Purpose: Many predicted that COVID-19 would have a substantial impact on the sexual and reproductive health (SRH) trajectories of adolescents in sub-Saharan Africa. The lack of longitudinal data
with information collected before and into the pandemic has limited investigation into this topic.
Methods: We performed a secondary analysis using nationally representative longitudinal data
from Kenya and Burkina Faso, collected at three time points (preeCOVID-19 in late 2019, and
during COVID-19 in 2020 and 2021), to determine the extent to which SRH outcomes and behaviors, including pregnancy, contraceptive use, partnership status, and sexual activity, changed
during the pandemic among adolescent women.
Results: Among adolescents aged 15e19 years (Kenya n ¼ 1,893, Burkina Faso n ¼ 1,422), there was a
reduction in both partnership and pregnancy in 2021 as compared to pre-COVID 2019. Contraception
use significantly increased between 2019 and 2021 in Kenya only (adjusted odds ratio [aOR]: 1.42,
95% confidence interval [CI] 1.03e1.97). COVID-19erelated household income loss was associated
with a decline in sexual activity among unmarried Kenyan girls (aOR: 0.47, 95% CI 0.25e0.87) and
lower odds of pregnancy in Burkina Faso (aOR: 0.13, 95% CI 0.02e0.91). We did not find a relationship
between COVID-19 measures and initiation of partnership or marriage in either setting.
Discussion: Contrary to expectations, our results suggest that COVID-19 did not have a consistent or
sustainingimpacton adolescent SRH and behaviorsinBurkina Faso andKenya. Further researchisneeded
to assess the longer-term implications of the pandemic on adolescent social and health outcomes.