Abstract
BACKGROUND: Early sexual debut among adolescent girls in Ghana contributes to high rates of unintended pregnancy and sexually transmitted infections. However, there is limited evidence on modern contraceptive use after sexual debut among Ghanaian adolescent girls aged 15-19 years. Therefore, this study aimed to examine the prevalence of modern contraceptive use after sexual debut among Ghanaian adolescent girls aged 15-19 years and the factors associated with it. METHODS: We analyzed data from the 2022 Ghana Demographic and Health Survey, including a weighted sample of 1,198 adolescent girls aged 15-19 years who had initiated sexual activity. A modified Poisson regression with a log link was used to assess the factors associated with modern contraceptive use. Statistical significance was set at p < 0.05. RESULTS: The prevalence of modern contraceptive use after sexual debut among Ghanaian adolescent girls aged 15-19 years was 28.5% (n/N: 341/1,198; 95% CI: 25.30-31.93). Factors associated with modern contraceptive use included being in the richer wealth quintile (aPR = 1.58; 95% CI: 1.02-2.45; p = 0.039), exposure to family planning information through social media (aPR = 1.57; 95% CI: 1.14-2.16; p = 0.006), and health facilities (aPR = 1.39; 95% CI: 1.02-1.92; p = 0.040). CONCLUSION: Approximately one in four Ghanaian adolescent girls aged 15-19 years used modern contraceptives after their sexual debut. We found that belonging to a richer household wealth quintile and exposure to family planning information through social media and health facilities were significantly associated with modern contraceptive use. These findings suggest the need for targeted interventions to enhance modern contraceptive use among adolescent girls from poorer households. Additionally, the findings highlight the need to continue promoting family planning information through social media and support the integration of family planning services into routine facility-based care within the primary health care system.