Sexual violence as a predictor of unintended pregnancy, contraceptive use, and unmet need among female youth in Colombia.

AIMS Violence against women is an important risk factor for unintended pregnancy and contraceptive use, although less is known about this relationship among youth. This study aims to investigate linkages between sexual violence and unintended pregnancy among Colombian female youth (aged 13-24). METHODS Using the nationally representative Colombian Demographic and Health Survey (2005), the association of sexual violence with unintended pregnancy, current modern contraceptive use, and unmet need for contraception is examined using Pearson's chi-square tests and logistic regression models. RESULTS Of female youth who have been pregnant in the past 5 years, 13% report experiencing sexual violence during their lifetimes, with 6% reporting sexual violence perpetrated by a spouse or partner and 8% by someone else. Among female youth at risk of unintended pregnancy, sexual violence is reported by 11%. About 5% of these female youth report sexual violence from a spouse or partner, and 7% report being forced to have sex with someone else. In cross-tabulations, female youth who have experienced sexual violence report significantly higher levels of unintended pregnancy and unmet need for contraception and lower levels of current modern contraceptive use compared to those who have not experienced sexual violence. In multivariate logistic regression models, sexual violence is associated with increased risk for unintended pregnancy (adjusted odds ratio [AOR] 1.4, 95% confidence interval [CI] 1.1-1.8), unmet need for contraception (AOR 1.5, 95% CI 1.1-2.0), and decreased likelihood of current contraceptive use (AOR 0.8, 95% CI 0.6-1.0). CONCLUSIONS This analysis indicates that sexual violence is pervasive in Colombia and is consistently linked to increased risk of unintended pregnancy among female youth. Because youth are particularly vulnerable to sexual violence and may have difficulty accessing services, preventive efforts and clinical responses should be specifically crafted to curb violence against young women as well as reduce the longitudinal impact of experiencing sexual violence.