Self-reported pregnancy and access to primary health care among sexually experienced New Zealand high school students.
OBJECTIVE
To determine the prevalence of self-reported pregnancy among sexually experienced high school students, and the association between teenage pregnancy and access to primary health care.


METHODS
Between March and October 2007, 96 high schools throughout New Zealand participated in Youth'07, a cross-sectional Health and Wellbeing survey. The dataset included 2,620 (1,217 females and 1,403 males) year 9 through 13 students who reported ever having sexual intercourse and responded to a question about whether they had ever been pregnant or ever caused a pregnancy.


RESULTS
Nationwide, 10.6% of sexually experienced high school students self-reported that they had been pregnant (11.6%) or caused a pregnancy (9.9%). Māori (15.3%) and Pacific Island (14.1%) students had the highest self-reports of pregnancy. Foregone health care was reported by 24.2% of sexually experienced students. Students who self-reported pregnancy reported greater difficulty accessing health care (41.7% vs. 20.6%; odds ratio: 2.6); however, when they accessed care, the majority received confidential care (67.4%) as compared with pregnancy-inexperienced peers (51.6%). Concern about privacy was the most common reason for not accessing health care. Other barriers included uncertainty about how to access care and lack of transportation (all p values < .05).


CONCLUSIONS
Self-reported pregnancy among sexually active high school students in New Zealand is high and ethnic disparities exist. Being pregnant or causing a pregnancy is associated with difficulty accessing health care. Further research is needed to identify drivers for ethnic differences and determine what the cause-and-effect relationship between teenage pregnancy and access to health care looks like.
Department of Community Paediatrics, School of Population Health, The University of Auckland, Auckland, New Zealand.
Rachel J
RJ
Copland
Simon J
SJ
Denny
Elizabeth M
EM
Robinson
Sue
S
Crengle
Shanthi
S
Ameratunga
Robyn
R
Dixon
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D003151:Community Health Centers / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000523:psychology / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012572:School Health Services / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000706:statistics & numerical data; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires