The selected background characteristics of 439 sexually active immigrant youths are summarised in Table 2a, b. About two out of five of the study population were males, while three out of five were females. Those in the age group from 18–24 years constituted two out of five of the study population. Majority, 68% (300) of the immigrant youths have completed secondary education or higher, about 63% (275) were not married, while 40% (176) were in the poor wealth quintile. Over half—54% (239) reported being documented, while 46% (200) reported themselves as undocumented. Over half—58% (254) of the respondents reported having experienced discrimination in Hillbrow, and 79% (346) reported having social support in South Africa. With regards to sexual and reproductive health characteristics, 60% (264) reported having had information about family planning six months prior to the survey. Regarding current use of contraception, 81% (357) reported that they were using a contraceptive method. Figure 2 shows the different sources of information on SRH among sexually active respondents disaggregated by gender. The main sources of information on SRH among all respondents were television and radio—38.7% (170), friends—22.8% (100) and poster 21.2% (93). Community clinic and government hospital were 11.6% (51) and 9.1% (40) respectively. Similarly, among the females, the main sources of information on SRH were television and radio 45.9% (118), friends 29.6% (76) and poster 24.1% (62); while only 15.6% (40) and 10.5% (27) of females sourced information about SRH issues from the community clinic and government hospital respectively. Among the males however, 28.6% (52) got information about family planning from television or radio, while 13% (24) relied on friends. Only a small proportion of males, 6% (11) received information on SRH from the community clinic and 7% (13) from government hospital. Table 1c summarised the distribution of the two outcome variables. For knowledge of family planning, inadequate knowledge and adequate knowledge were 46.2% (203) and 53.8% (236) respectively. For the distribution of access to SRH services, no access, some access and access were 35.5% (156), 41.5% (182) and 23.0% (101) respectively.

Table 2 a Socio-demographic characteristics of sexually active immigrant youths (N = 439). b Reproductive Health characteristics of sexually active immigrant youths (N = 439)Fig. 2

Sources of information about sexual and reproductive health issues by gender

Factors associated with knowledge about family planning among sexually active immigrant youths

The socio-demographic factors that are significantly associated with the knowledge about family planning at bivariate level are presented in Table 3a. The factors were gender (p < 0.001), age group (p < 0.001), highest level of education attained (p < 0.01), marital status (p < 0.01), and wealth index (p < 0.001). The bivariate association between knowledge of family planning, migration and reproductive health characteristics of the immigrant youths is presented in Table 3b. The factors were migration status (p < 0.001), having experienced discrimination in Hillbrow (p < 0.01), having social support in South Africa (p < 0.001), having received information about family planning six months prior to the survey (p < 0.001) and use of family planning at the time of the survey (p < 0.001). Multivariate logistic regression model adjusted for socio-demographic, migration and SRH factors that were significant at bivariate analysis as shown in Table 4. The females were more likely to have knowledge about family planning compared to males (AOR: 3.85, CI = 2.34–6.35). Immigrant youths in the age groups 25–29 years and 30–34 years were more likely to have knowledge of family planning compared to those aged 18–24 years; (AOR:2.14, CI = 1.12—4.05) and (AOR: 3.87, CI = 2.00–7.49) respectively. Belonging to the middle and high wealth indexes increase the likelihood of having knowledge of family planning compared to those in poor wealth index (AOR: 1.83, CI = 1.05—3.18) and (AOR:2.55, CI = 1.32—4.93) respectively. Immigrant youths who did not receive information about family planning 6 months prior to the survey had reduced likelihood of having knowledge about family planning compared with their counterparts that received the information 6 months prior to the survey (AOR: 0.17, CI = 0.10 – 0.29). Similarly, immigrant youths who were not using a family planning method at the time of the survey had reduced likelihood of having knowledge about family planning (AOR: 0.37, CI = 0.19—0.70).

