Significant numbers of adolescents in Zimbabwe do not have access to the essential sexual and reproductive health information and services they need to protect themselves from HIV and prevent pregnancy. A new report released today, "Sexual and Reproductive Health Needs of Adolescents in Zimbabwe," by the Centre for Population Studies at the University of Zimbabwe and the New York‒based Guttmacher Institute, finds that fewer than half of all 15‒19-year-olds have comprehensive knowledge about HIV and AIDS, and one-third of all births to adolescents are unplanned.

The report analyzed data from three recent Zimbabwe Demographic and Health Surveys to identify levels of and trends in the need for sexual and reproductive health education and services among adolescents. Single, sexually active adolescents have by far the greatest unmet need for contraception—62% as of 2011, compared with 19% of their married counterparts.

According to the findings, the previous trend of rising use of modern contraceptives in urban areas has reversed, likely because of Zimbabwe’s economic crisis in 2008. Modern contraceptive use among married adolescents declined in urban areas (from 50% in 2006 to 29% in 2011), even as it increased in rural areas (from 30% to 37%). Trends in unmet need for contraception were similar: In urban areas, the proportion of married adolescents who wanted to postpone childbearing but were not using a method doubled between 2006 and 2011 (from 14% to 28%), while among their rural counterparts, unmet need fell from 20% to 15% over this period.

Despite a significant reduction in overall HIV prevalence, HIV infection remains higher among women (6.3%) than among men (3.9%) aged 15‒24. Furthermore, just one-third of single 15‒19-year-old women who reported having had sex in the past year used a condom with their most recent partner. The comparable proportion among adolescent males, regardless of marital status, was nearly twice as high. Not surprisingly, a far lower proportion of female than of male adolescents said they can get a condom on their own (28% vs. 62%).

"These findings are critical in informing policies and programs that best serve adolescents’ needs. Young people’s actions and experiences will determine our nation’s future," said coauthor Marvelous Mhloyi, of the Centre for Population Studies. "Protecting adolescents from unintended pregnancy and HIV infection is critical not just to their own well-being but also to fulfilling Zimbabwe’s long-term development goals."

The authors recommend steps that can be taken to eliminate barriers that prevent adolescents from accessing the information and services they need to protect their health. They note that outreach to health care providers is critical to dispel the widely held misperception that parental or spousal consent is required before providing adolescents with family planning and HIV services. They also recommend that providers be trained on the importance of maintaining confidentiality and having nonjudgmental attitudes. Moreover, the authors note that greater efforts are needed to keep adolescent girls in school as long as possible, as education is linked to better health outcomes and improved future prospects.