use because they were not ready for another unplanned pregnancy. Those that didn’t use condoms reported that their girlfriends use other contraceptive methods. Participant single, 17years said, “I do not use them but I think my woman uses family planning. She first resisted its use and as a result our second child was unexpected. But she’s probably using family planning now.” Discussion Prevalence of ever impregnating an adolescent girl The prevalence of ever impregnating a girl was 46% which was higher compared to findings from studies conducted in sub-Saharan Africa. For instance, a survey conducted in Namibia by Mogotsi and Mwetulundila ( 8 ) found that 31.4% of 685 young men aged 15 to 22 years had impregnated an adolescent girl. De Wet, Amoo ( 15 ) also found that over 22.5% of the young men had ever impregnated an adolescent girl. This high prevalence of impregnating adolescent girls might be attributed to low or inconsistent contraceptive use among these sexually active young men. Myths, cultural and religious beliefs, also influence this poor contraceptive uptake. For instance, in this study, the majority of the sexually active young men reported their religions and cultures do not permit the use of contraceptives, which are a cornerstone for pregnancy prevention. Sexually active young men who reported condom use were 71% less likely to impregnate an adolescent girl compared to those who did not. In this study, the median age at first sexual encounter among the young men in the study was 15 years. This age is 3 years lower than the findings from the country-wide survey of 18.5 as stated in the UDHS ( 16 ). Early age for sexual exposure and exploration directly puts these young men at a higher risk of impregnating adolescent girls. Previous studies have found that the earlier a young man starts to have sexual intercourse, the more likely he will impregnate an adolescent girl ( 17 ). This study found that the average age a young man reported impregnating an adolescent girl was 17 years. This age at impregnation is markedly lower than that in previous studies. For instance, a study by Mogotsi and Mwetulundila ( 8 ) found that the 20 to 22-year age group of young men had impregnated 41.0% of adolescent girls. The lower age at impregnating an adolescent in Kampala could have arisen from the early age of sexual debut, lack of sexual education, and poor knowledge about contraceptive use. Factors associated with ever impregnating an adolescent girl In this study, older age (19 to 24 years) put young men at higher risk for impregnating an adolescent girl compared to their younger counterparts. This finding is consistent with findings from other studies. For instance, a cross-sectional study conducted among 685 male youths aged between 15 to 22 years residing in urban and rural areas in Namibia, Mogotsi and Mwetulundila ( 8 ) found that the 20 to 22-year age group had impregnated 41.0% of teen girls in the study compared to 19.2% and 23.5% of the age groups 15 to 16 years and 17 to 19 years respectively. This age disparity could have placed young girls in a position of vulnerability to sexual coercion or hindered their ability to negotiate safer sexual practices, thereby increasing their risk of becoming pregnant. This study also found that young men who used alcohol were 34% more likely to impregnate adolescent girls in comparison to those who refrained from alcohol use. A meta-analysis of 50 studies involving 465,595 adolescents indicated that alcohol consumption was significantly associated with risky sexual behaviors including early sexual initiation, inconsistent condom use, and multiple sexual partners among others ( 18 ). These behaviors significantly increase the likelihood of unintended adolescent pregnancies. Another study highlighted that binge drinkers have a five-fold increased risk of becoming pregnant or impregnating someone compared to non-drinkers. The prevalence of pregnancy among binge drinkers was as high as 23.9%, highlighting the direct link between alcohol consumption and unintended pregnancies ( 19 ). Additionally, the study found that young men whose friends had impregnated adolescent girls were most likely to also impregnate an adolescent. This could possibly be because people within the same social network exhibit the same social behaviors ( 20 , 21 ). A study conducted in Mbarara Municipality, Uganda, found that negative peer interactions and unhealthy friendships among adolescents increased the likelihood of teenage pregnancy ( 22 ). A qualitative design that explored masculine discourses among boys, such as the belief that "you are not a real man until you have scored," reinforces peer pressure to impregnate adolescent girls. This study involved 42 male learners and revealed that many of the participants felt that having unprotected sex enabled them to impregnate girls, thereby demonstrating their masculine identity ( 23 ). This social norm within peer groups encourages young men to engage in sexual activity and fatherhood as a marker of masculinity, further supporting the link between friends' behaviours and individual actions. The study also found that young men who had more than one sexual partner were more likely to impregnate an adolescent girl compared to those who had one sexual partner. This finding is similar to those from other studies. For instance, ( 15 ) found that respondents with two or more lifetime sexual partners were more likely to impregnate a girl than those with only one partner. A case-control study of teenage girls (aged 13–19 years) in Lira District, Uganda, found that behavioural factors such as having multiple sexual partners, frequent sexual activity, and irregular contraceptive use were significant predictors of teenage pregnancy ( 21 ). This indicates that multiple sexual partnerships among young men contribute to higher rates of adolescent pregnancies. The study also found drug use to be significantly associated with ever-impregnating an adolescent. For instance, Holmberg and Berg-Kelly ( 24 ) not only found that young males who had impregnated teen girls used illicit drugs, and smoked cigarettes but also found that impregnation occurred more among young men who often used the drugs compared to those who seldom used the drugs. Life experiences of early fatherhood. The young men reported that they had an inherent fear of impregnating their girlfriends and were shocked at the revelation as they were not ready to become fathers. However, despite the fear of challenges associated with impregnating a girl and early pregnancy, these young men inconsistently used condoms. Previous studies have shown that most young men have sexual intercourse for pleasure, and they believe the responsibility for contraceptive use lies solely on the girls which in turn leads to inconsistent use of condoms and other contraceptives, leading to unplanned pregnancies ( 5 ). Additionally, the young men in the study reported financial hardships as they were minors with low educational attainment and lacked work skills. Since the young men were obligated to provide for their expecting girlfriends and prepare for the baby’s birth, they sought low-income, casual jobs, while others resorted to theft, which led them to prison. These findings align with previous studies that explored the lived experiences of young fathers, indicating that they suffered financial difficulties due to low educational attainment, a lack of work skills, and experience necessary to sustain formal employment, which limited their job opportunities ( 10 ). In this study, family and friends were crucial in helping these young men cope with the transition to fatherhood. The study found that the boys’ parents facilitated talks with the girls’ families, and their families also took care of the baby after birth, which lessened the burden of new responsibilities for the young men. This finding is consistent with other research indicating that family support plays a vital role in the early transition to fatherhood ( 25 , 26 ). However, although family support positively impacts these young fathers, it holds some negative consequences where other young men may follow in the same footsteps with the hope of support from their family, which in turn perpetuates adolescent pregnancy. Furthermore, the young men in the study reported experiencing stigma from peers at school, at home, and in the community, which subsequently led to school dropouts, fleeing the village, and social exclusion. In fact, previous studies have found that young fathers face stereotypes that label them as predators, absent, and selfish, which negatively impact their relationships with both the mother and the child ( 27 , 28 ). This not only demotivates the young father but can also lead to absence from their baby’s life. Strengths and limitations The study used both qualitative and quantitative methods, which allowed a deeper understanding of the role of young men in adolescent pregnancy. Additionally, this is the first study in Kampala and Uganda at large to assess the sexually active young men’s role in adolescent pregnancies and their experience of early fatherhood. However, the dependent variable of the study which was “ever impregnating an adolescent girl” was self-reported which made it prone to social desirability bias which could have led to under/over-reporting of sexual lifestyles. Conclusions and recommendations The