Sexual autonomy and the use of modern contraceptives in Nigeria evidence from the 2018 demographic and health survey

Objective: The objective of the study was to determine the prevalence and relationship between sexual autonomy and modern contraceptive use among Nigerian women. Methods: Secondary data analysis of the 2018 Nigerian Demographic and Health Survey was conducted among Nigerian women aged 15-49 years who were married or had a partner. Analysis was conducted using descriptive analysis and univariate and multivariate logistic regression. P < 0.05 was considered statistically significant. Results: Participants that had never heard or seen a family planning awareness message were 59.6%, whereas 55.9% were capable of deciding whether to refuse their husband/partner's sex or not. The prevalence of modern contraceptive use was 12%, and the likelihood of using modern contraceptives increased with the level of education, wealth status, and the number of living children. Sexual autonomy was also a significant predictor of modern contraceptive use (odds ratio = 1.35, 95% confidence interval: 1.25-1.46). Conclusion: There is a very low prevalence of modern contraceptive use among women in Nigeria. Sexual autonomy, poverty, education, and the number of living children play a major role. Thus, women empowerment and girl-child education are critical interventions needed for the best outcomes on contraceptive use in Africa. Male involvement in sexual autonomy is also key since they are major decisionmakers regarding women's issues.

Socioecological analysis of determinants of early adolescent sexuality in Benin: a qualitative study

Introduction: early adolescent sexuality is associated with an increase in risky sexual behaviour, unwanted pregnancies, and the occurrence of sexually transmitted infections. However, despite the efforts of governments and their partners, the implementation and effectiveness of appropriate and adapted services to improve adolescent sexual and reproductive health are lagging. Therefore, this study aimed to document determinants of early adolescent sexuality in the central district of Tchaourou in Benin based on a socio-ecological approach. Methods: an explorative and descriptive qualitative study was conducted using focus groups and individual interviews based on the socio-ecological model. Participants included adolescents, parents, teachers, and community leaders in Tchaourou. Results: the number of participants in each focus group was 8 (32). There were 20 girls and 12 boys aged 10-19 years, of whom 16 were students (7 females and nine males) and 16 were apprentice dressmakers and hairdressers. In addition, five participants attended individual interviews (two community leaders, one religious' leader, one teacher and one parent). Four themes were identified that influence early sexuality among adolescents and grouped into individual determinants related to knowledge about early sexuality; interpersonal determinants related to adolescents' function, including the influence of family and peers; community and organizational determinants related to where harmful sociocultural norms; political determinants comprising the disadvantaged socioeconomic status of the communities where adolescents live. Conclusion: many factors at multiple social levels influence early adolescent sexuality in the commune of Tchaourou in Benin. Therefore, interventions directed at these various levels are needed urgently.

Sexually transmitted infection (STI): A malady with skewed marital unfaithfulness, the Nigerian experience

Marital unfaithfulness is a major contributor to sexually transmitted infections in both sexes; however, societal view of the menace seems to use various lenses for the different sexes. Globally, evidence suggests that marital infidelity has existed in history. In Africa, as well as in Western society, infidelity is a problem facing many families and accounts for high incidence of divorce. This narrative review described and synthesized literature on marital infidelity and its association with sexually transmitted infections. We conducted informal interviews with married women on their experiences with marital infidelity in Nigeria. Associated physical, social and psychological cultured imposed consequences were experienced by women in Nigeria. The recurrent themes felt helplessness, enduring physical, emotional and psychological torture, accepting fate with reservation and being strangers in marital union. This narrative review could initiate critical thoughts and discussions on the factors in skewed marital unfaithful and the contribution to reproductive health and family life.

Roe vs. Wade conundrum: Africa must increase commitment to sexual and reproductive health and rights

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Sexual behaviours and their associated factors among young people in the Dodowa Health and Demographic Surveillance Site (DHDSS) in Ghana

Objective: This paper describes sexual behaviours and their associated factors among young people. Design: The study design is cross-sectional. Setting: Dodowa Health and Demographic Surveillance Site (DHDSS) in Ghana's Shai-Osudoku and Ningo Prampram districts. Participants: Young people aged 10 to 24 years, median age 17 years. Outcome measures: Self-reported to have ever had sex, non-use of a condom at last sex, and ever been pregnant or gotten someone pregnant. Results: Of the 1689 young people; 42% reported having ever had sex, not using a condom at last sexual activity (64%), and ever been pregnant or gotten someone pregnant (41%). The proportion of non-use of condoms at last sex was high across all age groups but was highest (93%) in a small proportion of 10 to 14-year-olds who have ever had sex. Higher proportions of females than males; were reported to have ever had sex (46%), not using a condom at their last sex (66%) and ever been pregnant or getting someone pregnant (56%). Age group (20 to 24), females, primary or junior high school, living alone and lower household socio-economic status were risk factors associated with all three outcome measures. Conclusion: Risky sexual behaviour is high among young people in the Dodowa HDSS. Therefore, interventions that promote safer sexual practices and help young people make timely decisions on their sexual and reproductive health care needs are required.

