BACKGROUND: Studies done in both developed and developing countries have reported the tendencies of adolescents to engage in risky behaviours. Such behaviours include indulging in early and unsafe sexual activities, having multiple sexual partners, alcohol and drug use and dropping out of school among others. PURPOSE: The main aim of the study was to develop intervention strategies for reducing sexual risk practices among adolescents in Ethiopia. METHODS: A mixed method approach using quantitative and qualitative approaches was employed in order to investigate the risks of sexual practices among urban and rural adolescents in the selected area. A cross-sectional survey was used to gather data quantitatively and focus group discussions were used for the qualitative part of data collection. A total of 449 students and 72 FGD participants were selected for quantitative and qualitative study respectively using systematic random sampling technique. Logistic regression was done to identify possible factors associated with knowledge on emergency contraceptive, condom utilisation, pre-marital sex practices and perception of risky sexual practices. RESULTS: One hundred and seventy (37.9%) respondents had experienced sexual intercourse at the time of the study. The higher proportion (42.6%) of those who had engaged in sexual relationships was from the rural school compared to 33.1% in the urban schools. The proportion of sexually active respondents was higher among males (44.8%) compared to (29%) females. Multiple partners were higher in rural adolescents (44.7%) compared to 31.8% among urban adolescents. Sexually Transmitted Diseases were reported by 28.6% of the sexually active adolescents and the prevalence was higher among males (73.5%) compared to 27% females. 87% of the sexually active adolescents rarely used a condom. CONCLUSION: The study identified a knowledge gap on ASRH which limited adolescents to access reproductive services. Social, cultural and economic factors contributed to adolescent engagement in risky sexual behaviours. Based on the major findings of this study, intervention strategies targeting behavioural, biomedical and structural interventions were proposed. / Health Studies / D. Litt. et Phil. (Health Studies)

Adherence to long-term medications has remained a problem among adolescents worldwide. Antiretroviral therapy adherence is a wide-reaching challenge among HIV positive adolescents. The aim of this study is to explore and describe poor ART adherence among HIV positive adolescents in Maseru: influential factors and the need of social work support. Qualitative approach was used, following an explorative, descriptive and contextual research design. The research was conducted at BCMCOE Lesotho. Data was collected by using semi-structured in-depth interviews and purposive sampling was applied to select a sample of adolescents who are HIV positive and who have poor adherence to ART. Data was analysed according to the framework provided by Tesch (in Creswell 2003). Guba’s model (in Krefting 1991) was employed for data verification. Conclusions were drawn and recommendations were made about factors influencing adherence of adolescents to ART and support needed from social workers. / Social Work / M.A.(S.S.)

This study involves an analysis of accounts of first and subsequent early sexual experiences in a deep rural area of the Eastern Cape in South Africa over the last forty years. Through interviews and focus group discussions, the enculturation of youth into sexual activity in the community of interest is explored. The study looks into sexual experiences from childhood, through early adolescence to adults of up to sixty five years old, allowing an analysis of the changing forms of sexual experimentation and sexual debut in this context. Contextual factors mediating these changes are explored, with special emphasis on the changing regulatory practices around early sexual experiences and the effect thereof on behaviors connected to HIV infection risk. Practices that were previously important mediators of sexual behavior were: anxiety about the social consequences of pregnancy, which was previously a significant disincentive to sexual intercourse; men's previous acceptance of the need to practice non-penetrative forms of sex and girls postponing sexual debut for as long as possible. All these were culturally endorsed, but are now noted to have changed due to changes in the regulatory practices surrounding youth sexuality. The context of early sexual experiences and the surrounding cultural practices have also changed significantly, and this needs to be taken into account in understanding receptivity to condom use messages. Implications for HIV/AIDS prevention are discussed. Among other interventions, the study describes a participatory, community-based, multi-sectoral approach that takes social conditions into account as a way of empowering the community to strengthen its response to the pandemic. This incorporates different sectors of the community, including youth, parents, religious and traditional leaders, and various other structures, services and institutions that make up the community.

Voluntary Counselling and Testing (VCT) is at the core of HIV and AIDS prevention, treatment and care programmes. Timely access to treatment and related services requires knowledge of one‟s HIV status. Adolescents are at the epicentre of the HIV and AIDS pandemic. This study investigated the factors that influence adolescents‟ decisions to actively seek VCT. Semi-structured, in-depth individual interviews were conducted with twelve adolescents aged 15 to 19 who were conveniently selected to participate in the study. The study found that adolescents have extensive knowledge regarding the benefits of VCT and acknowledge the need to test for HIV. However, fear of the consequences of testing positive for HIV such as stigmatisation by family and the community, inability to influence their partners to take an HIV test and the inability to make their own decisions and follow through on them still hinder their maximum uptake of VCT. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

This qualitative study was done in Livingstone, Zambia, and used focus group discussions to investigate the reasons that youths aged 15 to 24 years see as justifying, or compelling, their non-use of recommended methods for prevention of sexual transmission of HIV. It focused on four methods, namely abstinence, condom use, voluntary counseling and testing, and mutual faithfulness. The study found that non-adherence to HIV preventative methods is linked to variables in the process of adolescent growth and development, to contextual variables in society, to characteristics of products and services associated with these HIV preventative methods, and to disease characteristics of HIV itself. A key conclusion of this study is that to improve the effectiveness of HIV prevention programs among the youths it is essential that factors that hinder adherence to preventative methods are recognized and addressed. / Social Work / M.A.(Social Work)