prevalence of “ever impregnating an adolescent girl” by a sexually active young man in Kampala city, Uganda, is high and is associated with factors such as older age, drug use, peer influence and multiple sexual partners. To address this, it is essential to provide accessible and youth-friendly healthcare services, including counselling on responsible sexual behaviour and family planning. Integrating comprehensive sex education into the school curriculum can further empower students with knowledge about healthy relationships, contraception, and the consequences of early parenthood, thereby reducing risky sexual behavior. Additionally, establishing community centers or support groups for young men can offer much-needed guidance and psychosocial support to help them navigate personal challenges and make informed life choices. Abbreviations CSE Comprehensive Sexual Education HIV Human Immunodeficiency Virus MOGLSD Ministry of Gender, Labor and Social Development NSCN&TP Uganda National Strategy on Ending Child Marriage and Teenage Pregnancy SRH Sexual Reproductive Health TPR Teenage Pregnancy Rate UNICEF United Nations Children’s Fund WHO World Health Organization Declarations Ethics Approval Ethics approval and consent to participate were received from the Makerere University School of Public Health Research Ethics Committee (REC) under protocol number 056. Administrative clearance was obtained from the KCCA’s Director of Health Services. Written informed consent of eligible participants was obtained, and assent was sought for those who were below 18 years before enrolment into the study. Parental consent was waived for this study because all participants were considered emancipated minors able to provide their consent as directed by the Uganda National Council of Science and Technology. Clinical Trial Number Not applicable Consent for publication Not applicable Competing interests The authors declare no competing interests. Funding No funding Author Contribution DM conceived the idea, designed the study, recruited participants, and collected the data. LN, SPK, JK, and JB reviewed the protocol. DM, NM, AB, CN, and VM analyzed the data. All authors reviewed the tables of results. KN, NM, AB, LN, and DM wrote the first draft of the manuscript. All authors reviewed and approved the final draft of the manuscript. Acknowledgement The KCCA’s Director of Health Services permitted the study in Kampala. My sincere appreciation goes out to the division medical officers and my research assistants for their support in participant recruitment and data collection. Data Availability The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request. References UNFPA. ADOLESCENT PREGNANCY: A Review of the Evidence. 2013. ACERWC ACoEotRaWotC. Teenage Pregnancy in Africa Status, Progress, and Challlenges. 2022. Kisambira S, Schmid K. Selecting adolescent birth rates (10–14 and 15–19 years) for monitoring and reporting on sustainable development goals. Indicator. 2022;3:2. UDHS and ICF. Ugand Demograhic and Health Survey 2016 2018 [Available from: http://dhsprogram.com/pubs/pdf/FR333/FR333.pdf Fasula AM, Chia V, Murray CC, Brittain A, Tevendale H, Koumans EHJJ. Socioecological risk factors associated with teen pregnancy or birth for young men: A scoping review. 2019;74:130–45. Kane J, Lohan M, Kelly C. Adolescent men's attitudes and decision making in relation to pregnancy and pregnancy outcomes: An integrative review of the literature from 2010 to 2017. J Adolesc. 2019;72:23–31. UNDP. UNDP youth strategy 2014–2017: United Nations Development Programme. 2014 [Available from: http://www.undp.org/content/dam/undp/library/Democratic%20Governance/youth/UNDP_Youth-Strategy2014-17_Web.pdf Mogotsi I, Mwetulundila PJAJRH. Understanding unwanted pregnancy from the perspectives of the Namibian male youth. 2020;24(3):41–50. Terefe B, Mekonen EG, Tamir TT, Zegeye AF, Workneh BS, Techane MA. The prevalence of adolescent fatherhood and its associated factors in East African countries. BMC Public Health. 2024;24(1):1716. Lau Clayton C. The Lives of Young Fathers: A Review of Selected Evidence. Soc Policy Soc. 2016;15(1):129–40. Nabugoomu J, Seruwagi GK, Hanning R. What can be done to reduce the prevalence of teen pregnancy in rural Eastern Uganda? multi-stakeholder perceptions. Reproductive Health. 2020;17(1):1–12. Storck KE, Gawron LM, Sanders JN, Wiaderny N, Turok DK. I just had to pay the money and be supportive: A qualitative exploration of the male-partner role in contraceptive decision-making in Salt Lake City, Utah family planning clinics. Contraception. 2022;113:78–83. KCCA. Statistical Abstract for Kampala city 2019. 2019. Adewole O, Otubanjo OMJTQR. Young Men's Perceptions of Teenage Pregnancy. 2020;25(9):3367–80. De Wet N, Amoo EO, Odimegwu CJSAJCH. Teenage pregnancy in South Africa: Where are the young men involved? 2018;2018(1):s44-s50. UBOS. Uganda Demographic and Health Survey 2022. 2022. Brahmbhatt H, Kågesten A, Emerson M, Decker MR, Olumide AO, Ojengbede O et al. Prevalence and determinants of adolescent pregnancy in urban disadvantaged settings across five cities. 2014;55(6):S48–57. Cho H-S, Yang Y. Relationship between alcohol consumption and risky sexual behaviors among adolescents and young adults: a meta-analysis. Int J public health. 2023;68:1605669. PennyPhillips M, LisaJones HC. CONTRIBUTIONS OF ALCOHOL USE TO TEENAGE PREGNANCY. Muhanguzi FK, Ninsiima AJA. Embracing teen sexuality. Teenagers’ Assess sexuality Educ Uganda. 2011;25(3):54–63. Ochen AM, Chi PC, Lawoko S. Predictors of teenage pregnancy among girls aged 13–19 years in Uganda: a community based case-control study. BMC Pregnancy Childbirth. 2019;19(1):1–14. Mary Patricia Kukundakwe. Peer Influence And Teenage Pregnancy Among Adolescents In Secondary Schools. A Case Study of Mbarara Municipality, Uganda.; 2021. Shikukutu F, Ramrathan P. You Can’t Be in Grade 12 and Don`T Have a Kid`. Boys’ Masculine Conversations Towards Impregnating in Namibian Schools: A Case Study of the Kavango East Region. Med Res Archives. 2022;10. Holmberg L, Berg-Kelly K. Health, health-compromising behaviour, sexuality and involvement in pregnancy among 18-year-old Swedish males: a cross-sectional survey. Acta paediatrica (Oslo, Norway: 1992). 2002;91(7):838 – 43. Madlala ST, Sibiya MN, Ngxongo TS. Perceptions of young men at the Free State School of Nursing with regards to teenage pregnancy. Afr J Prim Health Care Family Med. 2018;10(1):1–7. Assini-Meytin LC, Green KMJJAH. Long-term consequences of adolescent parenthood among African-American urban youth: A propensity score matching approach. 2015;56(5):529–35. Cousins JM. THE LIVED EXPERIENCE OF ADOLESCENT FATHERHOOD. 2011. Weber JB. Becoming teen fathers: Stories of teen pregnancy, responsibility, and masculinity. Gend Soc. 2012;26(6):900–21. Additional. file 1 (.docx): QUESTIONNAIRE FOR THE PREVALENCE AND FACTORS ASSOCIATED WITH ADOLESCENT PREGNANCY BY A YOUNG MAN IN KAMPALA. This document contains the. questions that were developed and used for this study to answer objectives 1 and 2. Additional Declarations No competing interests reported. Supplementary Files ADDITIONALFILE1.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 29 Aug, 2025 Editor assigned by journal 28 Aug, 2025 Editor invited by journal 04 Aug, 2025 Submission checks completed at journal 01 Aug, 2025 First submitted to journal 01 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7111985","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":510411783,"identity":"282b09d4-ea5c-4355-ae17-8de76addf567","order_by":0,"name":"Damalie Mirembe","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABAklEQVRIie3PvWrDMBDAcQmDRntV3kIhEDqEvkiXE4FuBx09pEFTugS6dijJ0BdIMGhWEDhDDV4NXdKlW8DdPBRa2UM6+WMsVH/QIcH9MCbE5/uLGXdOgghWPyB2IwhUP4ELyWpChxBCRPOgq2Z2k/D4Kku4m03C6MWW75v7m+jBkSrWrWSUYcJB3E4Z/wAh9RGfLFV0nb21EmFw54idMZ4JkDpF5UhAVx0kPycViO+GGPmc4raXFKjdV8yUReuxkmqBuz4yKs76CsR8wjibE0gN7h05dP1LmGNSlF/X4+2jtZ/VYomb3B5OVdxOfuNQT9vczYB9V9TsLYct+3w+37/qB2kKYkIlWqkcAAAAAElFTkSuQmCC","orcid":"","institution":"Makerere University","correspondingAuthor":true,"prefix":"","firstName":"Damalie","middleName":"","lastName":"Mirembe","suffix":""},{"id":510411784,"identity":"fd160773-f8fd-4a7a-b8cb-556e0bb29c2d","order_by":1,"name":"Simon P.S Kibira","email":"","orcid":"","institution":"Makerere 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08:08:18","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7111985/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7111985/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":90675669,"identity":"922c24ce-44f3-40ad-8980-e2482017250b","added_by":"auto","created_at":"2025-09-05 14:30:39","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1266752,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7111985/v1/25ebcc62-a57c-4e5c-aa29-2c707a7c70c1.pdf"},{"id":90674812,"identity":"ceef0966-e2f9-491c-af3b-86918ac413a7","added_by":"auto","created_at":"2025-09-05 14:22:38","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":24000,"visible":true,"origin":"","legend":"","description":"","filename":"ADDITIONALFILE1.docx","url":"https://assets-eu.researchsquare.com/files/rs-7111985/v1/1171e226a78376a0689c677b.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence and factors associated with having ever impregnated a teenage girl among young men (15-24 years) in Kampala and their early fatherhood experiences","fulltext":[{"header":"Background","content":"\u003cp\u003eApproximately 7.3\u0026nbsp;million girls become pregnant before the age of 18 annually, with projections estimating an increase to around 86\u0026nbsp;million by 2030 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Teenage pregnancy rates are exceptionally high in developing regions, especially in Sub-Saharan Africa, where an estimated 23% of these pregnancies occur, with approximately 105 in 1,000 girls aged 15 to 19 giving birth (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Despite ongoing interventions, data from the SDG Indicators Global Database indicate that the number of childbirths to adolescents has not changed, which is attributed to the large and growing population of adolescent girls in developing regions (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn Uganda, the Teenage Pregnancy Rate remains high at 25%, showing stagnation over the past decade from 25% in 2006 to the same percentage in 2016, and is currently threatening to rise. In Kampala, the teenage pregnancy rate has risen from 13.4% (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) to 14.3% in 2021. Several factors influencing this trend have been explored. However, male-specific factors that may increase the risk of teenage pregnancies have not been investigated (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe UN Development Program defines young men as being 10\u0026ndash;24 years old and youth as being 15\u0026ndash;24 years old. In this context, teen pregnancy or birth for young fathers is defined as pregnancy or birth before age 20, or pregnancy or birth to a female under age 20, for young men aged 15 to 24 years (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Research indicates that males aged 20\u0026ndash;24 years father a higher proportion of children born to teen mothers than males aged 19 years or younger, particularly in societies with gender inequalities that create power differences between males and females (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). This suggests that young men, especially those in their early 20s, need consideration in teen pregnancy research and prevention, particularly in predominantly patriarchal societies.\u003c/p\u003e\u003cp\u003eAdolescent pregnancies pose significant challenges to young girls, and early fatherhood also presents a unique set of challenges to young fathers, including school dropout, low education attainment, and unemployment (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Young fathers often deny responsibility for the pregnancy and are rarely involved in the child\u0026rsquo;s life, leading to stereotypes such as predators, absent, and selfish men (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). However, previous studies have also shown that father absence, low education level, and poverty are risk factors for young men impregnating adolescent girls, perpetuating a cascade of this problem (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eMeasures to decrease teenage pregnancy rates in Uganda include enacting laws to protect teenagers, ensuring the availability and accessibility of high-quality education, and providing sexual education. Additionally, policies, approaches, awareness campaigns, and educational efforts led by the Ministry of Gender and Labor and Social Development, in collaboration with organizations affiliated with the \"GIRLS NOT BRIDES\" alliance and UN agencies, share a common objective of addressing adolescent childbearing (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eHowever, these efforts have not reduced the teenage pregnancy rates, possibly due to global strategies overwhelmingly focusing on adolescent girls while neglecting the unique prevention needs of young men and the opportunities to engage them as partners in prevention. Young men significantly contribute to conception and play a vital role in the reproductive health outcomes of teenage pregnancies. For instance, male partner involvement in contraceptive decision-making increases the use of effective pregnancy prevention methods (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Therefore, documenting and exploring the role young men play in teenage pregnancies is crucial for reinforcing current interventional efforts.\u003c/p\u003e\u003cp\u003eSince research towards teen pregnancy prevention is biased towards young girls and little is known about the interplay between the characteristics of young men who engage in sex with teenage girls and the occurrence of teenage pregnancy within this risk group, this study aimed to investigate and understand the prevalence and factors associated with impregnating adolescent girls by young men and to explore their life experiences of early fatherhood. The findings from this study will help to focus public attention on young men\u0026rsquo;s involvement in teenage pregnancies and provide baseline information for designing the much-needed interventions targeting men as contributors to the burden of teenage pregnancy.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cb\u003eStudy design and setting\u003c/b\u003e\u003c/p\u003e\u003cp\u003eWe conducted a concurrent mixed methods design for this study as quantitative and qualitative data collection and analyses were done separately during a single phase of the research. The study was conducted in Kampala which is the capital and largest city of Uganda. It is divided into 5 administrative divisions namely; Kawempe division, Nakawa Division, Rubaga Division, Kampala Central Division, and Makindye Division. Kampala is neighboring Mukono district and Lake Victoria in the east, Buikwe in the south, and Wakiso district in the west and north (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). It is estimated to have a population of 1.75\u0026nbsp;million people of which 51% are female and 49% are male, with a diverse ethnic population drawn from all parts of Uganda and a home to many foreigners. The majority of the population works in the informal sector as traders and transportation businesses (taxis and boda-boda) and urban agriculturalists (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cb\u003eStudy Participants and Eligibility\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe study included all young men between 15 to 24 years living in the areas of Kampala who had sexual relationships with adolescent girls including those who were \u0026ldquo;culturally married or cohabiting\u0026rdquo; during the study period and consented to be part of the study. Intoxicated young men including those who had slurred and incoherent speech from alcohol at the time of the interview were excluded. The qualitative arm of the study considered young men who had impregnated an adolescent girl and birthed a baby.\u003c/p\u003e\u003cp\u003e\u003cb\u003eSample Size and Sampling Procedure\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe sample size for the quantitative study was 360 sexually active young men, calculated using the Kish-Leslie (1965) formula for a descriptive objective in a single population proportion. It is given by; n\u0026thinsp;=\u0026thinsp;Z\u003csub\u003eα\u003c/sub\u003e\u003csup\u003e2\u003c/sup\u003e*P (1 - P)/d\u003csup\u003e2\u003c/sup\u003e, where: Z\u003csub\u003eα\u003c/sub\u003e is 1.96, the critical value of 95% level of confidence at \u003cb\u003eα\u003c/b\u003e\u0026thinsp;=\u0026thinsp;0.05; P is the proportion of self-reported impregnating of a teenage girl, assumed to be 0.225, based on a 22.5% prevalence reported in a study in Uganda (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e); d is 0.05 (5%), the margin error of estimation. A multistage mixture of probability and non-probability cluster sampling was utilized, with five parishes selected randomly from each division in Kampala, recruiting 18 young men from each parish.\u003c/p\u003e\u003cp\u003eParticipants were then purposively sampled from the hot spots for young men for instance sports betting parlors, boda boda stages, bars, markets, and churches among others. Qualitatively, the study employed a purposive sampling strategy, and solicitations were made on a personal level within the quantitative sample. Five young men with a known history of impregnating an adolescent girl, resulting in the birth of a baby, were recruited.\u003c/p\u003e\u003cp\u003e\u003cb\u003eData Collection Tools and Procedures\u003c/b\u003e\u003c/p\u003e\u003cp\u003eBefore the study, all research assistants (RAs) participated in a one-day training through the principal investigator (PI) on study procedures, data collection tools, and conducting qualitative interviews. The questionnaire and audio recorders were pretested, and necessary refinements were made to enhance functionality, clarity, and reliability. Upon participants expressing interest in participating, a consent form was read to each participant to ensure comprehension, and allowance was given for all questions and concerns from the participants. A structured questionnaire was used to collect participants\u0026rsquo; socio-demographic, individual factors, interpersonal factors, as well as community factors (see Additional file 1).