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183Eastern Europe and Eurasia: A Comparative Report

SEXUAL ANDCONTRACEPTIVE

BEHAVIOR OFYOUNG ADULTS

14C H A P T E RThe reproductive health knowledge of

young adults and their sexual andcontraceptive behavior have important

implications for the future of a population’shealth and well being. Parents, teachers, andhealth professionals are often unable tocommunicate effectively with young adultsabout their sexual and reproductive lives. Inmany countries, young people are seldomprepared with the information, skills, andresources needed to make a healthy transitionto adulthood. Inadequate programs and lackof sex education can leave youth at the mercyof mass media and misinformation from peers.

Worldwide, it has been estimated that almosthalf of new HIV infections and one-third of allnew sexually transmitted infections occur topeople younger than 25 years of age. Inaddition to the consequences of sexual andreproductive decisions on health, anunintended pregnancy can disrupt a younggirl’s life by interrupting further schooling andtraining. In most countries, adults andcommunities generally hold young women,and not young men, responsible for theconsequences of unprotected sex (Greene, etal., 2002; UNAIDS, 1999; Mcauley and Salter,1995).

A young adult module, for women 15–24 yearsof age, has been included in the ReproductiveHealth Surveys (RHS) in Eastern Europe andthe Caucasus region to obtain data to addressthese concerns. The young adult modules haveincluded questions related to family lifeeducation (which are presented in Chapter 15,Sexuality Education), first sexual experience,and current sexual behavior includingcontraceptive use. Additionally, several ofthese surveys have included questions onattitudes toward condom use and knowledgeof reproductive health issues.

Sexual and Contraceptive Behavior of Young Adults184

In each of the surveys, first sexual experienceis classified as premarital or marital. Thisclassification is ascertained by two questionsin the survey instrument: (1) the date of thefirst sexual intercourse and the relationshipto the partner at the time of first sexualintercourse, and (2) the date of first union forthose women who have been or are in a maritalunion. If their partner was their husband, thedates of first sexual experience and of firstmarriage were compared in order to classifythe first sexual experience as marital orpremarital. Sexual experience was classified aspremarital if the first sexual experience occurredat least one month prior to the date of marriage.

14.1 First Sexual Experience

Information on first sexual experience isavailable for seven RHS countries in the region:the five countries surveyed in Eastern Europe,and two of the three countries in the Caucasusregion. As mentioned previously in this report,three surveys were conducted in Romaniaduring the 1990s but the data shown are fromthe most recent survey in 1999 (a briefoverview of trend data for Romania is includedin section 14.5 of this chapter). The reportedsexual experience of young adult women bymarital status at the time of first sexualexperience, by current age group and byresidence, is shown in Tables 14.1.1 and14.1.2, respectively.

There are distinct differences between EasternEurope and the Caucasus region. At least halfof young adult women in the Eastern Europeancountries report sexual experience, comparedwith approximately 30 percent of youngwomen in Georgia and Azerbaijan. (Althoughnot included in Table 14.1.1, 29% of 15–24year old women in Armenia report sexualexperience (Armenia National StatisticalService and ORC MACRO, 2001). In EasternEurope, sexual experience ranges from aboutone-half of young women in Romania and

Moldova to 60% in Ukraine and approximately75% in the Czech Republic and the areassurveyed in Russia. (As noted in previouschapters, the sub-national survey in Russiawas conducted in three primarily urban sitesin central Russia, and cannot be consideredrepresentative of Russia as a whole). Of thosewith sexual experience, the majority reportpremarital experience in Eastern Europecompared with only 3%–4% in the Caucasusregion. Almost all women in the CzechRepublic and in the areas surveyed in Russiawho report sexual experience have hadpremarital sex. This is true for approximatelyfour-fifths in Ukraine and Romania and 53%in Moldova.

As may be expected, sexual experienceincreases as age increases with markeddifferences between adolescents (15–19 years)and 20–24-year-olds. In Eastern Europe, mostadolescents who report sexual experience havehad premarital experience, as well as mostwomen 20–24 years of age in Czech Republicand Russia; in Ukraine, 83% of sexuallyexperienced women 20–24 years of age reportpremarital sex with the correspondingproportion at 75% in Romania and 53% inMoldova.

In rural areas, women marry earlier and aremore likely to be married at first sexualexperience (Table 14.1.2). For example, inMoldova, about half of all young adults reportsexual experience. However, only 19% ofyoung women in rural areas reportedpremarital sexual experience, compared with37% in the four largest urban municipalitiesand 25% in other urban areas. The samepattern is seen in Romania with no significantdifference in overall reported sexual experienceby residence but a greater proportion ofpremarital sex in urban areas.

Sexually experienced respondents were askedif they or their partner used any contraceptivemethod, including condoms, during their first


sexual encounter. In Russia and Ukraine,however, these questions were not posed towomen who were married at first sexualintercourse. Table 14.1.3 shows that thehighest rates of contraceptive use at the timeof first intercourse among unmarried womenwere in the Czech Republic (57%) andRomania (58%). Lower rates were found inUkraine (46%), Russia (46%), and Moldova(33%), and were only 14% and 3% for the fewwomen reporting premarital sex in Azerbaijan

and Georgia, respectively. Compared with theother Eastern European countries, a muchhigher proportion of women used modernmethods in the Russian areas surveyed andin Ukraine. In Moldova and Romania, wheredata are available for contraceptive use at firstsex after marriage, fewer women reported thatthey or their husbands used contraceptioncompared with women having premarital sex,and the predominant method was withdrawal.In all countries, independent of the timing of

Region and CountryNo Sexual Experience

After Marriage

Before Marriage Total

Eastern EuropeCzech Rep., 1993

15–19 46 † 54 100 64620–24 2 1 97 100 737Total 27 † 73 100 1,383

Moldova, 199715–19 79 6 14 100 74720–24 17 43 40 100 910Total 50 23 26 100 1,657

Romania, 199915–19 74 4 22 100 92420–24 22 20 58 100 1,239Total 47 13 41 100 2,163

Russia, 1999*15–19 51 † 49 100 74820–24 8 5 87 100 1,058Total 25 3 71 100 1,806

Ukraine, 199915–19 68 3 30 100 1,07920–24 12 15 73 100 1,151Total 40 9 51 100 2,230

CaucasusAzerbaijan, 2001

15–19 90 10 † 100 1,20720–24 53 45 3 100 1,207Total 74 25 1 100 2,414

Georgia, 199915–19 84 15 † 100 1,14220–24 47 50 2 100 1,246Total 67 31 1 100 2,388

* Data for Russia pertain to three primarily urban areas as described in Chapter 2.† Less then 0.5%.

No.of Cases

Table 14.1.1Reported Sexual Experience by Marital Status at Time of First Sexual Experience by Current Age

Among Young Women Aged 15–24(Percent Distribution)

Eastern Europe and Eurasia: A Comparative Report

Reported Sexual Experience


first sexual experience, condoms were the mostused modern method, and withdrawal was themost commonly used traditional method.

Table 14.1.4 displays the primary reasons fornot using contraception among sexuallyexperienced respondents who did not usecontraception at first sexual intercourse. Datafor married women are available for four of theseven countries. In Moldova, Romania,Azerbaijan and Georgia, the majority of

married respondents did not use contraceptionbecause “they wanted to become pregnant.”“Did not think about using contraception” wasthe second most common reason for not usingcontraception in each of these four countries,especially Romania.

The most common reason unmarried womenin the Czech Republic and Ukraine gave fornot using contraception at first sexualintercourse was that “sex was unexpected”

Region and CountryNo Sexual Experience After Marriage Before Marriage Total

Eastern EuropeCzech Rep., 1993

Urban 26 0 74 100 940Rural 28 0 72 100 443Total 27 0 73 100 1,383

Moldova, 1997Municipalities * 49 14 37 100 507Other Urban 51 24 25 100 302Rural 51 29 19 100 848Total 51 23 26 100 1,657

Romania, 1999Urban 48 7 45 100 1,668Rural 44 21 35 100 995Total 47 13 41 100 2,163

Russia, 1999 †

Urban 25 3 71 100 1,806Total 25 3 71 100 1,806

Ukraine, 1999Urban 41 7 52 100 1,734Rural 40 12 48 100 496Total 40 9 51 100 2,230


Urban 78 21 1 100 1,155Rural 68 31 1 100 1,259Total 74 25 1 100 2,414

Georgia, 1999Urban 72 26 2 100 1,444Rural 61 38 1 100 944Total 67 31 1 100 2,388

* Less than 0.5%† Includes four major cities: Chisinau, Tiraspol, Balti and Bender.‡ Data for Russia pertain to three primarily urban areas as described in Chapter 2.