Table 3 a Association between knowledge about Family Planning and socio-demographic characteristics of sexually active immigrant youths. b Association between knowledge about Family Planning and Reproductive Health characteristics of sexually active immigrant youthsTable 4 Binary logistic regression of knowledge of Family Planning among sexually active immigrant youths (N = 439)Factors associated with access to SRH services from government health facilities by sexually active immigrant youth

The unadjusted multinomial logistic regression for access to SRH services and socio-demographic characteristics is shown in Table 5a. With access to SRH services as the base outcome, the socio-demographic factors associated with no access and some access were highest level of education attained and wealth quintile. The bivariate result showed that immigrant youths with complete secondary education and higher have increased risk to have no access to SRH services in government health facilities (RRR = 2.64, 95% CI = 1.55–4.48, p < 0.001). Similarly, the relative risk for having some access to SRH services for those with secondary education and higher was increased by a factor of 2.55 (RRR = 2.55, 95% CI = 1.53–4.25, p < 0.001). There was an increased relative risk of having no access to SRH services for immigrant youths in rich wealth quintile (RRR = 3.48, 95% CI = 1.67–7.23, p-value < 0.001). Similarly, there was an increased relative risk of having some access by those in the middle (RRR = 2.10, 95% CI = 1.22–3.61, p-value < 0.01) and rich wealth quintiles (RRR = 3.0, 95% CI = 1.42–6.30, p-value < 0.001). Table 5b presented the unadjusted multinomial regression of migration and reproductive health characteristics. With access to SRH services as the base outcome, the migration and reproductive health factors associated with no access were migration status, having received information about family planning 6 months prior to the survey and use of contraceptive methods. The factors associated with having some access were migration status, duration of stay in Hillbrow, having social support in in South Africa, having received information about family planning 6 months prior to the survey and use of contraceptive methods. The relative risk of having no access by undocumented immigrant youths decreased by a factor of 0.37 compared to documented immigrants (RRR = 0.37, 95% CI = 0.22–0.62, p-value < 0.001). Similarly, among those with some access to SRH services, the relative risk of undocumented immigrant youths decreased by a factor of 0.36 (RRR = 0.36, 95% CI = 0.21–0.60, p-value < 0.001). Immigrant youths who have lived in Hillbrow for 3–5 years have increased relative risk for some access to SRH services compared with those with 0–2 years of stay (RRR = 2.35, 95% CI = 1.24–4.45, p-value < 0.01). Similarly, those who have lived for 6–20 years in the community have increased relative risk of having some access (RRR = 1.97, 95% CI = 1.04–3.73, p-value < 0.05). The relative risk of having no access by immigrant youths who did not receive information about family planning 6 months prior to the survey decreased by a factor of 0.48 compared to those who received such information (RRR = 0.48, 95% CI = 0.28–0.80, p-value < 0.01). Similarly, the relative risk of having no access to SRH services by immigrant youths who were not using a contraceptive method at the time of the survey decreased by a factor of 0.56 compared to those who were using contraceptives at the time of the survey (RRR = 0.56, 95% CI = 0.31–0.99, p-value < 0.05).

Table 5 a Association between access to Sexual and Reproductive Health services and socio-demographic characteristics of immigrant youths. b Bivariate association between access to Sexual and Reproductive Health services and Reproductive Health characteristics

The results of adjusted relative risk ratio on factors associated with access to SRH services by immigrant youths is presented in Table 6. With access to SRH services as the base outcome, the factors associated with no access to SRH services were level of education attained, wealth quintile, migration status, having experienced discrimination in Hillbrow and having received information about family planning 6 months prior to the survey. The results showed that immigrant youths with completed secondary education and higher have increased relative risk to have no access to SRH services compared to their counterparts with primary or incomplete secondary education (ARRR = 1.89, 95% CI = 1.06–3.36, p-value < 0.05). Compared with those in the poor wealth quintile, those in the rich quintile had an increased relative risk of having no access to SRH services (ARRR = 2.25, 95% CI = 1.00–5.07, p-value < 0.05). Compared to the documented, undocumented immigrant youths had a reduced risk of having no access to SRH services (ARRR = 0.49, 95% CI = 0.27–0.88, p-value < 0.05). Immigrant youths who reported not having experienced discrimination in Hillbrow were at increased risk for not having access to SRH services (ARRR = 2.06, 95% CI = 1.15–3.67, p-value < 0.05). Compared to immigrant youths who received information about family planning 6 months prior to the survey, those who did not receive such information had reduced risk of no access to SRH services (ARRR = 0.49, 95% CI = 0.26–0.90, p-value < 0.05). Using access as the baseline outcome, the determinants of having some access to SRH services by immigrant youths are being undocumented (ARRR = 0.51, 95% CI = 0.29–0.91, p-value < 0.05), not having received SRH information 6 months prior to the survey (ARRR = 0.38, 95% CI = 0.21–0.70, p-value < 0.01) and not using any family planning methods at the time of the survey (ARRR = 0.31, 95% CI = 0.16–0.62, p-value < 0.001).

Table 6 Multinomial logistic regression analysis on access to Sexual and Reproductive Health services by immigrant youths