| Summary: | Background: The literature posits that HIV knowledge is associated with precautious sexual behaviour and practice. We hypothesised and investigated the association between knowledge of HIV transmission and adolescent pregnancy in Ghana, given that the relationship between HIV knowledge and adolescent pregnancy has not been extensively studied. Methods: We did analyses on 5836 cases (weighted as 5121) of 15–24 years old reproductive age women in the female dataset of the 2017 Multiple Cluster Indicator Survey. Adolescent pregnancy was operationalized as reproductive age women between 15-24 years who became pregnant before the age of 18 years. Accurate HIV knowledge was measured by computing the scores of correct responses on six questions exploring women's knowledge about HIV transmission. We accounted for sample design and weight before performing a Chi-square test of independence and Poisson regression. Results: The results indicate that having lower scores on the HIV transmission knowledge scale was correlated with a higher probability of girls becoming pregnant before their 18th birthday. After controlling for the moderating effect of socio-demographic characteristics of the participants, we found that accurate HIV transmission knowledge loses its statistical significance in determining adolescent pregnancy. The factors that remain significant in the adjusted model were formal education status, household wealth, and region of residence. HIV transmission knowledge was statistically significantly related to adolescent pregnancy in the model after the education level variable was omitted. This observation was due to the significant effect of school education on other variables in the model. This result demonstrates that HIV knowledge has a major impact on adolescent pregnancy, but this effect is predicated by formal education attainment of the adolescent girl. Conclusions: Given the results, adolescent pregnancy issues can be resolved by the government and other development partners by adequately educating adolescents about HIV transmissions. Also, because they have the potential to reduce pregnancy among adolescents in Ghana, we recommend that programs and initiatives should address existing disparities in formal educational attainment and household wealth.
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