No. of Cases




Table 14.1.2Reported Sexual Experience by Marital Status at Time of First Sexual Experience by Residence


(44% and 39%, respectively). The mostcommon reason, reported by more than onethird (37%) of unmarried women in theRussian areas surveyed was “they or theirpartner did not think about usingcontraception” and another 30% said that “sexwas unexpected.” In both Moldova andRomania, “did not think about usingcontraception” and “sex was unexpected” wereabout equally important. One may hypothesize

that these two reasons are related, as it maybe difficult to plan to use or think aboutcontraception if sex is unexpected. Despite thesmall sample size, a striking 49% of unmarriedwomen in Azerbaijan and 68% of unmarriedwomen in Georgia did not use contraceptionat first sexual intercourse because they wantedto get pregnant. Most of their first partnerswere steady partners and perhaps gettingpregnant was a transition to marriage.

Any MethodRegion and Country Condom Other Withdrawal Calendar

Eastern EuropeCzech Rp., 1993

Married † † † † †Not Married 57 23 5 28 1Total 58 23 5 29 1

Moldova, 1997Married 18 3 0 13 1Not Married 33 13 1 16 4Total 26 8 0 15 3

Romania, 1999Married 27 6 1 18 2Not Married 58 26 2 26 4Total 51 22 2 24 3

Russia, 1999*Married ‡ ‡ ‡ ‡ ‡Not Married 46 33 0 12 2

Ukraine, 1999Married ‡ ‡ ‡ ‡ ‡Not Married 46 27 4 13 2


Married 1 0 0 § §Not Married 14 5 2 0 7Total 1 § § § §

Georgia, 1999Married § § § § §Not Married 3 3 0 0 0Total § § § § §

* Data for Russia pertain to three primarily urban areas as described in Chapter 2.

§ Less than 0.5%.‡ Question was not asked.

Table 14.1.3Contraceptive Use at First Sexual Intercourse by Marital Status at First Sexual Intercourse


† Fewer than 25 cases.

Among Sexually Experienced Young Adult Women Aged 15–24,

Modern Methods Traditional MethodsReported Contraceptive Use (%)


Cze

ch R

ep.

Mol

dova

R

oman

iaR

ussi

aU

krai

neA

zerb

aija

nG

eorg

ia19

9319

9719

9919

99*

1999

2001

1999

†59

30‡

‡ 86

76†

1328

‡ ‡

713

†8

15‡

‡ §

3†

312

‡ ‡

45

†12

2‡

‡ ║

3†

44

‡ ‡

4║

†§

8‡

‡ 0

║

100

100

100

100

100

100

100

No.

of C

ases

541

123

1‡

‡ 78

791

6

319

54

1049

68§

2832

376

169

§11

7§

§§

32

613

¶¶

83

4429

3031

3927

1811

§§

9#12

#§

027

§§

1222

§0

36

63

21

012

§7

58

§0

100

100

100

100

100

100

100

No.

of C

ases

479

284

394

650

563

3429

* D

ata

for R

ussi

a pe

rtain

to th

ree

prim

arily

urb

an a

reas

as

desc

ribed

in C

hapt

er 2

.

¶ In

clud

ed in

Acc

ess/

Kno

wle

dge/

Ava

ilabl

ility,

etc

.

(Per

cent

Dis

trib

utio

n)

Tota

l

Tota

l

Mos

t Com

mon

ly C

ited

Rea

sons

for N

ot U

sing

Con

trac

eptio

n at

Firs

t Sex

ual I

nter

cour

se

Acc

ess/

Kno

wle

dge/

Ava

ilabi

lity,

etc

.Th

ough

t She

Cou

ldn’

