Table 1.

Example of coding process and data synthesis of the rumours, myths, and misperceptions as barriers to contraceptive use among AGYW who were recipients of a combination HIV prevention intervention in five districts of South Africa, HERStory study, 2018–2019.

Overarching theme	Sub-themes	Illustrating examples/quotes
Contraception service benefits	Benefits of using contraceptives	“It is important because what if you get raped while walking, get kidnapped and raped, there is a difference in what happens because you will be safe from being pregnant even though you can have STI's and HIV.” AGYW 15–18 years, FGD “Prevention is the way to go because we don’t get pregnant from our boyfriends only, but a situation may occur [rape] where you find yourself raped, so if you are on prevention, you can be protected …. You must remember that when they rape you, they don’t use a condom, so prevention is better because it can protect you from being pregnant.” AGYW 15–18 years, FGD “You don’t care about what people think [when using contraceptives] so long you know you are going to be safe if you are having sex.” AGYW 15–18 years, SIDI “They [girls using contraceptive] are doing well because they are protecting their future so that they don’t conceive whilst at school … I think family planning is a right thing … Because if we cannot pursue family planning we would have a lot of kids” AGYW 19–24 years, SIDI “I think it is wise and important for one to use a condom because if they are sexually active, they can prevent pregnancy and STIs” AGYW 15–18 years, FGD
Barriers to contraception services	Perceived general barriers to contraceptive access and use	“Some clinics can be frustrating like you would go to a clinic for contraception, the nurses will start asking all sorts of question; why are you here? Young as you are! Do you have a boyfriend? And because of these questions and that you feel embarrassed you end up leaving without accessing the services.” AGYW 15–18 years, FGD “I agree with what she is saying regarding nurses not being able to talk to people nicely, they can’t. A nurse will utter something that will be so hurtful, when you speak and tell them you are here to get contraceptives, they won’t speak to you privately in a room instead they will loudly say why are you here for contraceptives in front of people and you can imagine how many people are at the clinic. They will make noise and say why are you here for contraceptives when you are so young, why? You like boys.” AGYW 15–18 years, FGD “Ahh! Sometimes when you arrive, you will find that the nurses are mean …. I wanted to do family planning …. Then, they shouted at me, and remarked that I am too young …. I was not comfortable about what happened ever since. So, I accepted that it means I will never go to the clinic … No [they didn’t give me the contraceptives … It was my first time and that was my last day I visited the clinic.” AGYW 15–18 years, SIDI
	Myths and misconception	“… the needle makes other people gain weight, it makes others lose weight. Out there people will start to gossip about you and say you have AIDS, you have TB you are sick and stuff.” AGYW 15–18 years, FGD “… Some say contraceptives are going to ruin their wombs and in the future, they will not be able to have kids, so they decide not to use contraceptives because they would like to have kids in future.” AGYW 15–18 years, FGD “… and even when I am ready, I don’t want to use preventative methods because I feel as though … How do I say this … not that it’s not healthy … but it makes you sick. People I know that have prevented are sick, some get thin, some get fat I don’t know, they say it depends on how the injection affects you …” AGYW 15–18 years, SIDI
Influence of the combination HIV prevention intervention on contraceptive use and information	AGYW feeling educated and informed about using contraceptives	“Like contraceptive, I did not know the different types but now I have a little bit of knowledge about them” AGYW 15–18 years, FGD “In the programme we are taught as girls, how to behave ourselves as well as how to prevent (family planning)…” AGYW 15–18 years, SIDI
	Positive influence on overall livelihood of AGYW	“… it has changed my life because I was not allowed to prevent [use contraceptives], but I joined the programme and told them [parents] that not only a person that sleeps with boys should prevent … a person could get raped, so then they understood.” AGYW 15–18 years, FGD “… The programme has also helped me because (without it) I would have fallen into the trap of falling pregnant and having a child.” AGYW 15–18 years, FGD “I think it has changed my life because my mom did not want me to prevent, so I joined Rise (Rise Club) and explained to her what they told us there. So she let’s me prevent now …” AGYW 19–24 years, SIDI

AGYW, adolescent girls and young women; FGD, focus group discussion; SIDI, serial in-depth interview.