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Table 1 Example of coding process and data synthesis of the perceptions of contraception services among AGYW who were recipients of a combination HIV prevention intervention in five districts of South Africa

From: Perceptions of contraception services among recipients of a combination HIV-prevention interventions for adolescent girls and young women in South Africa: a qualitative study

Quote (meaning unit)

Theme

Sub-theme

aSEM level

Contraceptives are very important you see…Because if you don’t use contraceptives you may fall pregnant

Importance of using contraceptives

Perceived benefits of contraceptive use

Intrapersonal

It is important because what if you get raped while walking, get kidnapped and raped, there is a difference in what happens because you will be safe from being pregnant even though you can have STI’s and HIV

  

Intrapersonal

Interpersonal

Contextual

I have some information. I also get from LO [Life Orientation] however it is not enough I still need some more information, for example, I don’t know the different types of contraceptives and how they work on your body

Barriers to contraceptive access and use

Lack of information

intrapersonal

To be honest, we are not sure but we know that the injection can prevent you from being pregnant, we don’t have much knowledge about the other issues like the fact that it makes your body to hang, the gaining of weight, and the issue of being wet

  

Intrapersonal

Interpersonal

The clinic is far…sometimes you don’t get assisted if you go after school, and then you have to go the next day and be absent at school

 

Facility distance

Health services

Structural/ environmental

The needle makes other people gain weight, it makes others lose weight. Out there people will start to gossip about you and say you have AIDS, you have TB you are sick and stuff

 

Myths and Misconception

Interpersonal

Contextual

Some clinics can be frustrating like you would go to a clinic for contraception, the nurses will start asking all sorts of question; why are you here? Young as you are! Do you have a boyfriend? And because of these questions and that you feel embarrassed you end up leaving without accessing the services

 

Provider attitude

Health services

My boyfriend doesn’t know that I am on contraceptives I hide it from him, because if he found out, I don’t know what would happen because he doesn’t approve of me taking the injection

 

Lack of male partner support

Interpersonal

I don’t think my mother would understand if I talk about going to prevent (family planning). She would think that I’m planning to have sex or that I have slept with a boy that’s why I want to go prevent or if I want to check for HIV she’d think that I’ve had sex with a boy

 

Lack of parental support

Interpersonal

Contextual

For most of us here we live nearby so the day hospital is a walking distance so its easy for us to get condoms and family planning and its free also

Factors enabling access

Clinic/ service provider proximity

Health services

I talk to my mom, she even reminds me of the next visit date for family planning, and she tells me that just because I have my first child

 

Parental/caregiver support

Interpersonal

He also tells me that I have to prevent because I am in school. I cannot afford another child. My future will get ruined if I am busy having children. I have to prevent.

 

Male partner support

Interpersonal

But as for me, there was a time when I was using tablets… Then 1 day when I went to the clinic to fetch them, the nurse told me that an injection is much better than tablets because with tablets, you are expected to drink them everyday… But, with injection, when you use it, you are again expected to come after 3 months for a repeat… So, she discussed it with me and made me to understand the difference between the injection and the tablet, unlike other nurses who do not have time to explain, they just give you what you said you wanted.

 

Provider positive attitude

Health services

Like contraceptive, I did not know the different types but now I have a little bit of knowledge about them

Influence of the intervention

Gained information

Intrapersonal

At first, we were using only condom, but after we joined Rise [Rise Club] they said things like preventing, which is good... for me not to be pregnant. So now I know when I have to have sex, I must use a condom so to protect myself and prevent [using contraceptives]

  

Intrapersonal

Interpersonal

I think it has changed my life because my mom did not want me to prevent, so I joined Rise [Rise Club] and explained to her what they told us there. So she let’s me prevent now

 

Parental support

Interpersonal

  1. aSEM Socio-ecological model