t Get

Pre

gnan

t

Did

Not

Kno

w A

bout

Con

trace

ptio

n

Wan

ted

to G

et P

regn

ant

Did

Not

Thi

nk A

bout

Usi

ng C

ontra

cept

ion

Did

Not

Wan

t to

Use

Con

trace

ptio

n

Tabl

e 14

.1.4

Did

Not

Wan

t to

Use

Con

trace

ptio

nD

id N

ot T

hink

Abo

ut U

sing

Con

trace

ptio

nW

ante

d to

Get

Pre

gnan

t

East

ern

Euro

peC

auca

sus

East

ern

Euro

pe a

nd E

uras

ia: A

Com

para

tive

Rep

ort

Amon

g Se

xual

ly E

xper

ienc

ed Y

oung

Wom

en A

ged

15–2

4,

by M

arita

l Sta

tus

at F

irst S

exua

l Int

erco

urse

Mar

ried

Not

Mar

ried

Doe

s N

ot K

now

/Doe

s N

ot R

emem

ber

Oth

erS

ex w

as U

nexp

ecte

d

Did

Not

Kno

w A

bout

Con

trace

ptio

nS

ex W

as U

nexp

ecte

d

# In

clud

es: D

idn’

t Kno

w A

ny M

etho

ds, H

ard

to G

et M

etho

ds, a

nd W

ante

d to

Use

but

Did

Not

Hav

e a

Met

hod.

Oth

er

† F

ewer

than

25

case

s.

§ In

clud

ed in

“Oth

er” c

ateg

ory.

‡ Q

uest

ion

was

not

ask

ed.

Doe

s N

ot K

now

/Doe

s N

ot R

emem

ber

║ L

ess

than

0.5

%.


14.2 Current Sexual Activity

Table 14.2.1 illustrates the current sexualactivity status (at the time of the survey) of allwomen 15–24 years of age by current maritalstatus for six of the seven countries. Sexuallyexperienced respondents were asked whenthey had sexual intercourse. Most of themarried women either have had sexualintercourse in the past three months or werecurrently pregnant or postpartum; pregnancyor postpartum status was the case for aboutone-third of the married young adults inAzerbaijan and Georgia. With the exception ofthe areas surveyed in Russia, the majority ofcurrently unmarried women had never had

intercourse. However, differences in theproportion of women who had never had sexualintercourse varied substantially acrosscountries, from 63% in Ukraine to 98% inAzerbaijan. Of those unmarried women withsexual experience, from 63% to 76% werecurrently sexually active (within the last 3months) in the four Eastern Europeancountries but only 30% were currently activein Azerbaijan and 13% in Georgia.

Almost three-quarters of sexually experiencedwomen in the Eastern European countriesused contraception at their most recent sexualintercourse (Table 14.2.2). Use ofcontraception does not vary substantially

Moldova Romania Russia Ukraine Azerbaijan Georgia1997 1999 1999* 1999 2001 1999

Never Had Intercourse 0 0 0 0 0 0

Ever Had Intercourse 100 100 100 100 100 100Within the Last Month 75 76 74 70 55 661–3 Months ago 6 6 3 5 6 2Over 3 Months ago, Within Last Year 2 1 2 8 3 1One Year or Longer 1 0 1 † † 1One Month or Longer/Unknown Interval † † 12 6 † †Currently Pregnant or Postpartum 16 16 8 11 36 30

Total 100 100 100 100 100 100

No. of Cases 769 780 691 839 795 900

Sexual Activity Status Among Previously Married & Never Married

Never Had Intercourse 80 65 44 63 98 85

Ever Had Intercourse 20 35 56 37 2 16Within the Last Month 7 20 32 18 † 11–3 Months ago 5 6 9 5 † 1Over 3 Months ago, Within Last Year 3 5 10 7 † 1One Year or Longer 5 3 3 3 1 12One Month or Longer/Unknown Interval 0 † 2 5 0 1Currently Pregnant or Postpartum † † 1 1 † 1

Total 100 100 100 100 100 100

No. of Cases 888 1,383 1,047 1,388 1,619 7,798

* Data for Russia pertain to three primarily urban areas as described in Chapter 2.† Less than 0.5%.

Table 14.2.1Sexual Activity Status by Marital Status

Eastern Europe Caucasus



Sexual Activity Status Among Married


Region and Country Total Modern Traditional

Eastern EuropeMoldova, 1997

Married 78 48 30Not Married 66 40 26Total 75 46 29

Romania, 1999Married 62 25 37Not Married 79 47 32Total 70 35 34

Russia, 1999*†Married 74 55 19Not Married 80 66 14Total 76 59 17

Ukraine, 1999†Married 68 37 32Not Married 78 57 21Total 71 43 28


Married 38 7 31Not Married 9 2 7Total 36 6 30

Georgia, 1999Married 28 17 11Not Married 2 2 0Total 27 16 11

* Data for Russia pertain to three primarily urban areas as described in Chapter 2.† Among women who reported having sex in the previous 30 days.

