Behavioural responses of South African youth to the HIV/AIDS epidemic: A nationwide survey

Abstract

South Africa is reported to have the largest number of people living with HIV/AIDS in the world. The present study investigated the behavioural responses of South African youth to the HIV/AIDS epidemic. A multi-stage stratified cluster sample of 2,430 youths aged 15–24 was selected, 46.9% of them males and 53.1% females. Nurses administered questionnaires to consenting youths, measuring behavioural risks and also took an oral fluid specimen for HIV antibody testing. It was found that the median age of sexual debut for both sexes was 16.5 years; most of the youths were sexually experienced with no variation by sex; sexual experience was highest among Africans living in informal urban areas; partner turnover was low and multiple partners were more common among African males living in urban informal settings; sexual frequency among sexually active youth was relatively low; secondary abstinence during the past 12 months was 24%; condom use at last sexual intercourse was high, at 52.8% for males and 47.6% for females, especially among Africans living in urban informal settings; and the majority of youths (74%) indicated that they had discussed HIV prevention with their partners during the past 12 months. These results suggest that South African youth are heeding the message to abstain, be faithful and use a condom; messages that are at the core of South Africa's HIV/AIDS prevention programme.

Acknowledgments

This research was funded by the Nelson Mandela Foundation, The Nelson Mandela Children's Fund, The Swiss Agency for Development and Corporation and the Human Sciences Research Council.

Notes

It is important to note that Gisselquist et al. (2002) recently estimated that 20–40% of HIV infections in Africa could not be explained by mother-to-child transmission or heterosexual transmission, but might be due to inadequate medical care (i.e. nosocomial or iotrogenic transmission). However, UNAIDS/WHO (2003) estimates that only 5% of HIV infection is via this route.

The overwhelming majority (77%) of the South African population is indigenous in origin and classified as African. The rest of the population that descended from Europe and the Indian sub-continent are classified as Whites (12%) and Indians (2%), respectively. Another significant racial minority group (6%) is known as Coloured(s) and is mainly made up of people who are of mixed race, Malay or aboriginal in origin. Such racial classification continues to be used in South Africa even today due to the existence of many disparities in most spheres of life, including health status and access to health services that largely reflect the legacy of the pre-1994 apartheid history of the country, with Whites still enjoying relatively more privileges than their counterparts from the other races.

This is a probability sample of census enumeration areas (EAs) throughout South Africa, and representative of the country's population according to provincial distribution, settlement patterns and racial diversity.