Sexual harassment in South African schools: Is there an association with risky sexual behaviours?

Background. Several drivers of risky sexual behaviour are known, although research has not yet examined the relationship between experiences of sexual harassment at school and risky sexual behaviours among adolescents. Objective. To examine the association between peer- and teacher-perpetrated sexual harassment and risky sexual behaviours among adolescents in South Africa. Methods. Cross-tabulations and logistic regression models were fitted to data from 219 456 school-going adolescents (aged 10 - 19 years) who participated in the fourth South African National HIV, Behaviour and Health Survey (2011/2012). The outcomes were lack of condom use during last sexual activity and multiple sexual partnerships. Results. Of the respondents who had experienced sexual harassment by peers, 27.27% did not use a condom during their last sexual activity and 41.67% reported having had multiple sexual partnerships. Of the respondents who had experienced sexual harassment by a teacher, 5.56% reported to have had multiple sexual partnerships in the study period. Results show that respondents who had experienced peer-perpetrated sexual harassment were more likely to not have used a condom during their last sexual activity (odds ratio (OR) 1.08; 95% confidence interval (CI) 1.04 - 1.11), as were those who had experienced teacher-perpetrated sexual harassment (OR 1.37; 95% CI 1.32 - 1.43). Conclusion. A substantial number of school-going adolescents were found to have experienced sexual harassment and engaged in risky sexual behaviours. Sexual harassment at school should be considered as part of programmes aimed at addressing risky sexual behaviours among adolescents

Teenage pregnancy in South Africa: Where are the young men involved?

Background. The level of unintended pregnancies among teenage girls in South Africa (SA) has remained a public health concern. However, studies and interventions generally do not consider young men's involvement in teenage pregnancies. Objective. To investigate the sociodemographic and sexual behaviour characteristics of young men who have impregnated at least one teenage girl. Methods. The study used data from the Centre for Justice and Crime Prevention (2009), which included responses from young men (aged 12 - 22 years) across all SA provinces. Univariate and bivariate analyses and binary logistic regression were performed. Results. The results showed that 93.2% of the sample had ≥2 lifetime sexual partners, 22.4% rarely used condoms and 11.5% had never used condoms. Teenage pregnancy incidence was ≥35% in all provinces except Gauteng and the Western Cape. The likelihood of being involved in a teenage pregnancy was higher among respondents who reported having ≥2 lifetime sexual partners (odds ratio (OR) 2.510; 95% confidence interval (CI) 0.43 - 14.77). Respondents with a higher education were less likely to be involved in a teenage pregnancy (OR 0.819; 95% CI 0.36 - 1.84) than those with a lower education (OR 1.219; 95% CI 0.59 - 2.50). Conclusion. Engaging in multiple sexual partnerships could increase the vulnerability of young people to sexually transmitted infections or teenage pregnancies. Initiatives to create awareness among SA youth regarding the consequences of sexual behaviour are recommended, with a specific focus on addressing young men's involvement in teenage pregnancy

Cervical cancer screening among adolescent girls in Lesotho: levels and determinants

Background. International guidelines have discouraged screening of young women under the age of 21 for cervical cancer. However, a high screening rate is still evident among adolescent girls in Lesotho. Objective. To explore the levels and determinants of cancer screening among adolescent girls in Lesotho. Methods. This cross-sectional study used secondary data from the 2014 Lesotho Demographic and Health Survey collected from 1 542 adolescent girls aged 15 - 19 years. Descriptive statistics, the chi-square test and a binary logistic regression model were used to analyse the data. Results. Despite recommendations that adolescents should not screen for cervical cancer, results show that 15% of adolescent girls in Lesotho attend screening services. Adolescent girls from rural areas are less likely to screen than those from urban areas (odds ratio (OR) 0.22, 95% confidence interval (CI) 0.07 - 0.68; p=0.009). Marital status and level of education were significantly associated with cervical cancer screening among respondents; however, age at first sex was not statistically associated with screening among adolescent girls. Conclusion. With reference to international guidelines, the screening rate for cervical cancer is high among adolescents in Lesotho. Future studies should focus on why adolescents in Lesotho still screen for cervical cancer despite international recommendations discouraging screening before the age of 21

Disease prevalence and grade repetition among adolescents in South Africa: is there any relationship?

Background. A universal goal of public health is to ensure that adolescents have a healthy transition to adulthood. In developing countries, a host of social, economic and political factors inhibit this from happening. The results of these challenges include an increasing disease prevalence among an age group (10 - 19-year-olds) that should be healthy. Objectives. The purpose of this study is to identify the most prevalent diseases and assess the relationship between disease and grade repetition among adolescents in South Africa (SA), and to assess the impact of disease on grade repetition. Methods. Data from the SA General Household Surveys (2009 - 2016) were analysed, and both adolescent (10 - 19 years) sexes from all geographical and racial groups were included. Frequencies, percentages and rates of infectious, non-communicable diseases (NCDs) and mental health outcomes were estimated. The relationship between disease and grade repetition was determined using logistic regression. Results. Infectious diseases, NCDs and mental illnesses are increasing in adolescents over time. In urban areas, rates of NCDs are higher than those of infectious diseases, while in rural areas a high burden of infectious disease persists. Among adolescents who repeated a grade, 7.07% had an infectious disease. In addition, infectious disease (odds ratio (OR) 1.17, p<0.05), younger adolescents, 15 - 19-year-olds (OR 1.52, p<0.05) and urban residence (OR 1.12, p<0.05) are associated with increased likelihood of grade repetition. Conclusion. Policies and programmes in SA which address the health of adolescents need to be more aware of the disease prevalence among school pupils in the country. Prolonged disease occurrences are contributing to the slow school progression and eventual matriculation of pupils