Table 14.2.2

Use of Contraception (%)

Use of Contraception at Most Recent Sexual Intercourse by Current Marital Status Among Sexually Experienced Young Women Aged 15–24,


between married and unmarried women inthese countries. The use of moderncontraception is more common than traditionalmethods, although in Romania use is fairlyevenly split between modern and traditionalmethods. In Azerbaijan and Georgia, less than40% of sexually experienced young adultsused contraception at last intercourse, and useof contraception was substantially greateramong married women. Most women inAzerbaijan used traditional methods, but 60%of users in Georgia reported using modernmethods.

14.3 Condom Attitudes

Table 14.3.1 shows the percentage of sexuallyexperienced women aged 15–24 who agreedwith statements about condoms and condomuse for the same four countries (Moldova,Romania, Azerbaijan and Georgia), categorizedby women who have used condoms and neverusers of condoms. In general, but with someexceptions, a higher proportion of sexuallyexperienced women who have used condomsat some time agreed with the statements aboutcondoms and condom use than did women


who had never used condoms. This is true forall four countries for the first four statementsshown in the table. In Azerbaijan, only 29% ofnon-users agreed with the statement that“using condoms with your partner is a smartidea” compared with 71% of users. In Georgia,slightly less than 50% of non-users agreedwith this statement, compared with 85% ofever users. More than three-fourths of bothuser and non-user groups in Moldova andRomania believed that using condoms withyour partner was a smart idea.

About half of both users and non-users ofcondoms in Moldova agreed that condoms“diminish sexual enjoyment (58% and 47%,respectively). In Azerbaijan and Georgia, agreater number of condom users than non-users believed that “condoms diminish sexualenjoyment” (67% vs. 18% in Azerbaijan and44% vs. 9% in Georgia). One can only assumethat the opinions of never-users are based onwhat they have heard from other persons asthey have never used condoms.

In conservative societies such as Azerbaijanand Georgia, it is not surprising that amongcondom non-users, not more than one-quarterof women (25% and 16%, respectively) agreedthat women should ask their partners to usecondoms. Similarly, in Azerbaijan andGeorgia, only 15% and 8% of non-users,respectively, thought it was easy to discusscondoms with a prospective partner. Notsurprisingly, those who were experienced withcondoms were more at ease with the topic; inthe four countries, 59% to 82% of ever-usersagreed that “women should ask their partnersto use condoms” and from one-third in Georgiato 69% in Romania agreed that “it is easy todiscuss condoms with a prospective partner.”

From 35% (non-users in Azerbaijan) to 59%(non-users in Romania) of young adult womenagreed that “condoms are not necessary if you

know your partner.” There were no substantialdifferences between non-users and users(range of 41%–50% for users) for thisstatement about condoms compared with thestatements discussed above. The fact that lessthan 60% of respondents, independent ofprevious condom use, thought that “condomsare not necessary if you know your partner”may indicate the possibility of risky behaviorif a young woman does not know her partner’sprevious sexual history.

Users of condoms in Romania and Georgiawere the least embarrassed about asking forcondoms in family planning clinics orpharmacies (12% and 8%, respectively).Almost half of non-users in Moldova believedthat it was embarrassing to ask for condoms(46%). Only one to five percent of both usersand non-users in each country, with theexception of Azerbaijan (15%), believedincorrectly that the same condoms could beused more than once. The belief that “peoplewho use condoms sleep around a lot” was morecommon among non-users than among usersin each country. This type of “social stigma”may influence non-user’s decisions to usecondoms.