\u003c/p\u003e\u003cp\u003eQualitative data were gathered using an open-ended in-depth Interview Guide. Participants were contacted via mobile phone to set and confirm appointments the day before, and the interviews took place in a private setting chosen by the interviewees. These interviews were conducted by male research assistants. Anonymity and confidentiality were emphasized, and each interview lasted for about 30 minutes.\u003c/p\u003e\u003cp\u003e\u003cb\u003eStudy Variables\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe dependent variable was self-reported \u0026ldquo;ever impregnated an adolescent girl,\u0026rdquo;. The independent variables included socio-demographic factors such as age, occupation, education level, religion, marital status, alcohol use, and illicit drug use. Behavioral sexual factors comprised age at first sex, number of sexual partners in the last year, lifetime sexual partners, frequency of condom use, having had sex in the last 30 days, condom use at first sex, prevention methods used at last sex, and sex education. Interpersonal variables included peer pressure, parental support, a history of teenage parenthood, father support, and the history of teenage pregnancy in the social network. Community variables included access to information, social norms, cultural beliefs, and religious beliefs.\u003c/p\u003e\u003cp\u003e\u003cb\u003eData analysis and Management\u003c/b\u003e\u003c/p\u003e\u003cp\u003eData were collected using the Kobo Collect mobile app and exported to Microsoft Excel for cleaning. The cleaned data were then exported to Stata Version 14 for analysis. Baseline characteristics were summarized as means with standard deviations, medians, and interquartile ranges for continuous variables, while categorical variables were presented as frequencies and proportions. The prevalence of self-reported ever-impregnating an adolescent was expressed as a percentage of the total sample size. The numerator was the number of young men who reported having ever impregnated an adolescent girl in their lifetime. Modified Poisson regression was utilized to test associations between individual, sexual behavioral, inter-relational, and community factors and the occurrence of ever-impregnating an adolescent girl. Variables with a p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.2 in bivariate analysis and \u0026lt;\u0026thinsp;0.05 in multivariate analysis were considered statistically significant. Results were presented in tables, including both unadjusted and adjusted prevalence ratios with corresponding 95% confidence intervals (CIs).\u003c/p\u003e\u003cp\u003eQualitatively, audio recordings from in-depth interviews were transcribed and translated by a trained qualitative research assistant, while the principal investigator (PI) cross-checked the transcripts for completeness, accuracy, and correctness using field notes and audio recordings. The PI and experienced qualitative research analysts reviewed the transcripts multiple times to identify themes and sub-themes. Data were coded using an inductive thematic approach with Nvivo software, and key themes were reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. To ensure confidentiality, all completed questionnaires, audio recordings, and consent forms were securely stored under lock and key, accessible only to the PI.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 360 sexually active young men in sexual relationships with adolescent girls participated in the study. The mean age of the participants was 20 years (\u0026plusmn;2.4). Most of the young men were single (71.1%), had completed secondary education (48.3%), and did not consume alcohol (64.2%). The average age at their first sexual encounter was 15 years (\u0026plusmn;2).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe majority of the participants reported having multiple sexual partners within a year (80%), using condoms during sexual activity (87.7%), and supporting the idea that adolescent girls should have access to contraceptives (56.6%). However, approximately a quarter of participants had never tested for HIV (26.1%), used condoms at their first sexual encounter (25%), but did not use contraceptives during their last sexual encounter (26.1%).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOver half of the young men disclosed feeling pressure to engage in sexual relations (69.7%), knowing friends who had impregnated an adolescent girl (73.1%), having access to contraceptive information in the community (75.8%), and lacking paternal support (50.6%) (Table 4).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePrevalence Of Ever Impregnating An Adolescent Girl\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOut of 360 sexually active young men, 145 (45.8%) reported to have ever impregnated an adolescent girl. Of those that impregnated, 100(57.6%) became young fathers, 62(35.6%) aborted the pregnancy, while 6.9% did not know the outcome of the pregnancy (fig3). The mean age of impregnating an adolescent girl was 17 years (Table 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003cstrong\u003e;\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eprevalence of impregnating an adolescent girl\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"601\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56.5724%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.1414%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56.5724%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge at impregnating an adolescent girl\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.1414%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56.5724%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.1414%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56.5724%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver impregnated an adolescent girl\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.1414%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56.5724%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e195\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e54.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.1414%;\"\u003e\n \u003cp\u003e49-59.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56.5724%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e165\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e45.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.1414%;\"\u003e\n \u003cp\u003e40.7-51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56.5724%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePregnancy outcome for impregnated teenage girl\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.1414%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56.5724%;\"\u003e\n \u003cp\u003eAbortion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e35.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.1414%;\"\u003e\n \u003cp\u003e28.8- 43.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56.5724%;\"\u003e\n \u003cp\u003eBirthed a baby\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e57.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.1414%;\"\u003e\n \u003cp\u003e49.9-64.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 56.5724%;\"\u003e\n \u003cp\u003eI don\u0026apos;t know outcome of the pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 14.1431%;\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.1414%;\"\u003e\n \u003cp\u003e3.9-11.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eF\u003c/strong\u003e\u003cstrong\u003eactors associated with ever impregnating an adolescent girl\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAt the bivariate level, age, marital status, alcohol use, drug use, condom use at first sexual encounter, number of sexual encounters in the last 1 year, friends impregnating teenagers, and lifetime number of sexual partners were associated with ever impregnated an adolescent girl and further included in the multivariate analysis (Table 2). At multivariate analysis,\u0026nbsp;independent association with ever impregnating an adolescent girl was found with age, where young men aged 18-20 years and 21-24 years were 2.09 times and 2.54 times more likely to ever have impregnated an adolescent girl compared to those aged 15-17, (aPR:1.23, 95%CI:1.11-1.36, p=0.014) and (aPR:1.16, 95%CI:1.05 1.29, p=0.002) respectively. In regards to alcohol consumption, young men who reported alcohol use were 34% more likely to ever have impregnated an adolescent girl compared to those who did not use alcohol, (aPR:1.34, 95% CI:1.8-1.67, p=0.008). Additionally, men who reported to use drugs were 29% more likely to ever have impregnated an adolescent girl compared to those that do not use drugs, (aPR:1.29, 95% CI: 1.04-1.6, p=0.022). Sexually active young men who had 2 to 5 sexual partners in a year were 54% more likely to ever have impregnated an adolescent girl and those that had more than 5 sexual partners in a year were twice as likely to ever have impregnated an adolescent girl, compared to their counterparts with just one sexual partner, (aPR :1.54, 95% CI:1.04-2.3, p=0.033) and (aPR:2, 95%CI:1.33-3.01, p=0.001) respectively (Table 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003cstrong\u003e; Bivariate and multivariate analysis of factors associated with ever impregnating an adolescent girl by a young man\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"102%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEver-impregnating a girl\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 29px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBivariate Analysis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 30px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMultivariate analysis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable name\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ecO.R (C.I)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep value\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdj OR (C.I)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 13px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"bottom\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge in completed years\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e15-17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e39(81.