Year: 2011
Type: dissertation
Abstract: Background \nRisky sexual behaviour, especially among 15-24 year olds, is a public health concern in South \nAfrica since this age group is the most at risk of contracting HIV. The concern is to what \nextent youth are indulging in risky sexual behaviour. In 2002, the Department of Health \nconducted a nationally representative survey on issues surrounding HIV/AIDS. A mass media \nintervention was launched in the same year, i.e. the Khomanani Campaign, and a year later, \nin 2003, a survey was conducted to assess the impact of the Khomanani Campaign. \nObjectives \nThe main question being asked is, “What are the factors associated with risky sexual \nbehaviour amongst the young people of South Africa”. The indicators of risky sexual behaviour \nbeing explored are age of sexual debut, condom use at last sexual encounter, condom use in \nthe past year and use of condoms consistently over the entire sexual lifetime. The three \nobjectives of the research report are to describe the cohort of the youth in the sample under \ninvestigation, to describe the indicators of risky sexual behaviour among youth that are \ndeemed at risk, and to investigate the factors associated with these indicators of risky sexual \nbehaviour. \nData \nThe research uses the Khomanani Survey Findings of the Khomanani survey which was \nconducted in 2003, a year after the Khomanani Campaign. Only youth aged 15-24 years old \nwho indicated that they were sexually active were included in the sample. \nMethod \nThe research is a cross sectional, secondary analysis of existing data, i.e. the Khomanani \nSurvey Findings. Descriptive statistics were carried out and Chi-squares or Fisher’s exact \ntests were used for the initial bivariate analysis testing for associations between the \nindicators of risky sexual behaviour and the factors deemed to affect such behaviour. Factors \nsuch as media, self-esteem, self-efficacy, beliefs and accessibility of condoms which were \ndeemed to be associated with risky sexual behaviours were explored in this report. Multiple logistic regression models were carried out with variables which were significant at p<0.20 in \nthe bivariate analysis being included in the models. Factors that were significant in the \nmultiple regression models were regarded as the most important variables to be associated \nwith risky sexual behaviour. \nResults \nThe final sample comprised 481 sexually active respondents with slightly more girls than boys \n(55% vs. 44% with 1% not indicating the gender); 48% of respondents were aged 15-19 years \ncompared with 52% of respondents in the 20-24 age group. The majority of the youth had a \npartial secondary education. Only 5% of the youth were reported as married. \nThe proportion of youth that had used a condom at last sexual encounter was 57%. The \nproportion of youth reporting that they used condoms consistently in the past year was 39% \nand some 28% of youth had used condoms consistently during the entire sex life. Of the 481 \nyouth in the sample, 31% reported their first sexual encounter as before 16 years (“early \nsexual debut”). \nIn the final regression model for condom use at last sex, females were 48% (aOR=0.52; 95% \nCI=0.34, 0.78) less likely to have used a condom at last sexual encounter compared with \nmales. Being a youth from metropolitan areas was associated with condom use at the last \nsexual encounter (aOR=2.60; 95% CI=1.47, 4.57). Youth who have heard the term ‘safe sex’ \nwere twice (aOR=1.98; 95% CI=1.10, 3.56) as likely to have used a condom at the last sexual \nencounter as to those who hadn’t heard the term “safe sex”. Being comfortable talking \nabout using condoms with partners was also associated with use of condoms at last sex \n(aOR=3.86; 95% CI=1.74, 8.53). \nConcerns over the quality of government issued condoms were postulated to have an impact \non condom use. Therefore respondents were asked whether they thought that government \ncondoms differed from those purchased from shops. Respondents who indicated that condoms \nwere the same were 2.71 times (aOR=2.71; 95% CI=2.28, 5.73) as likely to have used condoms \nconsistently in the past year as those who indicated that government condoms were better \nthan the ones from shops. Respondents who indicated that government condoms are of poor \nquality were 2.18 times (aOR=2.18; 95% CI=1.04, 4.58) as likely to have used condoms consistently in the past year as those who indicated that government condoms were better \nthan the ones from the shops. \nConsistency in using condoms since being sexually active was associated with being from a \nmetropolitan area (aOR=1.99; 95% CI=1.12, 3.51) and also respondents who had the opinion \nthat condoms are the same (aOR=3.04; 95% CI=1.33, 7.07) whether they are government \nissued or from the shops.. \nThe age of the respondent and also the belief that one should have sex with a partner to show \ntheir love were the only factors associated with early sexual debut. Respondents who were \nolder (20-24 years) were 61 %( OR=0.39; 95% CI=0.23, 0.65) less likely to have had early sexual \ndebut below the age of 16 compared to their counterparts aged 15-19 years. Respondents \nwho did not believe that a person should have sex with their partner to show their love were \n41 %( OR=0.59;95% CI=0.37,0.94) less likely to have had early sexual debut to those who \nbelieved that a person should have sex with their partner to show their love controlling for \ngender, area of stay, age group and employment. \nConclusions \nThe findings from the survey point out that more than half of the youth are using condoms at \nmost recent activities, with differences between men and women. Some youth are \nconsistently using condoms and not only using at last sex. Hence programs targeting youth \nshould continue taking into account issues that may be contributing to youth not using \ncondoms and not using them consistently. Messages on safe sex, messages encouraging youth \nto communicate with partners on sexuality issues, as well as the government making condoms \naccessible in all areas, should continue to be reinforced. Future research should also focus on \ndevelopment and evaluation of interventions to delay sexual debut with issues of beliefs, and \ncommunity beliefs being discussed.
Author: Diana Zhou
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W602097263