The percentage of sexually experienced womenwho agreed with specific statements regardinginterpersonal impact of condom use ispresented in Table 14.3.2. Less than half ofwomen in Azerbaijan said that they would feelsafe from getting pregnant if their partnerasked to use a condom (47%). In contrast,almost 9 out of 10 Moldovan and Romanianwomen agreed that they would feel safe fromgetting pregnant if their partner asked to usea condom (98% and 87%, respectively). Theproportion of women who agreed that theywould feel safe from being infected with HIV/AIDS if their partner asked to use a condomvaried across the four countries. Only 33% ofwomen in Azerbaijan and 53% in Georgia


Stat

emen

ts

Eve

r Use

rs

of C

ondo

ms

(%)

Nev

er U

sers

of

Con

dom

s (%

)

Eve

r Use

rs

of C

ondo

ms

(%)

Nev

er U

sers

of

Con

dom

s (%

)

Eve

r Use

rs

of C

ondo

ms

(%)

Nev

er U

sers

of

Con

dom

s (%

)

Eve

r Use

rs

of C

ondo

ms

(%)

Nev

er U

sers

of

Con

dom

s (%

)

Usi

ng C

ondo

ms

with

You

r Par

tner

Is a

Sm

art I

dea

9380

9877

7129

8548

Con

dom

s D

imin

ish

Sex

ual E

njoy

men

t58

4737

2467

1844

9

Wom

en S

houl

d A

sk T

heir

Par

tner

s to

Use

Con

dom

s64

4982

5659

2561

16

It Is

Eas

y to

Dis

cuss

Con

dom

s w

ith a

Pro

spec

tive

Par

tner

60

3869

4355

1533

8

Con

dom

s A

re N

ot N

eces

sary

If Y

ou K

now

You

r Par

tner

5053

4159

4935

4840

It is

Em

barra

ssin

g To

Ask

for C

ondo

ms

in F

P C

linic

s or

Pha

rmac

ies

2846

1226

3424

818

The

Sam

e C

ondo

ms

Can

be

Use

d M

ore

Than

Onc

e2

21

115

52

1

Peo

ple

Who

Use

Con

dom

s S

leep

Aro

und

a Lo

t17

399

2110

183

6

No.

of C

ases

343

632

587

676

9773

711

883

3

Tabl

e 14

.3.1

Agre

emen

t with

Sta

tem

ents

Abo

ut C

ondo

ms

and

Con

dom

Use

By

Con

dom

Exp

erie

nce

Sexu

ally

Exp

erie

nced

You

ng W

omen

Age

d 15

–24

East

ern

Euro

pe a

nd E

uras

ia: A

Com

para

tive

Rep

ort

East

ern

Euro

peC

auca

sus

Mol

dova

199

7R

oman

ia 1

999

Aze

rbai

jan

2001

Geo

rgia

199

9


agreed with this statement, whereas inMoldova and Romania, more than 85% agreed.

A similar proportion of women who would feelprotected against HIV/AIDS if their partnerwanted to use a condom, agreed that they“would be safe from getting other sexuallytransmitted infections”. Women in Moldovaand Azerbaijan would be more likely to beangry (24% and 22%, respectively) if theirpartner asked to use a condom than wouldwomen in Romania and Georgia (both 13%).This same pattern holds true for being worriedabout having done something wrong. Thewomen in Romania were the most likely to besuspicious of their partners’ behavior (23%,as opposed to 18% in Azerbaijan and 14% inGeorgia), and women in Moldova were the mostinclined (33%) to be embarrassed by thequestion; 22% of women in Georgia and 15%in Romania would be embarrassed by theirpartner asking to use a condom.

14.4 Trend Data in Romania (1993–1999)

As previously noted, trend data for youngadults are only available for Romania, wheredata are available for females for 1993, 1996and 1999, and for males for 1996 and 1999.One of the objectives of the 1999 RHS inRomania was to examine current indicatorsand recent trends in sexual behavior,pregnancy experience, and contraceptive useamong young adults. Findings from the 1993RHS and the 1996 YARHS in Romania allowedan examination of the trends among youngadult women during the 1990s. In addition,young adult men were included in the 1996and 1999 surveys.

Data from all three surveys showed thatinitiation of sexual activity for young womenin Romania took place fairly late; in 1999, only26% of female adolescents (15–19 years of age)

(%) (%) (%) (%)Statements Moldova, 1997 Romania, 1999 Azerbaijan, 2001 Georgia, 1999

Safe from Getting Pregnant 90 87 47 63

Safe from Getting HIV/AIDS 87 85 33 53

Safe from Getting Other STDS 89 85 37 52

Angry 24 13 22 13

Insulted * * 22 *

Worried You Have Done Something Wrong 21 9 21 11

Suspicious of Partner’s Behavior * 23 18 14

Embarrassed 33 15 * 22

No. of Cases 975 1,263 834 951

* Question was not asked.