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e9(18.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e18-20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e76(55.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e61(44.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2.37(1.28-4.41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2.09(1.16-3.75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.014\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e21-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e80(45.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e95(54.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2.9(1.58-5.30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2.54(1.43-4.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003eNot married\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e147(57.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e109(42.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003eMarried\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e48(46.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e56(53.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1.26(1.01-1.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAlcohol use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e147(63.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e84(36.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e48(37.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e81(62.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1.73(1.39-2.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1.34(1.8-1.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.008\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDrug use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e165(60.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e106(39.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e30(33.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e59(66.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1.69(1.37-2.09)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1.29(1.04-1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.022\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of sexual partners in the last 1 year\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e51(73.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e18(26.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e2 to 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e122(55.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e98(44.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1.71(1.12-2.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1.54(1.04-2.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.033\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003emore than 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e22(31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e49(69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2.65(1.73-4.06)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2(1.33-3.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"bottom\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCondom use at first sexual encounter\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e133(49.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e137(50.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e62(68.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e28(31.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e0.61(0.44-0.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLifetime number of sexual partners\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e16(76.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e5(23.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e2 to 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e100(73.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e36(26.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1.11(0.49-2.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003emore than 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e79(38.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e124(61.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2.57(1.18-5.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"bottom\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFriends impregnating teenagers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e72(74.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e25(25.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e123(46.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e140(53.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e2.07(1.45-2.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 20px;\"\u003e\n \u003cp\u003e1.73(1.22-2.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 113px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 97px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 114px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 81px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 51px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eLife Experiences Of Early Fatherhood\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe qualitative arm of the study explored\u0026nbsp;lived experiences of fatherhood from the perspective of young men who have fathered children with adolescent girls. This included 5\u0026nbsp;in-depth interviews conducted among 5 young men whose ages\u0026nbsp;varied from 16 to 20.\u0026nbsp;Their responses were categorized into four major themes: perception of early fatherhood, Family and friends support,\u0026nbsp;adjustment, and reforming\u0026nbsp;with each theme containing sub-themes and supporting testimonies\u0026nbsp;(Table 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003cstrong\u003e; Thematic Presentation of life experiences of early fatherhood\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"652\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eTHEME\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 170px;\"\u003e\n \u003cp\u003eSUBTHEME\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 350px;\"\u003e\n \u003cp\u003eCODE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eTHEME 1:\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ePerception of early fatherhood\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 170px;\"\u003e\n \u003cp\u003eFear of pregnancy and early fatherhood.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 350px;\"\u003e\n \u003cp\u003e\u0026ldquo;When she told me she was pregnant, I was scared especially because of the responsibility that came with it since I had never dealt with such circumstances. I wanted her to have an abortion because I could not afford to take care of a child but she insisted on having the baby.\u0026rdquo; [Cohabiting, 20years]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 170px;\"\u003e\n \u003cp\u003efatherly duties\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 350px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026ldquo;I was happy but I also cried because my child was born when I was not in hospital with them because I had to be at work looking for money.\u0026rdquo; [Single 2,16years]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eTHEME 2:\u003c/p\u003e\n \u003cp\u003eFamily and friends\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 170px;\"\u003e\n \u003cp\u003emoral and emotional support\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 350px;\"\u003e\n \u003cp\u003e\u0026ldquo;I talked to my parents, who then talked to her parents to inform them about what was going on. Both sets of parents were understanding and she carried the pregnancy to term.\u0026rdquo; [Single 1, 16years]\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 170px;\"\u003e\n \u003cp\u003eraising the child\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 350px;\"\u003e\n \u003cp\u003e\u0026nbsp;Single, 19years \u003cem\u003e\u0026ldquo;\u003c/em\u003eI took the child to my mother since I also couldn\u0026rsquo;t stay with and take proper care of him all the time. My mother has done a good job of taking care of him and everyone appreciates\u003cem\u003e.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eTHEME 3:\u003c/p\u003e\n \u003cp\u003eAdjustment to early fatherhood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 170px;\"\u003e\n \u003cp\u003efinances and employment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 350px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026ldquo;I was now working and doing casual labor activities like digging in people\u0026rsquo;s farms to earn a living.