The unintended consequences of intended pregnancies: youth, condom use, and HIV transmission in Mozambique.

Although unwanted pregnancies can cause social and economic problems for Sub-Saharan African youth, the consequences of intended adolescent pregnancies have gone unnoticed. Rarely do studies recognize that youth who desire a pregnancy are less likely to practice safe sex and, therefore, are at greater risk of contracting sexually transmitted infections (STIs), including HIV. This study uses data from the 2003 Mozambique Demographic and Health Survey to explore youth fertility desires and condom use. In multivariate analyses, controlling for other factors associated with condom use, female youth who want to get pregnant soon are significantly less likely (odds ratio: 0.35; 95% confidence interval: 0.22-0.55) to use condoms with nonmarital partners than youth who want to delay childbearing. Programs for sexually active youth should recognize the importance of fertility desires as a potential moderator of condom use, even if the woman is at risk of HIV or STI. Recommendations are provided for HIV prevention counseling for youth who want to get pregnant and youth who are ambivalent about a future pregnancy.