“If Your Partner Would Want to Use Condoms with You, Would You Feel…”Eastern Europe Caucasus

Table 14.3.2Agreement with Specific Statements Regarding Interpersonal Impact of Condom Use

Eastern Europe and Eurasia: A Comparative ReportAmong Sexually Experienced Young Women Aged 15–24


had ever had sexual intercourse. However, thisproportion was an increase of 62% over 1993(26% vs.16%) as shown in Table 14.4.1. Theincrease in the level of sexual experienceamong 20–24 year old women, from 70% to78%, was less dramatic. Similarly, sexualexperience among young men had changedlittle between 1996 and 1999: the proportionof 15–19 year old males who reported sexualexperience increased by 10% (from 41% to45%) and there was no change among 20–24year olds (93%).

In all three surveys, most sexually experiencedwomen reported that their first sexualintercourse was premarital. In 1993 and 1996only slightly more than one-half of womenreporting sexual experience had premaritalsexual experience. However, in 1999, morethan three out of four sexually experiencedwomen reported premarital sexual intercourse.In all three surveys, sexually experiencedadolescents were more likely to reportpremarital sex than 20–24 year olds were.However, the increase in premarital initiation

No Sexual After BeforeExperience Marriage Marriage Total

Romania RHS, 199315–19 84 7 9 100 74520–24 30 33 37 100 896Total 59 19 22 100 1,641

Romania YARHS, 199615–19 80 7 13 100 1,23920–24 26 36 38 100 786Total 54 21 25 100 2,025

Romania RHS, 199915–19 74 4 22 100 92420–24 22 20 58 100 1239Total 47 13 41 100 2,163

No Sexual After BeforeExperience Marriage Marriage Total

Romania YARHS, 199615–19 59 † 41 100 1,32220–24 7 1 92 100 725Total 34 1 66 100 2,047

Romania RHS, 199915–19 55 0 45 100 31120–24 7 2 91 100 320Total 29 1 70 100 631

* Men were not interviewed in 1993† Less than 0.5%.Source: Serbanescu F, Morris L, Marin M, (eds), 2001.

(Percent Distribution)Eastern Europe and Eurasia: A Comparative Report

Unweighted

Table 14.4.1Reported Sexual Experience by Marital Status at Time of First Sexual Experience by Gender

Among Young Women and Men Aged 15–24 Reproductive Health Surveys: Romania, 1993, 1996 and 1999

Current Age

Current Age

Women 15–24

Men 15–24


Reported Sexual Experience Unweighted

No. of Cases

No. of Cases


of sexual intercourse was substantial andparallel among both 15–19 and 20–24 year oldsin 1999 compared with previous years. Theproportion of adolescent women who initiatedsexual activity before marriage was muchhigher in 1999 than in previous years: 83% ofsexually experienced women aged 15–19 werenot married when they first had sex, comparedwith 64% in 1996 and 57% in 1993. Similarly,premarital intercourse among sexuallyexperienced 20–24 year olds increased from53% in 1993 to 75% in 1999. The very highproportion of young men who initiated sexbefore marriage remained unchanged between1996 and 1999 (>95%).

Compared with the 1993 and 1996 surveys,in 1999 the proportion of sexually experiencedyoung women whose first intercourse waspremarital increased substantially among 15–19 year olds in urban areas—from 67% in 1993

to 80% in 1996 to 91% in 1999—and almostdoubled among adolescents in rural areas—from 43% to 48% to 74% (data not shown).

As shown in Table 14.4.2, contraceptive useat first premarital intercourse among youngwomen, which increased by 50% between1993 and 1996 (from 26% to 39%), continuedan upward trend reaching 58% in 1999; almostall the increase was due to the increased useof condoms, whose prevalence more thantripled from 1993 to 1996 (from 4% to 13%)and doubled from 1996 to 1999 (from 13% to26%). Although withdrawal was the leadingmethod at first intercourse in both 1993 and1996, and had increased by 50% since 1993,in 1999 condom use was equal to withdrawaluse. Among young men, the increase between1996 and 1999 was equally dramatic. Overallcontraceptive use at first premaritalintercourse almost doubled from 35% to 64%,

Contraceptive Method Women Women Men Women Men

Any Method 26 39 35 58 64

Modern Methods 5 15 17 28 40Condom 4 13 16 26 39Other Modern 1 2 1 2 1

Traditional Method 21 24 24 30 24Withdrawal 17 21 15 26 22Calendar 3 3 2 4 2

No Method 75 61 66 42 36

Total 100 100 100 100 100

% of All Users Using a Modern Method 19 39 49 49 63

Unweighted No. of Cases 431 425 1,208 937 442

Source: Serbanescu F, Morris L, Marin M, (eds), 2001.