\u0026rdquo; [Single,17years]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;dropping out of school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 350px;\"\u003e\n \u003cp\u003e\u0026ldquo;I dropped out of school when I became a father because I had to fend for my child and take on my responsibility.\u0026rdquo; [Single, 16years]\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 132px;\"\u003e\n \u003cp\u003eTHEME 4:\u003c/p\u003e\n \u003cp\u003eReforming\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 170px;\"\u003e\n \u003cp\u003ecriminal activity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 350px;\"\u003e\n \u003cp\u003e\u0026ldquo;Being banished from the village really helped me because it pushed me to move to the city. I didn\u0026rsquo;t know anyone in the city but I had to come to look for a better life. I stopped committing robbery and I also became a Christian and changed my ways.\u0026rdquo; [Single,17years]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 170px;\"\u003e\n \u003cp\u003econtraceptive use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 350px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026ldquo;I do not use them but I think my woman uses family planning. She first resisted its use and as a result our second child was unexpected. But she\u0026rsquo;s probably using family [single, 17years]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003ePerception of early fatherhood\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe young men had an inherent \u0026ldquo;fear\u0026rdquo; of impregnating an adolescent girl and were not ready to become fathers. This fear was not only due to the financial responsibilities but also the stigma, societal perceptions and stereotypes associated with impregnating an adolescent. For example;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;When she told me she was pregnant, I was scared especially because of the responsibility that came with it since I had never dealt with such circumstances. I wanted her to have an abortion because I could not afford to take care of a child but she insisted on having the baby.\u0026rdquo;\u003c/em\u003e [Cohabiting, 20years] \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDespite the fear and uncertainty of early fatherhood due to its inevitable challenges, the young men were happy to be called \u0026ldquo;father\u0026rdquo; after the baby was born. Infact, the men decidedly chose to take responsibility of the expectant mother and baby. However, due to societal perceptions associated with fatherhood, the young men also believed that fatherhood meant financial responsibility. For instance, Participant Cohabiting, 20years said,\u0026nbsp;\u003cem\u003e\u0026ldquo;I was very happy, although I also realized that it came with financial implications.\u0026rdquo;\u003c/em\u003e While participant\u0026nbsp;Single 2,16years\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003cem\u003e\u0026ldquo;I was happy but I also cried because my child was born when I was not in hospital with them because I had to be at work looking for money.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFamily and friends\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDue to societal perceptions and stereotypes associated with impregnating an adolescent, the young men initially feared their parents\u0026rsquo; and friends\u0026rsquo; reactions. Despite the disappointment and anger they expressed, the\u0026nbsp;parents and friends provided emotional and moral\u0026nbsp;support for their expectant sons to help them cope with the challenges of pregnancy and fatherhood. For example;\u003c/p\u003e\n\u003cp\u003eParticipant Single 2, 16 years said,\u0026nbsp;\u003cem\u003e\u0026ldquo;Her parents considered arresting me, but my mother managed to talk them out of it because we came from a very humble background since my father passed on when I was 7 years old. The girl\u0026rsquo;s parents calmed down since I had not denied the pregnancy and I had agreed to take on the responsibility.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAdditionally, four of the young men reported that they sent their children to stay with their parents who took on the responsibility to raise their grandchildren. For instance, Participant Single, 19years\u0026nbsp;\u003cem\u003e\u0026ldquo;I took the child to my mother since I also couldn\u0026rsquo;t stay with and take proper care of him all the time. My mother has done a good job of taking care of him and everyone appreciates.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAdjustment to early fatherhood\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUnplanned early fatherhood drastically transformed the young men\u0026rsquo;s lifestyle trajectories towards education, finances, employment and social life in order to meet their responsibilities as fathers and \u0026ldquo;husbands\u0026rdquo;. The young men who had been fully dependent on their parents for all their livelihoods including food, shelter, and all financial provisions had got the same responsibility and had to immediately find ways to support the mother and baby. For example; participant Single,17years said, \u0026ldquo;\u003cem\u003eI was now working and doing casual labor activities like digging in people\u0026rsquo;s farms to earn a living.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn order to fend for the expecting mother and the child, the four young men who were attaining an education made a difficult decision to drop out of school. Such a decision was made to enable them have extra time to work in turn increase their earnings. For example, participant Single, 17years shared that \u003cem\u003e\u0026ldquo;I dropped out of school when I became a father because I had to fend for my child and take on my responsibility\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eHowever, despite their new found time consuming responsibilities and the negative societal perception challenges, these young men were determined to resume school and get an education or even to attain a new skill.\u0026nbsp;For instance;\u0026nbsp;Single, 19years said that, \u003cem\u003e\u0026ldquo;Although I put my studies on hold up to now, but I intend to resume in the future and go to university.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eReforming\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFatherhood also became a period of reformation. Choices and lifestyles had to be adjusted for the young fathers to meet their new responsibilities. The young men reported that the birth of their babies inspired them to be better fathers as their actions directly affected the wellbeing of their families. Therefore, they had to reform and distance themselves from friends who were involved in the criminal activities. For example; Participant Cohabiting,20 years said,\u0026nbsp;\u003cem\u003e\u0026ldquo;I stopped robbery, and I also had to mature mentally. I had to distance myself from the groups I used to hang out with and fend for my child. This happened particularly when I was arrested along with my friends who had murdered someone they were trying to rob. I had to leave my pregnant girlfriend alone in the house for a week. I cried and after I was released, I had to be a better person. I no longer deal with those friends of mine who are still robbers.\u0026rdquo;\u003c/em\u003e\u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSince the young men believed that they impregnated the young girls following inconsistent contraceptive use, they reported consistent condom use because they were not ready for another unplanned pregnancy. Those that didn\u0026rsquo;t use condoms reported that their girlfriends use other contraceptive methods. Participant single, 17years said, \u003cem\u003e\u0026ldquo;I do not use them but I think my woman uses family planning. She first resisted its use and as a result our second child was unexpected. But she\u0026rsquo;s probably using family planning now.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e\u003cb\u003ePrevalence of ever impregnating an adolescent girl\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe prevalence of ever impregnating a girl was 46% which was higher compared to findings from studies conducted in sub-Saharan Africa. For instance, a survey conducted in Namibia by Mogotsi and Mwetulundila (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) found that 31.4% of 685 young men aged 15 to 22 years had impregnated an adolescent girl. De Wet, Amoo (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e) also found that over 22.5% of the young men had ever impregnated an adolescent girl. This high prevalence of impregnating adolescent girls might be attributed to low or inconsistent contraceptive use among these sexually active young men. Myths, cultural and religious beliefs, also influence this poor contraceptive uptake. For instance, in this study, the majority of the sexually active young men reported their religions and cultures do not permit the use of contraceptives, which are a cornerstone for pregnancy prevention.