Sociodemographic correlates of contraceptive use among sexually active 15-year-old schoolchildren: a cross-sectional study in Albania

BACKGROUND: Measuring contraceptive use and its sociodemographic distribution among teenagers is crucial for informing targeted sexual health education and equitable interventions. Our aim was to assess the prevalence and sociodemographic correlates of contraceptive use among sexually active adolescents. METHODS: A cross-sectional study, conducted in Albania in 2022, included a nationwide representative sample of 1877 schoolchildren aged 15 years (55% girls; overall response 96%). Data on condom use, contraceptive pill use and sociodemographic characteristics were collected. Binary logistic regression was used to assess the associations of contraceptive use with sociodemographic factors. RESULTS: Among 15-year-olds who reported engagement in sexual intercourse (N = 316), 176 (55.7%) reported condom use and 39 (12.6%) reported contraceptive pill use at last sexual intercourse. Conversely, one in five and one in 10 participants did not know whether they or their partner had used, respectively, a contraceptive pill or a condom, indicating gaps in partner communication and decision-making. Independent positive correlates of condom use at last sexual intercourse included male gender (OR 4.4, 95% CI 1.9-10.0) and a higher family affluence (OR 2.3, 95% CI 1.3-3.9). Furthermore, neither condom nor contraceptive pill use at last sexual intercourse was inversely related to male gender (OR 0.3, 95% CI 0.1-0.6) and a higher family affluence (OR 0.5, 95% CI 0.3-0.8). CONCLUSIONS: Contraceptive use among Albanian sexually active 15-year-olds is among the lowest in the European region, particularly among girls and those from low socioeconomic groups, highlighting persistent structural inequities in this transitional society. Our findings indicate an urgent need for targeted and equitable interventions to promote comprehensive contraceptive education and access in Albania.