(Percent Distribution) Eastern Europe and Eurasia: A Comparative Report

Romania RHS, 1993

Romania YARHS, 1996

Romania RHS, 1999

Table 14.4.2Use of Contraception at Time of First Premarital Sexual Intercourse

Among Young Women and Men Aged 15–24 Reproductive Health Surveys: Romania, 1993, 1996 and 1999


and condom use was almost 2.5 times greater(39% vs. 16%) in 1999 than in 1996. As withwomen, the use of withdrawal by menincreased moderately between the two surveys,but unlike women, the use of modern methodswas much higher among men than the use oftraditional methods.

If the first sexual experience was marital(Table 14.4.3), many fewer women reportedusing contraception, mainly withdrawal, inall three surveys. The levels of use remainedbasically unchanged between 1993 and 1996but almost doubled in 1999 from 14% to27%. Although the use of modern methodsparalleled the increase in traditional methoduse (from 3% to 7%), most of the increase incontraceptive use was the result of greateruse of traditional methods, which increasedfrom 11% to 20%, accounting for 75% of useat first intercourse.

Although detailed tables are not shown here,comparison with the previous surveys alsoreveals important changes in contraceptiveprevalence and contraceptive method mixamong young adult women in 1999 at theirmost recent sexual encounter. Among womencurrently married or in consensual union,whose contraceptive prevalence was onlyslightly higher in 1996 than in 1993 (53% vs.50%), the use at last intercourse increased to62% in 1999. Moreover, the use of modernmethods continued to increase, from 10% in1993 to 20% in 1996 to 25% in 1999, whereasthe use of traditional methods remainedrelatively stable (from 40% to 34% to 37%).Among unmarried young women,contraceptive use increased from 67% in 1996to 79% in 1999, with most of the improvementdue to a substantial increase in the use ofmodern methods (from 36% to 47%),particularly in condom use (from 22% to 32%).

Contraceptive Method

Any Method 15 14 27

Modern Methods 3 3 7Condom 2 2 6Other Modern * 1 1

Traditional Method 13 11 20Withdrawal 11 10 18Calendar 2 1 2

No Method 85 86 73

Total 100 100 100

% of All Users Using a Modern Method 19 20 27

Unweighted No. of Cases 387 363 326

*Less than 0.5%.Source: Serbanescu F, Morris L, Marin M, (eds), 2001.

(Percent Distribution)Eastern Europe and Eurasia: A Comparative Report

Romania RHS, 1993

Romania YARHS, 1996

Romania RHS, 1993

Table 14.4.3Use of Contraception at Time of First Sexual Intercourse

Among Young Women Aged 15–24 Whose First Sexual Intercourse Was MaritalReproductive Health Surveys: Romania, 1993, 1996 and 1999


14.5 Summary of Findings

♦ There are distinct differences betweenEastern Europe and the Caucasus region.At least one-half of young adult women (ages15-24) in the Eastern European countriesreport sexual experience (from 50% inMoldova to 75% in Russia) compared withapproximately 30% of women in thecountries of the Caucasus region.

♦ In Eastern Europe, the majority of youngadults who report sexual experience havehad premarital sexual intercourse comparedwith less than 5% in the Caucasus.

♦ In all countries, a higher proportion ofwomen with premarital sexual experiencereport that they or their partner usedcontraception at sexual debut than did

women whose first sexual experience wasat the time of marriage. However, only 3%to 33% of women with premarital sexualexperience used a modern method at thetime of first intercourse.

♦ In Eastern Europe, 40% to 66% ofunmarried women who are sexually activeused modern contraception at lastintercourse indicating an improvement inuse since sexual debut. In Romania, moderncontraceptive use increased from 36% in1996 to 47% in 1999, particularly in condomuse (from 22% to 32%).

♦ Although the proportion of sexually activeyoung adults in Romania increased between1993 and 1999, pregnancy rates declinedslightly, probably as a result of increased useof modern contraception.

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