Abortion and contraceptive use stigma: a cross-sectional study of attitudes and beliefs in secondary school students in western Kenya

Figures & data

Table 1. Characteristics of respondents by gender

Characteristic	Female		Male		Total		P-value^c
	n	(%)	N	(%)	n	(%)
Age (13–21)	618	(51.2)	582	(48.2)	1200	(99.4)
13–15	151	(24.6)	122	(21.2)	273	(23.0)	.001
16–17	322	(52.5)	267	(46.4)	589	(49.5)
18–21	140	(22.8)	187	(32.5)	327	(27.5)
Initiated sexual intercourse
Age 13–15	5	–	9	–	14	–
16–17	30	(48.4)	58	(49.2)	88	(15.3)
18–21	27	(43.5)	51	(43.2)	78	(24.5)
Used contraceptives at last intercourse
Age 13–15	4	–	7	–	11	–
16–17	25	(83.3)	45	(77.6)	70	(79.5)
18–21	26	(96.3)	41	(80.4)	67	(85.9)

^aThe analysis is based on respondents to all questions in the table.

^bThe internal drop-out range between 7–33 (0.6–2.7%).

^cPearson’s χ² test was used and the significance level was set at p < .05

Table 2. Frequency distribution of answers given to the questionnaire with ASABA scale

ASABA scale items		4) Agree and 5) strongly agree		3) Not sure		1) Strongly disagree and 2) disagree		Mean	SD	N	Missing
		n	(%)	n	(%)	n	(%)				n	(%)
1.	A girl who has an induced abortion is committing a sin	1085	(89.9)	24	(2)	98	(8.1)	4.48	1.07	1207	0	(0)
2.	Once a girl has one abortion, she will make it a habit	625	(51.8)	235	(19.5)	341	(28.3)	3.35	1.32	1201	6	(0.5)
3.	A girl who has an abortion cannot be trusted	456	(37.8)	183	(15.2)	563	(46.6)	2.90	1.41	1202	5	(0.4)
4.	A girl who has an abortion brings shame to her family	886	(73.4)	92	(7.6)	221	(18.3)	3.89	1.28	1199	8	(0.7)
5.	The health of a girl who has an abortion is never as good as it was before the abortion	823	(68.2)	132	(10.9)	247	(20.5)	3.79	1.34	1202	5	(0.4)
6.	A girl who has had an abortion might be a bad influence on other women	651	(53.9)	141	(11.7)	408	(33.8)	3.28	1.43	1200	7	(0.6)
7.	A girl who has an abortion will be a bad mother	273	(22.6)	238	(19.7)	693	(57.4)	2.50	1.32	1204	3	(0.2)
8.	A girl who has an abortion brings shame to her community	694	(57.5)	165	(13.7)	345	(28.6)	3.48	1.39	1204	3	(0.2)
9.	A girl who has had an abortion should be prohibited from going to religious services	56	(4.6)	39	(3.2)	1103	(91.4)	1.51	0.86	1198	9	(0.7)
10.	A girl who has had an abortion should be teased so that she will be ashamed about her decision	199	(16.5)	110	(9.1)	890	(73.7)	2.08	1.24	1199	8	(0.7)
11.	A girl should be disgraced in my community if she has had an abortion	136	(11.3)	156	(12.9)	903	(74.8)	1.99	1.11	1195	12	(1.0)
12.	A man should not marry a woman who has had an abortion	153	(12.7)	155	(12.8)	892	(73.9)	2.05	1.18	1200	7	(0.6)
13.	A girl who has had an abortion should no longer be associated with	122	(10.1)	85	(7)	993	(82.3)	1.84	1.08	1200	7	(0.6)
14.	A girl who had an abortion should be pointed fingers at so that other people would know what she has done	116	(9.6)	68	(5.6)	1015	(84.1)	1.74	1.05	1199	8	(0.7)
15.	A girl who has an abortion should not be treated the same as everyone else	110	(9.1)	54	(4.5)	1035	(85.7)	1.72	1.07	1199	8	(0.7)
16.	A girl who has had an abortion can make other people fall ill or get sick	90	(7.5)	93	(7.7)	1017	(84.3)	1.64	1.02	1200	7	(0.6)
17.	A girl who has had an abortion should be isolated from other people in the community for at least 4 weeks after having an abortion	136	(11.3)	225	(18.6)	839	(69.5)	2.09	1.12	1200	7	(0.6)
18.	If a boy has sex with a girl who has had an abortion, he will most likely become infected with a disease	108	(8.9)	248	(20.5)	844	(69.9)	1.95	1.14	1200	7	(0.6)

^aThe analysis is based on respondents to all questions in the table.

