CONTEXT: Nicaragua has one of the highest adolescent fertility rates in the world, but little is known about why approximately half of Nicaraguan women give birth before age 20.
METHODS: Data from the 2001 Nicaragua Demographic and Health Survey were used to examine the sexual and reproductive behavior of 3,142 females aged 15–19. Age at sexual debut and age at first birth were assessed using life table analysis, and the impacts of various factors on these measures were then examined in Cox proportional hazard models. Among sexually active females, current use of modern...