Background
Risky sexual behaviour, especially among 15-24 year olds, is a public health concern in South
Africa since this age group is the most at risk of contracting HIV. The concern is to what
extent youth are indulging in risky sexual behaviour. In 2002, the Department of Health
conducted a nationally representative survey on issues surrounding HIV/AIDS. A mass media
intervention was launched in the same year, i.e. the Khomanani Campaign, and a year later,
in 2003, a survey was conducted to assess the impact of the Khomanani Campaign.
Objectives
The main question being asked is, “What are the factors associated with risky sexual
behaviour amongst the young people of South Africa”. The indicators of risky sexual behaviour
being explored are age of sexual debut, condom use at last sexual encounter, condom use in
the past year and use of condoms consistently over the entire sexual lifetime. The three
objectives of the research report are to describe the cohort of the youth in the sample under
investigation, to describe the indicators of risky sexual behaviour among youth that are
deemed at risk, and to investigate the factors associated with these indicators of risky sexual
behaviour.
Data
The research uses the Khomanani Survey Findings of the Khomanani survey which was
conducted in 2003, a year after the Khomanani Campaign. Only youth aged 15-24 years old
who indicated that they were sexually active were included in the sample.
Method
The research is a cross sectional, secondary analysis of existing data, i.e. the Khomanani
Survey Findings. Descriptive statistics were carried out and Chi-squares or Fisher’s exact
tests were used for the initial bivariate analysis testing for associations between the
indicators of risky sexual behaviour and the factors deemed to affect such behaviour. Factors
such as media, self-esteem, self-efficacy, beliefs and accessibility of condoms which were
deemed 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
the bivariate analysis being included in the models. Factors that were significant in the
multiple regression models were regarded as the most important variables to be associated
with risky sexual behaviour.
Results
The final sample comprised 481 sexually active respondents with slightly more girls than boys
(55% vs. 44% with 1% not indicating the gender); 48% of respondents were aged 15-19 years
compared with 52% of respondents in the 20-24 age group. The majority of the youth had a
partial secondary education. Only 5% of the youth were reported as married.
The proportion of youth that had used a condom at last sexual encounter was 57%. The
proportion of youth reporting that they used condoms consistently in the past year was 39%
and some 28% of youth had used condoms consistently during the entire sex life. Of the 481
youth in the sample, 31% reported their first sexual encounter as before 16 years (“early
sexual debut”).
In the final regression model for condom use at last sex, females were 48% (aOR=0.52; 95%
CI=0.34, 0.78) less likely to have used a condom at last sexual encounter compared with
males. Being a youth from metropolitan areas was associated with condom use at the last
sexual encounter (aOR=2.60; 95% CI=1.47, 4.57). Youth who have heard the term ‘safe sex’
were twice (aOR=1.98; 95% CI=1.10, 3.56) as likely to have used a condom at the last sexual
encounter as to those who hadn’t heard the term “safe sex”. Being comfortable talking
about using condoms with partners was also associated with use of condoms at last sex
(aOR=3.86; 95% CI=1.74, 8.53).
Concerns over the quality of government issued condoms were postulated to have an impact
on condom use. Therefore respondents were asked whether they thought that government
condoms differed from those purchased from shops. Respondents who indicated that condoms
were the same were 2.71 times (aOR=2.71; 95% CI=2.28, 5.73) as likely to have used condoms
consistently in the past year as those who indicated that government condoms were better
than the ones from shops. Respondents who indicated that government condoms are of poor
quality 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
than the ones from the shops.
Consistency in using condoms since being sexually active was associated with being from a
metropolitan area (aOR=1.99; 95% CI=1.12, 3.51) and also respondents who had the opinion
that condoms are the same (aOR=3.04; 95% CI=1.33, 7.07) whether they are government
issued or from the shops..
The age of the respondent and also the belief that one should have sex with a partner to show
their love were the only factors associated with early sexual debut. Respondents who were
older (20-24 years) were 61 %( OR=0.39; 95% CI=0.23, 0.65) less likely to have had early sexual
debut below the age of 16 compared to their counterparts aged 15-19 years. Respondents
who did not believe that a person should have sex with their partner to show their love were
41 %( OR=0.59;95% CI=0.37,0.94) less likely to have had early sexual debut to those who
believed that a person should have sex with their partner to show their love controlling for
gender, area of stay, age group and employment.
Conclusions
The findings from the survey point out that more than half of the youth are using condoms at
most recent activities, with differences between men and women. Some youth are
consistently using condoms and not only using at last sex. Hence programs targeting youth
should continue taking into account issues that may be contributing to youth not using
condoms and not using them consistently. Messages on safe sex, messages encouraging youth
to communicate with partners on sexuality issues, as well as the government making condoms
accessible in all areas, should continue to be reinforced. Future research should also focus on
development and evaluation of interventions to delay sexual debut with issues of beliefs, and
community beliefs being discussed.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/10660 |
| Date | 27 October 2011 |
| Creators | Zhou, Diana |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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