Challenges on sexual health communication with secondary school learners, Limpopo province

A conversation about sexuality is most likely to encourage healthy and positive sexual practices while reducing risky sexual behaviour among adolescents. Traditionally, sexuality is discussed in hushed tones in proverbs and is reserved for adults. On the other hand, adolescents must be well informed about their sexuality to assist them to make informed decisions about their sexual behaviour.Objectives: The study determined parents' views regarding challenges of sexual health communication among secondary school learners in the Limpopo province.Method: A qualitative, exploratory-descriptive and contextual approach was employed for the study. Fifty-six parents were purposively selected, resulting in five focus group discussions that had 8­12 members. One central question was asked, and based on the participants' responses, probing questions followed. Data were analysed using thematic analysis. Trustworthiness and ethical considerations were ensured.Results: Three themes, namely communication concerns, role shifting in imparting sexuality education and poor parent­child relationships, and eight subthemes emerged from the data.Conclusion: This study identified that communication concerns influence parent­child dialogue on sexuality education. Therefore, there is a need to address factors hindering communication such as cultural barriers, role shifting in imparting sexuality education and poor parent­child relationships. This study suggests that parents should be empowered in dealing with children's sexuality.Contribution: Parents should be equipped with reproductive knowledge to enable them to talk freely about sexuality with their children. This should be complemented with broader programmes aimed at promoting sexual health education within the traditional family institution

Factors associated with risky sexual behaviour among sexually experienced undergraduates in Osun state, Nigeria

Background: Risky sexual behavior (RSB) is common among youths which predispose them to sexually transmitted infections. This study sets out to identify the factors associated with RSB among undergraduates in Osun state. Methods: The study design was descriptive cross sectional and a total of 550 respondents from two universities in Osun state were sampled using a multistage sampling technique, out of which data from 266 sexually experienced respondents was further analyzed. Data collected via a semi­structured self-administered questionnaire and analyzed using univariate, bivariate and multivariate analyses. Results: The 266 respondents consisted of 54.5% males and 45.5% females and larger percentage of them were in the age group 15-24years. Seven out of ten respondents (69.9%) were sexually active while 65.8% were involved in at least one RSB. Of the 266 respondents, 28.6% ever had concurrent multiple sexual partners, 15.8% used alcohol/drugs at last sex while 48.1% did not use condom at last sex. More males (71.7%), alcohol users (76.8%), drug users (78.0%), pornography watchers (82.7%), internet users (71.2%) respondents "not in good terms with mum" (86.7%) and "those whose mum doesn't instruct them morally" (84.2%) were involved in RSB compared to their respective counterparts (p<0.05). However, there were no identifiable predictors of RSB on regression analysis. Conclusion: Risky Sexual Behavior is prevalent among undergraduates with males being more involved, among other associated factors. Concerned stakeholders should engage youths via behavioral change communication strategies so as to significantly reduce their involvement in RSB

Factors associated with risky sexual behaviour among clients undertaking HIV testing and counselling services at a secondary referral hospital Lagos, Nigeria

Background: This study determined the prevalence of risky sexual behaviour and its associated factors among clients who accessed HIV counselling and testing services at a secondary referral hospital in Lagos, Nigeria. Methods: A retrospective review of clients' records was conducted. The Client Intake Form of people who accessed HIV counselling and testing services at Mainland Hospital in Lagos, Nigeria between July 1, 2016, and December 31, 2017, were reviewed. Multivariate analysis was conducted to determine the associated factors of risky sexual behaviour. Results: A total of 4273 client's records were analyzed, 3884 (90.9%) reported having sex before HIV counselling and testing (HCT). The prevalence of risky sexual behaviour among clients was 41.5%. More males and HIV positive clients had unprotected sex with a casual partner three months before HIV counselling and testing (p < 0.05). More singles than the married had unprotected sex with casual partners (p <0.001) and multiple sexual partners (p =0.002). The prevalence of risky sexual behaviour reduced with advancing age. Being single and having an HIV infection were associated with risky sexual behaviour in this study. Conclusion: Age, marital status and HIV status were associated factors of risky sexual behaviour

