Abstract
BackgroundPrevention of youth sexual risk behaviour among the youth in uMgungundlovu District Municipality continues to be a primary challenge for public health and health promotion. Current prevention interventions are targeted at an individual level, whilst youth behaviour is influenced by many social and environmental factors.AimThe aim of the study was to explore the factors influencing sexual risk behaviours of the youth at different socio-ecological levels in uMgungundlovu District Municipality.MethodsAn explorative and descriptive qualitative study design was used, using in-depth interviews and focus group discussions for data collection. A framework analysis was used to develop themes derived from the socio-ecological theory.ResultsFour themes were identified that influence youth to engage in sexual risk behaviours: (1) individual factors, related to role modelling behaviour, gender and negative stereotypes towards females; (2) the microsystem in which youth function including the influence of family and peers; (3) the exo-system comprising the disadvantaged socio-economic status of the communities where the youth live; and (4) the macrosystem where negative social norms were reported to influence youth health outcomes.ConclusionSexual risk behaviour among youth in uMgungundlovu is influenced by many factors at multiple social levels. Interventions directed at these multiple levels are needed urgently.
Highlights
With high-risk sexual behaviours evident among many South African youth aged 14–24 years, numerous interventions have been implemented intending to promote their sexual health.[1,2] The ability of youth to protect themselves from unplanned pregnancy,[3] intergenerational sex, intimate partner violence,[4] human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) and sexually transmitted infections (STI) remains a challenge.[5]
Most of these programmes[12] mainly revolve around provision of information about sexual health.[13,14]. These programmes have used a variety of communication approaches such as different media, including television, radio, billboards and newspapers, as well as face-to-face information sharing and teaching strategies such as HIV peer education programmes and the Life Orientation learning area, which was introduced in South African public schools in 1995
Most of the face-to-face education programmes for the youth are implemented in school settings, where youth spend most of their time, and evidence shows that many HIV peer education programmes and Life Orientation learning area are operating in a vacuum,[16] not linked to collaborative community structures and government services.[17,18]
Summary
With high-risk sexual behaviours evident among many South African youth aged 14–24 years, numerous interventions have been implemented intending to promote their sexual health.[1,2] The ability of youth to protect themselves from unplanned pregnancy,[3] intergenerational sex, intimate partner violence,[4] human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) and sexually transmitted infections (STI) remains a challenge.[5] The risk factors that have been found to increase this vulnerability to HIV, other STIs and unplanned teenage pregnancy include poor decision-making and peer pressure,[6] social norms and gender-based violence,[7] early sexual debut without protection,[5] concurrent partners,[8] intimate partner violence[9] and intergenerational sex.[10] Owing to the complexity of changing the above-mentioned factors influencing these risky behaviours among the youth, the South African government, civil organisations and non-governmental organisations have developed numerous educational programmes.[1,11] most of these programmes[12] mainly revolve around provision of information about sexual health.[13,14] These programmes have used a variety of communication approaches such as different media, including television, radio, billboards and newspapers, as well as face-to-face information sharing and teaching strategies such as HIV peer education programmes and the Life Orientation learning area, which was introduced in South African public schools in 1995. Current prevention interventions are targeted at an individual level, whilst youth behaviour is influenced by many social and environmental factors
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