Comportements sexuels à risque d'infections sexuellement transmissibles / VIH chez les élèves du secondaire du Collège d'Enseignement Général1 de Natitingou / Sexual behaviors at risk of sexually transmitted infections /HIV among secondary school students at the Natitingou General Education College1

Contexte et objectif. L'éviction des infections sexuellement transmissibles et du VIH (IST/VIH) chez les jeunes et adolescents passe par l'adoption de comportement sexuel sain. L'objectif était de décrire les comportements sexuels à risque d'IST/VIH chez les élèves du secondaire du CEG1 de Natitingou en 2020. Méthodes. Il s'est agi d'une étude transversale à visée analytique qui s'était déroulée au CEG1 de Natitingou. Ont été inclus dans l'étude, les élèves régulièrement inscrit au CEG1 de Natitingou. Résultats. Les élèves du CEG1 de Natitingou avaient des comportements sexuels à risque dans 28,71%. Ils fréquentaient les professionnelles de sexe dans 5,9 % et le préservatif était utilisé occasionnellement (55 %). Les élèves filles (17 %) avaient des rapports sexuels, en compensation de l'argent. La partouze a été pratiquée dans 9,9 % des cas. Le sexe masculin (p= 0,011), l'âge (p< 0,0001), l'auto prise en charge des frais d'étude (p= 0,037) et la méconnaissance des élèves sur les IST/SIDA (p= 0,041) étaient associés de manière indépendante à l'adoption d'un comportement sexuel à risque. Conclusion. Les adolescents du CEG1 de Natitingou ont des comportements sexuels à risque d'IST/VIH. L'école, l'environnement religieux et les parents doivent s'unir pour amener les jeunes à réduire les comportements à risque

Perceived causes of change in Nigerian adolescent sexual risk behaviour ­ Results from semi-structured mobile instant messaging interviews

The study explores the perceived causes of change in sexual risk behaviour among Nigerian adolescents over the past years. By embedding the results into a theoretical context, the study aims to further develop interventions targeting adolescent sexual health. To do so, 23 semi-structured interviews are conducted through the mobile-instant-messaging tool WhatsApp. The interview sample consists of both female and male adolescents and adults from different regions in Nigeria. The interviews are conducted as simultaneous chats and analysed based on the qualitative content analysis approach. Respondents perceive a multitude of different factors as causes of change in sexual risk behaviour among Nigerian adolescents. They can be categorised into (1) individual actors, (2) structural factors, and (3) socio-cultural factors. Interrelations between the different factors can partly be observed. The other factors are mostly modifiable and can therefore contribute to reducing adolescent SRB.

Factors influencing risky sexual behaviours of HIV-infected people on first-line antiretroviral therapy in Kigeme District Hospital, Rwanda: A cross-sectional study

INTRODUCTION: Evidence suggests that improved quality of life that follow antiretroviral therapy (ART) may be accompanied by increased sexual activity and risky sexual behaviour. Thus, this study aimed to determine the proportion of HIV infected people on first line ART who were sexually active, the prevalence of risky sexual behaviour defined as unprotected vaginal sex and factors influencing risk sexual behaviour among HIV-infected people on first -line ART in Kigeme District Hospital. METHODS: A cross-sectional study with a quantitative survey method was conducted among 358 HIV infected people on first line ART and an adopted structured questionnaire was used for data collection. STATA version 13 was used for data analysis and binary logistic regression was used to obtain adjusted odd ratio (AOR) with a 95% CI. RESULTS: Findings revealed that 68% of respondents were sexually active in the last 12 months of the interview and the prevalence of risky sexual behaviour among HIV infected people on the first line ART was 38%. Risky sexual behaviour was found to be significantly associated with age range of 30-40 year olds (AOR: 2.468, 95%CI: 1.007-2.046, P=0.048), having sex with HIV-positive partner ( AOR: 2.830, 95%CI: 1.351-5.928, P=0.006) and alcohol use prior to sexual activity (AOR: 2.347, 95%CI: 1.216-4.528, P=0.011). CONCLUSION: The majority of HIV infected people receiving the first-line ART are sexually active and the prevalence of risky sexual behaviour is significant hence effort should be put forth to target this group. Reinforcing behaviour change communication and discouraging alcohol use among HIV infected people receiving the first-line ART is recommended