The aim of this study was to investigate the perceptions, attitudes, opinions and fears of the adolescent high school learners towards HIV counseling and testing at school.Quantitative, descriptive, exploratory research was conducted to determine if high school learners would like to be tested for HIV at school. Data collection was done using structured questionnaires. The respondents in the study were daytime high school learners (n=120) who were in grade 8 to 12, between ages of 12 to 18 years of age. The study highlighted that adolescents engage in sexual activities at an early age. The results revealed that there is lack of knowledge, unavailability of HCT services for adolescents and the resources to keep a girl child school. This behavior may result in adolescents contracting sexually transmitted infections and HIV, falling pregnant at an early age, which may force adolescent high school learners to drop out of school. However, the study shows that government has more to educate adolescent high school learners about HIV/AIDS to modify their perceptions and attitudes towards HIV counseling and testing. / Health Studies / M.A. (Health studies)

This qualitative study was done in Livingstone, Zambia, and used focus group discussions to investigate the reasons that youths aged 15 to 24 years see as justifying, or compelling, their non-use of recommended methods for prevention of sexual transmission of HIV. It focused on four methods, namely abstinence, condom use, voluntary counseling and testing, and mutual faithfulness. The study found that non-adherence to HIV preventative methods is linked to variables in the process of adolescent growth and development, to contextual variables in society, to characteristics of products and services associated with these HIV preventative methods, and to disease characteristics of HIV itself. A key conclusion of this study is that to improve the effectiveness of HIV prevention programs among the youths it is essential that factors that hinder adherence to preventative methods are recognized and addressed. / Social Work / M.A.(Social Work)

Text in English / The purpose of the study was to investigate the experience explore the experience of virginity testing of female adolescents in the uThungulu district of KwaZulu-Natal. A qualitative research was conducted to explore and describe the experiences of female adolescents on virginity testing. In-depth phenomenological interviews were conducted on 18 participants during data collection. Proponents of virginity testing believe that virginity testing is a traditional practice that can assist in reducing HIV infection and teenage pregnancy amongst the youth. On the other hand, opponents of virginity testing strongly believe that the practice of virginity testing interferes with human rights and Constitutional prescripts that protect the rights to equity, privacy, bodily integrity and sexual autonomy of young women. The study found that participants had only positive experiences of the practice of virginity testing and none expressed having any negative experiences. The findings also confirmed that virginity testing is being done irrespective of different opinions from different scholars and experts on the subject. Little knowledge about the Children’s Act and the Commission for Rights of Cultural and Linguistic communities was observed. / Health Studies / M.P.H.

The aim of this study was to investigate the perceptions, attitudes, opinions and fears of the adolescent high school learners towards HIV counseling and testing at school.Quantitative, descriptive, exploratory research was conducted to determine if high school learners would like to be tested for HIV at school. Data collection was done using structured questionnaires. The respondents in the study were daytime high school learners (n=120) who were in grade 8 to 12, between ages of 12 to 18 years of age. The study highlighted that adolescents engage in sexual activities at an early age. The results revealed that there is lack of knowledge, unavailability of HCT services for adolescents and the resources to keep a girl child school. This behavior may result in adolescents contracting sexually transmitted infections and HIV, falling pregnant at an early age, which may force adolescent high school learners to drop out of school. However, the study shows that government has more to educate adolescent high school learners about HIV/AIDS to modify their perceptions and attitudes towards HIV counseling and testing. / Health Studies / M.A. (Health studies)

Adolescence is a significant period of change in physical and psychosocial development of human beings. Being HIV positive and growing up on a dynamically multifaceted HAART treatment, adds to the complexity of adolescence. This study was aimed at exploring the nature of experiences of adolescents who are on long-term Highly Active Antiretroviral Therapy (HAART) in Tembisa, Gauteng province. The study is based on a qualitative research method using in-depth semi-structured open-ended interviews and a focus group for data collection. The sample consisted of seven individual adolescent participants, three parents, guardians and caregivers, as well as 11 health care professionals. The thematic data analysis and the phenomelogical analysis methods were used to analyse data qualitative data while descriptive statistics were used to analyse quantitative biographical data. The study findings cover the negative and positive experiences and the perceived role of HAART treatment over a long period of time. The predominant themes identified from adolescent participants were disclosure of HIV positive status and the stigma surrounding a positive status, early childhood experience of parental death, challenges of taking HAART treatment, factors influencing adherence and non-adherence to HAART treatment, and lastly, the impact of religion on HAART treatment adherence. The findings suggest that adolescents who are on HAART treatment over an extended period of time experience drug fatigue. Drug fatigue has far-reaching implications for the health of an adolescent, as it has a higher likelihood that poor adherence or even complete refusal to take HAART treatment will occur. Poor adherence or refusal to take HAART treatment will most likely lead to cross infection and further spread of HIV and AIDS. A recommendation was made to include the establishment of a youth and adolescent-friendly centre by the hospital – one that is designated for the provision of tailored adolescent services and sensitive to adolescent developmental stages so as to minimise the likelihood of infected adolescents falling through the health care cracks. The introduction of a hospital-based school, an education unit run by dedicated and qualified facilitators focusing on aiding hospitalised learners with catch-up scholarly programmes, was a further recommendation. It was further recommended that reproductive health care needs of adolescents who grow up on HAART treatment be given attention in further research. / Psychology / Ph.D. (Psychology)