^bThe internal drop-out range between 0 and 12 (0–1.0%).

Table 3. Frequency distribution of answers given to the questionnaire with CUS scale

CUS scale items		4) Agree and 5) strongly agree		3) Not sure		1) Strongly disagree and 2) disagree		Mean	SD	N	Missing
		n	(%)	n	(%)	n	(%)				n	(%)
1.	A girl who uses a contraceptive method is promiscuous	492	(40.8)	262	(21.7)	433	(35.9)	3.08	1.42	1187	20	(1.7)
2.	A girl who uses a contraceptive method will encourage others to be promiscuous	566	(46.9)	197	(16.3)	430	(35.6)	3.15	1.40	1193	14	(1.2)
3.	A girl cannot decide for herself if to use a contraceptive method	220	(18.2)	244	(20.2)	723	(59.9)	2.37	1.26	1187	20	(1.7)
4.	A married woman is more deserving of a contraceptive method than an unmarried woman	320	(26.5)	240	(19.9)	632	(52.4)	2.59	1.36	1192	15	(1.2)
5.	A girl who uses contraceptives will have problem when she decides to get pregnant	544	(45.1)	240	(19.9)	400	(33.1)	3.18	1.45	1184	23	(1.9)
6.	A girl who carries condoms is likely to have many sexual partners	447	(37.0)	191	(15.8)	552	(45.7)	2.86	1.49	1190	17	(1.4)
7.	A girl should not insist to use a condom, it is the man to decide whether to use a condom or not	129	(10.7)	120	(9.9)	944	(78.2)	1.80	1.18	1193	14	(1.2)

^aThe analysis is based on respondents who responded to all items in the table.

^bThe internal drop-out range between 14 and 23 (1.2–1.9%).

Table 4. Descriptive statistics for the scales of ASABA and CUS, by gender^a

Scales		Female (n = 618)		Male (n = 582)		Total sample (n = 1207)		P-value^c
	Score range	Mean	(SD)	Mean	(SD)	Mean	(SD)
Total ASABA score (18 items)	18–90	45.04	(9.55)	47.56	(9.43)	46.27	(9.57)	.000
Negative stereotyping (8 items)	8–40	27.43	(6.28)	27.96	(5.49)	27.68	(5.91)	.125
Exclusion and discrimination (7 items)	7–35	12.17	(4.23)	13.74	(4.86)	12.94	(4.61)	.000
Fear of contagion (3 items)	3–15	5.47	(2.14)	5.91	(2.36)	5.68	(2.26)	.001
Total CUS score (7 items)	7–35	18.41	(5.68)	19.67	(5.17)	19.04	(5.48)	.000

^aThe internal dropout had a range of 9–53 (0.7–4.4%).

^bThe analysis is based on respondents who responded to all items in the table.

^cPearson’s χ² test was used and the significance level was set at p < .05

Table 5. A binary logistic regression of factors associated with stigmatising attitudes on abortion and contraceptive use among secondary school students (n = 1179/1207)

Independent factors	Associations with high level of stigma (summed score ≥ 65)
	Students (n = 1179)
	OR^a	CI 95%	P value
Male students	1.68	1.33–2.12	<.001
Reference group: female students
Age 16–17 years	0.77	0.50–0.90	.009
Reference group: 13–15 years
Age 18–21 years	0.58	0.42–0.80	.001
Reference group: 13–15 years

^aBinary logistic regression (of students who responded to all the questions included in the model = 1179/1207), presented as an odds ratio (OR) with 95% confidence interval (CI).