\u003c/p\u003e\u003cp\u003eSexually active young men who reported condom use were 71% less likely to impregnate an adolescent girl compared to those who did not. In this study, the median age at first sexual encounter among the young men in the study was 15 years. This age is 3 years lower than the findings from the country-wide survey of 18.5 as stated in the UDHS (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Early age for sexual exposure and exploration directly puts these young men at a higher risk of impregnating adolescent girls. Previous studies have found that the earlier a young man starts to have sexual intercourse, the more likely he will impregnate an adolescent girl (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThis study found that the average age a young man reported impregnating an adolescent girl was 17 years. This age at impregnation is markedly lower than that in previous studies. For instance, a study by Mogotsi and Mwetulundila (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) found that the 20 to 22-year age group of young men had impregnated 41.0% of adolescent girls. The lower age at impregnating an adolescent in Kampala could have arisen from the early age of sexual debut, lack of sexual education, and poor knowledge about contraceptive use.\u003c/p\u003e\u003cp\u003e\u003cb\u003eFactors associated with ever impregnating an adolescent girl\u003c/b\u003e\u003c/p\u003e\u003cp\u003eIn this study, older age (19 to 24 years) put young men at higher risk for impregnating an adolescent girl compared to their younger counterparts. This finding is consistent with findings from other studies. For instance, a cross-sectional study conducted among 685 male youths aged between 15 to 22 years residing in urban and rural areas in Namibia, Mogotsi and Mwetulundila (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) found that the 20 to 22-year age group had impregnated 41.0% of teen girls in the study compared to 19.2% and 23.5% of the age groups 15 to 16 years and 17 to 19 years respectively. This age disparity could have placed young girls in a position of vulnerability to sexual coercion or hindered their ability to negotiate safer sexual practices, thereby increasing their risk of becoming pregnant.\u003c/p\u003e\u003cp\u003eThis study also found that young men who used alcohol were 34% more likely to impregnate adolescent girls in comparison to those who refrained from alcohol use. A meta-analysis of 50 studies involving 465,595 adolescents indicated that alcohol consumption was significantly associated with risky sexual behaviors including early sexual initiation, inconsistent condom use, and multiple sexual partners among others (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). These behaviors significantly increase the likelihood of unintended adolescent pregnancies. Another study highlighted that binge drinkers have a five-fold increased risk of becoming pregnant or impregnating someone compared to non-drinkers. The prevalence of pregnancy among binge drinkers was as high as 23.9%, highlighting the direct link between alcohol consumption and unintended pregnancies (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAdditionally, the study found that young men whose friends had impregnated adolescent girls were most likely to also impregnate an adolescent. This could possibly be because people within the same social network exhibit the same social behaviors (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). A study conducted in Mbarara Municipality, Uganda, found that negative peer interactions and unhealthy friendships among adolescents increased the likelihood of teenage pregnancy (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). A qualitative design that explored masculine discourses among boys, such as the belief that \"you are not a real man until you have scored,\" reinforces peer pressure to impregnate adolescent girls. This study involved 42 male learners and revealed that many of the participants felt that having unprotected sex enabled them to impregnate girls, thereby demonstrating their masculine identity (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). This social norm within peer groups encourages young men to engage in sexual activity and fatherhood as a marker of masculinity, further supporting the link between friends' behaviours and individual actions.\u003c/p\u003e\u003cp\u003eThe study also found that young men who had more than one sexual partner were more likely to impregnate an adolescent girl compared to those who had one sexual partner. This finding is similar to those from other studies. For instance, (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e) found that respondents with two or more lifetime sexual partners were more likely to impregnate a girl than those with only one partner. A case-control study of teenage girls (aged 13\u0026ndash;19 years) in Lira District, Uganda, found that behavioural factors such as having multiple sexual partners, frequent sexual activity, and irregular contraceptive use were significant predictors of teenage pregnancy (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). This indicates that multiple sexual partnerships among young men contribute to higher rates of adolescent pregnancies.\u003c/p\u003e\u003cp\u003eThe study also found drug use to be significantly associated with ever-impregnating an adolescent. For instance, Holmberg and Berg-Kelly (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) not only found that young males who had impregnated teen girls used illicit drugs, and smoked cigarettes but also found that impregnation occurred more among young men who often used the drugs compared to those who seldom used the drugs.\u003c/p\u003e\u003cp\u003e\u003cb\u003eLife experiences of early fatherhood.\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe young men reported that they had an inherent fear of impregnating their girlfriends and were shocked at the revelation as they were not ready to become fathers. However, despite the fear of challenges associated with impregnating a girl and early pregnancy, these young men inconsistently used condoms. Previous studies have shown that most young men have sexual intercourse for pleasure, and they believe the responsibility for contraceptive use lies solely on the girls which in turn leads to inconsistent use of condoms and other contraceptives, leading to unplanned pregnancies (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAdditionally, the young men in the study reported financial hardships as they were minors with low educational attainment and lacked work skills. Since the young men were obligated to provide for their expecting girlfriends and prepare for the baby\u0026rsquo;s birth, they sought low-income, casual jobs, while others resorted to theft, which led them to prison. These findings align with previous studies that explored the lived experiences of young fathers, indicating that they suffered financial difficulties due to low educational attainment, a lack of work skills, and experience necessary to sustain formal employment, which limited their job opportunities (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn this study, family and friends were crucial in helping these young men cope with the transition to fatherhood. The study found that the boys\u0026rsquo; parents facilitated talks with the girls\u0026rsquo; families, and their families also took care of the baby after birth, which lessened the burden of new responsibilities for the young men. This finding is consistent with other research indicating that family support plays a vital role in the early transition to fatherhood (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). However, although family support positively impacts these young fathers, it holds some negative consequences where other young men may follow in the same footsteps with the hope of support from their family, which in turn perpetuates adolescent pregnancy.\u003c/p\u003e\u003cp\u003eFurthermore, the young men in the study reported experiencing stigma from peers at school, at home, and in the community, which subsequently led to school dropouts, fleeing the village, and social exclusion. In fact, previous studies have found that young fathers face stereotypes that label them as predators, absent, and selfish, which negatively impact their relationships with both the mother and the child (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). This not only demotivates the young father but can also lead to absence from their baby\u0026rsquo;s life.\u003c/p\u003e\u003cp\u003e\u003cb\u003eStrengths and limitations\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe study used both qualitative and quantitative methods, which allowed a deeper understanding of the role of young men in adolescent pregnancy. Additionally, this is the first study in Kampala and Uganda at large to assess the sexually active young men\u0026rsquo;s role in adolescent pregnancies and their experience of early fatherhood. However, the dependent variable of the study which was \u0026ldquo;ever impregnating an adolescent girl\u0026rdquo; was self-reported which made it prone to social desirability bias which could have led to under/over-reporting of sexual lifestyles.