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

'They tell you about the risks': exploring sources of sexuality education among very young adolescents in rural Mpumalanga

Background. Early adolescence (ages 10 - 14) is a crucial stage of development. The importance of early intervention in improving adolescent sexual and reproductive health (SRH) is increasingly acknowledged. Yet, school-based sexuality education largely focuses on older adolescents, leaving very young adolescents to contend with conflicting information from different sources. This study responds to the need for contextually nuanced research with very young adolescents, which can inform policy and programmes aimed at improving their SRH outcomes. Objectives. To explore very young adolescents' sources of SRH knowledge and investigate the implications of both formal school-based sexuality education and informal sources of information for their SRH rights. Methods. This research was conducted with schoolgoing adolescents (aged 10 - 14) from the Gert Sibande district in rural Mpumalanga. Data were collected qualitatively using individual interviews and group-based participatory workshops, all conducted with the same participants. Transcribed data were analysed using thematic analysis. Results. Findings indicate that while formal transfer of SRH information takes place through school-based sexuality education, learners' sexual knowledge is also shaped by informal sources, including household observations and sexual play. We identify three themes that cut across sources of SRH knowledge and position young adolescents in contradictory ways: prohibitive messaging, the notion of childhood innocence and everyday sexual learning. Conclusion. Recommendations are made for comprehensive sexuality education that is responsive to this age group's needs, draws on their everyday lived experiences and optimises the opportunities offered by foregrounding agency, while remaining cognisant of structural constraints

Longitudinal analysis of HIV risk behaviour patterns and their predictors among public primary care patients with tuberculosis in South Africa

The goal of this study was to identify various HIV risk behaviours among tuberculosis (TB) patients in a longitudinal study design in South Africa. In 42 public primary healthcare facilities in three districts in three provinces, adult new TB and TB retreatment patients with hazardous or harmful alcohol use were interviewed within 1 month of initiation of anti-TB treatment and were followed up at 6 months. The total sample with a complete 6-month follow-up assessment was 853. At the follow-up assessment, several HIV risk behaviours significantly reduced from baseline to follow-up. In multivariate Generalized Estimating Equations logistic regression analyses, high poverty (odds ratio (OR): 2.68, 95% confidence interval (CI): 1.56­4.62),Posttraumatic Stress Disorder (PTSD) symptoms (OR = 1.55, 95% CI = 1.03­2.36), and sexual partner on antiretroviral therapy(ART) (OR = 1.84, 95% CI = 1.09­3.10) were associated with a higher odds, and excellent/very good perceived health status (OR:0.61, 95% CI: 0.37­0.98), severe psychological stress (OR = 0.51, 95% CI = 0.34­0.77), and HIV non-disclosure to most recent sexual partner (OR = 0.40, 95% CI = 0.25­0.65) were associated with a lower odds of inconsistent condom use. Being HIV positive (OR = 4.18, 95% CI = 2.68­6.53) and excellent/very subjective health status (OR = 2.98, 95% CI = 1.73­5.13) were associated with a higher odds, and having PTSD symptoms (OR = 0.60, 95% CI = 0.36­0.99), being on ART (OR = 0.48, 95% CI= 0.25­0.95), having a sexual partner on ART (OR = 0.41, 95% CI = 0.18­0.96), and HIV status non-disclosure (OR = 0.25, 95%CI = 0.15­0.41) were associated with a lower odds of having sex with an HIV-positive or HIV status unknown person. High poverty index (OR = 1.97, 95% CI = 1.19­3.25) and having a sexual partner on ART (OR = 4.37, 95% CI = 1.82­10.48) were associated with a higher odds, and having a partner with HIV-negative status (OR = 0.29, 95% CI = 0.16­0.51) and inconsistent condom use (OR = 0.39, 95% CI = 0.24­0.64) were associated with a lower odds of HIV status non-disclosure at last sex. The study found that among TB patients with problem drinking over a 6-month TB treatment period, the frequency of some HIV risk behaviours (inconsistent condom use) declined (OR = 0.64, 95% CI = 0.41­0.98), but also persisted at a high-level calling for a strengthening and integration of HIV prevention into TB management