Abstract
Background: With a disparate HIV prevalence among young men and women, high rates of teenage pregnancies and a lack of responsible fatherhood, issues of reproductive health among young people need to be urgently addressed. The aim of this research was to assess the knowledge, attitudes and practices regarding sexual and reproductive health among young men in the Bethesda Hospital catchment area of northern KwaZulu-Natal province.Methods: This observational, descriptive cross-sectional study was conducted at six randomly selected high schools within the uMkhanyakude district. All grade 12 male learners ≥ 18 years completed a questionnaire regarding their reproductive health knowledge, attitudes and practices.Results: A total of 279 learners participated in the study with a median age of 20.2 years and a mean knowledge score of 63.8%. Only 28.3% of the learners showed good or excellent knowledge on basic sexual and reproductive health questions; 50.9% believed that girls say ‘no’ to sex when they mean ‘yes’, and 46.2% believed that girls were sexually aroused when dominated by a man. Some 156 (55.9%) of those who were sexually active did not know their current sexual partner’s HIV status. There were significant associations between being brought up in a female-headed family and early sexual debut but not between early sexual debut and paternalistic attitudes to women.Discussion and conclusions: Basic sexual and reproductive health knowledge among the majority of participants was adequate. Patriarchal attitudes of sexual domination were prominent, and these are probably influenced by sociocultural belief systems of traditional masculinity, which are defined and dominated by men. This perpetuates gender inequality and contributes to poor sexual and reproductive health outcomes. Poor health-seeking behaviour and attitude relating to sexually transmitted infections (STIs), and having concurrent multiple sexual partners, puts them and their sexual partners at risk of HIV/AIDS acquisition. Strategies need to be developed to enhance socially acceptable and comprehensive sexual and reproductive health education and services among young men in this area, foster positive attitudes towards women and encourage gender-equal relationships.
Highlights
With a disparate HIV prevalence among young men and women, high rates of teenage pregnancies and a lack of responsible fatherhood, issues of reproductive health among young people need to be urgently addressed
The participants’ demographic details are illustrated below, followed by their knowledge, attitudes and practices relating to their sexual behaviour
The study findings highlight several concerning issues regarding young men’s knowledge, attitudes and practices regarding sexual and reproductive health in the Bethesda Hospital catchment area. They perhaps point to major deficiencies or challenges in the implementation, evaluation and monitoring of the life orientation programme, and the important role that the school health team could play in comprehensive sexual and reproductive health education
Summary
With a disparate HIV prevalence among young men and women, high rates of teenage pregnancies and a lack of responsible fatherhood, issues of reproductive health among young people need to be urgently addressed. Young people aged 10–24 years account for 25% (1.8 billion) of the world’s population,[1] with 88% of the adolescent[2] population (adolescent: 10–19 years) residing in developing countries, of whom one in five live in sub-Saharan Africa (SSA).[2] Such a large adolescent population presents an opportunity for economic development, and is the foundation for remodelling the future of many African countries.[3] the social and economic trajectory of such development requires healthy citizens who can maximise their potential and actively participate in such job and economic opportunities Within this context, issues of sexual and reproductive health can impact negatively on African youth, including those in South Africa (SA).[4] Studies have indicated that at least 50% of teenagers in SA are sexually active by 16 years of age,[5] this being of concern in a country with HIV prevalence rates of up to 39.4% among young women and 15% among young men.[6] The high rates of teenage and unwanted pregnancies,[1] and a lack of responsible fatherhood, highlight the need to address issues regarding their reproductive health. According to the United Nations, reproductive health and well-being should encompass the following: all pregnancies should be intended, all births should be healthy and sexual activity should be free of coercion or violence and infection.[9,10]
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