Youth are having sexual intercourse at an early age and as such, are engaging in risky behaviors that are associated with adverse health outcomes, including HIV infection. Little research has been undertaken to examine the influence of contextual factors on youth intentions to delay sexual involvement. To address that gap, this study aimed to examine the influence of age, gender, race, immigration status, HIV knowledge, HIV-related stigma, concern about HIV, direct exposure to HIV/AIDS, peer pressure, and religious influence on youth intentions to delay sexual involvement. Delayed sexual involvement was conceptualized as youth attitudes towards abstaining from sex, their knowledge of the consequences of sexual involvement, and perceived parent or peer disapproval of the behavior. The theory of reasoned action was used as a framework to guide the study. The cross-sectional study involved secondary data analysis of baseline data pooled from a program evaluation. The sample included 536 urban low-income African American and Latino youth aged 11 to 16 years at high risk of HIV/AIDS. Multiple linear regression analyses revealed that the weighed combination of the predictor variables, age, gender, race, immigration status, HIV knowledge, direct exposure to HIV/AIDS, peer pressure, and religious influence explained the greatest variance of intention to delay sexual involvement (R2 = .246, p < .05). Also observed was a significant relationship between age, gender, and sexual intentions across the regression models. These findings can enhance HIV prevention and social change initiatives because of the potential to impact youth early sexual debut, reduce risky sexual behavior, and consequently decrease the rates of HIV infection among youth.

Thesis (MPhil)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Introduction: There is an increase in the prevalence of HIV among young females compared to their male counterparts in South Africa (Shisana, 2012). Previous studies have shown early sexual debut is one of the contributing factors to acquiring HIV. Early sexual debut being defined as first sexual intercourse below the age of 15 years as illustrated in the literature (Aji et al., 2013). The aim of the study is to determine the contributing factors to early sexual debut by female adolescents in the ages between 13-19 attending Town-Two Clinic. To establish the knowledge of adolescent females about HIV & STI transmission, to evaluate what sexual and reproductive health education and management is required by adolescents attending the clinic, and to provide guidelines to deal with the concerns and needs of female adolescents attending Town-Two Clinic as well as reproductive health education. Methods: This is an exploratory qualitative study. Twenty female adolescents between the ages 13-19 attending Town Two Clinic for family planning were voluntarily recruited. Data collection was done by means of a 20 minute interview; two participants were interviewed a day. The interview was semi-structured using open-ended questions. Socio-demographic data was obtained by means of a questionnaire; linked to the interviewee by means of a study code to maintain anonymity. Data analysis was done using inductive analysis and creative synthesis, which analyses the details of the information collected to discover important patterns, themes and interrelationships (Larry, 2014). Results: The average age of the participants was 16 years. The youngest and eldest was 13 and 19 years old respectively; average grade was grade10. Majority of participants resided with their mothers (35%), 20% lived with both parents, 20% with their elder siblings, 15% with grandparents and 5% with other relatives. Participants (45%) reported they were sexually active; average age at first sexual intercourse was 14 years. The participants’ acceptable age for sexual debut was 18yrs. Reasons contributing to early sexual debut were identified as: peer pressure, easy access to alcohol, transaction and cross-generational sex, media and social networks, crowded living conditions, sexual abuse and lack of parental supervision and communication with children. The participants (95%) said they received sex education at school;. (65%) reported they were taught about safe sex practices and using a condom every time they have sex. Knowledge gaps; (60%) of the participants reporting they would like to receive more information and teaching about STI’s, as they knew very little about them. Conclusion: The study demonstrates the contributing factors to early sexual debut amongst female adolescents as: Peer pressure, easy access to alcohol, transaction and cross-generational sex, media and social networks, crowded living conditions, sexual abuse and lack of parental supervision and communication with children, and its risk to HIV infection. Appropriate and current sex education with regards HIV, STI prevention, testing and treatment is crucial. Parents play a vital role in educating their own children and need to overcome their socio-cultural views about sex. Interdisciplinary collaboration is needed between the health sector, education, law enforcement, church youth groups, media and social networks in developing effective programs for educating youth on HIV prevention, reproductive health and dangers of substance abuse. / AFRIKAANSE OPSOMMING: Nie beskikbaar