Factors contributing to the risk of HIV infection in rural school-going adolescents.

Adedapo Awotidebe,Julie Phillips,Willy Lens

doi:10.3390/ijerph111111805

Abstract

The objective of this study was to determine the factors that increase the risk of HIV infection in rural school-going adolescents and young adults. This was a cross-sectional study of 430 secondary school students (47.4% boys and 52.6% girls) from two rural schools in South Africa. Data were collected with a self-administered questionnaire on demographic information, sources of HIV/AIDS information, HIV knowledge, sexual behaviors, communication and negotiation skills, self-efficacy to refuse sex, peer influence and time perspective. Out of 113 (27.2%) participants who reported being sexually active, about 48% reported having had sex before the age of 15 and 42.2% reported penetrative sex with more than one partner in their lifetime. Only 44.8% of them reported consistent and regular use of condoms for every sexual encounter. Peer influence (OR = 3.01 (95% CI = 1.97–4.60)), gender difference (OR = 6.60 (95% CI = 1.62–26.84)) and lack of HIV information (OR = 1.22 (95% CI = 1.03–1.44)) influenced the sexual risk behaviors of the adolescents. Greater numbers of school-going adolescents in rural areas are sexually active. Peer influence, especially in boys, is a factor that increases the preponderance of risky sexual behaviors in adolescents. Positively, adolescents with high knowledge of HIV infection are more likely to use condoms for every sexual encounter. There is a need to strengthen comprehensive sexual health education and youth-friendly HIV prevention strategies to promote abstinence and safe sexual behaviors, especially among boys.

Highlights

High proportions of adolescents and emerging adults between the ages of 15–24 years inSub-Saharan Africa are increasingly sexually active and at higher risk of contracting sexually transmitted diseases [1]
This is because risky sexual behaviors, including sexual intercourse before the age of 15 years, multiple sexual partners and sex without condoms, are rife among adolescents and disproportionately higher in rural areas [1]
We extended the recruitment of participants for two weeks, and we again approached the other schools for participation; we did not get their active, opt-in approval to participate in our study

Summary

Introduction

Sub-Saharan Africa are increasingly sexually active and at higher risk of contracting sexually transmitted diseases [1] This is because risky sexual behaviors, including sexual intercourse before the age of 15 years, multiple sexual partners and sex without condoms, are rife among adolescents and disproportionately higher in rural areas [1]. Overall, these risky sexual behaviors are predominantly higher in boys compared to girls of the same age, partly because of the high level of testosterone in boys, which increases early disposition to sexual activities [2]. Adolescents’ brain structures are less developed and less well equipped to make rational judgments on complex sexual relationships, thereby predisposing them to heightened risk [6]

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Conclusion