This study of reproductive health in adolescents 15-19 years old in 5 Sahel countries was undertaken by the Center for Study and Research on Population for Development (CERPOD) to provide information on adolescent sexual behavior, knowledge and attitudes toward family planning, and contraceptive usage by married and unmarried adolescents. Individual interviews and focus groups with adolescents, parents, teachers, and other community leaders provided qualitative data in Burkina Faso, Mali, and Niger. Quantitative data on these countries as well as Senegal and Gambia came form the Demographic and Health Surveys and other family planning surveys conducted in the 5 countries between 1987 and 1994. The first chapter discusses age at first marriage and health problems that may result from pregnancy in physically immature women. 17% of rural marriages in Gambia, 19% in Senegal, and 45% in Niger involve brides under the age of 15. At the same time, increases in the proportion of women who are still single at age 20, especially in the capital cities, have caused societal concern. Despite the strong traditional importance of female virginity in most Sahelian ethnic groups, premarital sexual activity is belived to be increasing, especially in urban ares. Until recently, contraceptive usage has been rare among adolescents in the region. Married adolescents are prevented from using a contraceptive method by strong societal pressure to begin childbearing. Rates of contraceptive usage among adolescents are low in all 5 countries, but use of modern contraceptives is higher among the unmarried. Many unmarried adolescents are nevertheless prevented by shame and disapproving staff attitudes from seeking contraception. A majority of adolescents are aware of AIDS, but their knowledge of other sexually transmitted diseases is incomplete. Few differences were noted between adolescent and older mothers in use of maternal-child health sevices, but urban adolescents had a greater tendency to postpone the first prenatal visit.