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusions and recommendations\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe prevalence of \u0026ldquo;ever impregnating an adolescent girl\u0026rdquo; by a sexually active young man in Kampala city, Uganda, is high and is associated with factors such as older age, drug use, peer influence and multiple sexual partners. To address this, it is essential to provide accessible and youth-friendly healthcare services, including counselling on responsible sexual behaviour and family planning. Integrating comprehensive sex education into the school curriculum can further empower students with knowledge about healthy relationships, contraception, and the consequences of early parenthood, thereby reducing risky sexual behavior. Additionally, establishing community centers or support groups for young men can offer much-needed guidance and psychosocial support to help them navigate personal challenges and make informed life choices.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eCSE\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eComprehensive Sexual Education\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eHIV\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eHuman Immunodeficiency Virus\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMOGLSD\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMinistry of Gender, Labor and Social Development\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eNSCN\u0026amp;TP\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eUganda National Strategy on Ending Child Marriage and Teenage Pregnancy\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eSRH\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eSexual Reproductive Health\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eTPR\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eTeenage Pregnancy Rate\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eUNICEF\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eUnited Nations Children\u0026rsquo;s Fund\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eWorld Health Organization\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval\u003c/strong\u003e\u003cp\u003e Ethics approval and consent to participate were received from the Makerere University School of Public Health Research Ethics Committee (REC) under protocol number 056. Administrative clearance was obtained from the KCCA\u0026rsquo;s Director of Health Services. Written informed consent of eligible participants was obtained, and assent was sought for those who were below 18 years before enrolment into the study. Parental consent was waived for this study because all participants were considered emancipated minors able to provide their consent as directed by the Uganda National Council of Science and Technology.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003ch2\u003eClinical Trial Number\u003c/h2\u003e\u003cp\u003eNot applicable\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003ch2\u003eConsent for publication\u003c/h2\u003e\u003cp\u003eNot applicable\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003ch2\u003eCompeting interests\u003c/h2\u003e\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eNo funding\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eDM conceived the idea, designed the study, recruited participants, and collected the data. LN, SPK, JK, and JB reviewed the protocol. DM, NM, AB, CN, and VM analyzed the data. All authors reviewed the tables of results. KN, NM, AB, LN, and DM wrote the first draft of the manuscript. All authors reviewed and approved the final draft of the manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe KCCA\u0026rsquo;s Director of Health Services permitted the study in Kampala. My sincere appreciation goes out to the division medical officers and my research assistants for their support in participant recruitment and data collection.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eUNFPA. ADOLESCENT PREGNANCY: A Review of the Evidence. 2013.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eACERWC ACoEotRaWotC. 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A Case Study of Mbarara Municipality, Uganda.; 2021.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShikukutu F, Ramrathan P. You Can\u0026rsquo;t Be in Grade 12 and Don`T Have a Kid`. Boys\u0026rsquo; Masculine Conversations Towards Impregnating in Namibian Schools: A Case Study of the Kavango East Region. Med Res Archives. 2022;10.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHolmberg L, Berg-Kelly K. Health, health-compromising behaviour, sexuality and involvement in pregnancy among 18-year-old Swedish males: a cross-sectional survey. Acta paediatrica (Oslo, Norway: 1992). 2002;91(7):838\u0026thinsp;\u0026ndash;\u0026thinsp;43.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMadlala ST, Sibiya MN, Ngxongo TS. Perceptions of young men at the Free State School of Nursing with regards to teenage pregnancy. Afr J Prim Health Care Family Med. 2018;10(1):1\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAssini-Meytin LC, Green KMJJAH. Long-term consequences of adolescent parenthood among African-American urban youth: A propensity score matching approach. 2015;56(5):529\u0026ndash;35.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCousins JM. THE LIVED EXPERIENCE OF ADOLESCENT FATHERHOOD. 2011.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWeber JB. Becoming teen fathers: Stories of teen pregnancy, responsibility, and masculinity. Gend Soc. 2012;26(6):900\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAdditional. file 1 (.docx): QUESTIONNAIRE FOR THE PREVALENCE AND FACTORS ASSOCIATED WITH ADOLESCENT PREGNANCY BY A YOUNG MAN IN KAMPALA.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eThis document contains the. questions that were developed and used for this study to answer objectives 1 and 2.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Adolescent pregnancy, young men, fatherhood, risk factors, Uganda","lastPublishedDoi":"10.21203/rs.3.rs-7111985/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7111985/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eAdolescent pregnancy remains a significant public health challenge in sub-Saharan Africa with approximately 7.3\u0026nbsp;million girls becoming pregnant before the age of 18 annually, a number projected to reach 86\u0026nbsp;million by 2030. In Uganda, 25% of teenagers become pregnant by age 19, despite declining fertility rates among women aged 15 to 19. The role of young men in adolescent pregnancies remains understudied, with most research focusing on girls. This study assessed the prevalence, associated factors, and lived experiences of early fatherhood among young men (15\u0026ndash;24 years) in Kampala, Uganda.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA descriptive cross-sectional study design employing mixed methods was conducted among 360 sexually active young men in relationships with adolescent girls in Kampala. Data on sexual behavior, inter-relational factors, and community data were collected using a pre-tested questionnaire uploaded on the Kobo Collect app. In-depth interviews explored the lived experiences of early fatherhood. Poisson regression analysis was used to assess factors associated with ever impregnating an adolescent, while content analysis was used for qualitative data.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe mean age of participants was 20 (\u0026plusmn;\u0026thinsp;2.4) years, and the mean age at first sexual encounter was 15 (\u0026plusmn;\u0026thinsp;2) years. The prevalence of ever impregnating an adolescent girl was 45.8% (95%CI: 40.7\u0026ndash;51), with 62 (35.6%) of these pregnancies being aborted. The mean age at impregnating an adolescent girl was 17 years (SD 1.6). Factors associated with ever impregnating an adolescent were older age (aPR: 2.09 (1.16 3.75) 2.54(1.43 4.54)), alcohol use (aPR: 1.34 (1.8 1.67)), drug use (aPR: 1.29 (1.04 1.6)), having friends who had ever impregnated an adolescent girl (aPR: 1.73 (1.22 2.45)), and having more than one sexual partner in a year (aPR: 1.54 (1.04 2.3). Qualitative findings revealed four key themes: perception of early fatherhood, support from family and friends, adjustment to fatherhood, and reforming.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eNearly half of sexually active young men in Kampala have ever impregnated an adolescent girl. Young fathers often face unpreparedness, financial stress, school dropout, and social stigma. Interventions targeting young men, focusing on behavior change, peer education, and reproductive health services, are essential to address adolescent pregnancy effectively.\u003c/p\u003e","manuscriptTitle":"Prevalence and factors associated with having ever impregnated a teenage girl among young men (15-24 years) in Kampala and their early fatherhood experiences","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-05 14:14:33","doi":"10.21203/rs.3.rs-7111985/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2025-08-29T13:59:19+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-28T05:10:54+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-08-04T18:39:09+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-01T07:04:08+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-08-01T07:00:39+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b2762ee6-7f5a-4b1f-b915-df295c2e34b3","owner":[],"postedDate":"September 5th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-09-05T14:14:33+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-05 14:14:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7111985","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7111985","identity":"rs-7111985","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}