Demographic determinants of risky sexual behaviours among senior high school students in the Hohoe municipality, Ghana

Senior High School (SHS) students fall within the age group (15-24 years) hardest hit by HIV/AIDS. Since about 90% of HIV transmission in sub-Saharan Africa (SSA) is through heterosexual intercourse, it is assumed that these students engage in risky sexual behaviours. Hohoe municipality has one of the highest HIV prevalence in Ghana (3.4%). The current study investigated the demographic determinants of risky sexual behaviours among senior high school students in the Hohoe municipality, Ghana.Methods: a descriptive cross-sectional design was employed in the study. A pretested structured questionnaire was used to collect data from a multistage sample of 270 SHS students who consented to participate in January 2019. Descriptive and inferential statistics were performed using Stata version 14.0 software program at the 0.05 level of significance.Results: of 270 respondents, 112 (41.5%) were engaged in risky sexual behaviours. Single students were 82% less likely to engage in risky sexual behaviours than their married counterparts (p=0.032) and muslims were 89% less likely to engage in risky sexual behaviours than christians (p=0.032).Conclusion: religion and marital status were the two socio-demographic characteristics that were significantly associated with risky sexual behaviour. Health promotion interventions to curb risky sexual behaviours among the SHS students should target the christian and married students

HIV self-testing services for female sex workers, Malawi and Zimbabwe

Objective To present findings from implementation and scale-up of human immunodeficiency virus (HIV) self-testing programmes for female sex workers in Malawi and Zimbabwe, 2013­2018. Methods In Zimbabwe, we carried out formative research to assess the acceptability and accuracy of HIV self-testing. During implementation we evaluated sex workers' preferences for, and feasibility of, distribution of test kits before the programme was scaled-up. In Malawi, we conducted a rapid ethnographic assessment to explore the context and needs of female sex workers and resources available, leading to a workshop to define the distribution approach for test kits. Once distribution was implemented, we conducted a process evaluation and established a system for monitoring social harm. Findings In Zimbabwe, female sex workers were able to accurately self-test. The preference study helped to refine systems for national scale-up through existing services for female sex workers. The qualitative data helped to identify additional distribution strategies and mediate potential social harm to women. In Malawi, peer distribution of test kits was the preferred strategy. We identified some incidents of social harm among peer distributors and female sex workers, as well as supply-side barriers to implementation which hindered uptake of testing. Conclusion Involving female sex workers in planning and ongoing implementation of HIV self-testing is essential, along with strategies to mitigate potential harm. Optimal strategies for distribution and post-test support are context-specific and need to consider existing support for female sex workers and levels of trust and cohesion within their communities

Reaching the youngest moms and dads: a socio-ecological view of actors and factors influencing first-time young parents' use of sexual and reproductive health services in Madagascar

Globally, few programs consider the needs of first-time young parents (FTYPs), who face disproportionate negative health consequences during pregnancy and childbirth. Scant evidence exists on FTYPs' broader health needs. Formative research in two regions of Madagascar used a socio-ecological lens to explore, via 44 interviews and 32 focus group discussions, the influences on FTYPs at the individual, couple, family, community, and system levels. We spoke with FTYPs who had, and who had not, used sexual and reproductive health (SRH) services, their parents/kin and influential adults, and community health workers and facility health providers. Data analysis, guided by a codebook, used Atlas.ti. Age, social position, and implicit power dynamics operating within and across socio-ecological levels affected FTYPs' service-seeking behaviors. The nature and extent of influence varied by health service type. Cross-cutting social factors affecting service use/non-use included gender dynamics, pressures from mothers, in-laws, and family tradition, and adolescent stigmatization for too-early pregnancy. Structural and economic factors included limited awareness of and lack of trust in available services, unfriendliness of services, and FTYPs' limited financial resources. A socio-ecological program perspective can inform tailoring of activities to address broader SRH issues, including how relationships, gender, power, and intergenerational dynamics influence service use

HIV fatalism and engagement in transactional sex among Ugandan fisherfolk living with HIV

HIV fatalism, or the belief that HIV acquisition and mortality is out of one's control, is thought to contribute to HIV risk in fishing populations in East Africa. The objective of this cross-sectional study was to investigate the association between fatalism and sexual risk behaviours (unprotected sex, engagement in transactional sex), beyond the influence of other known HIV risk factors (e.g. food insecurity, mobility), and identify demographic, psychosocial, and structural correlates of HIV fatalism. Ninety-one men and women living in fishing villages on two islands in Lake Victoria, Uganda completed an interviewer-administered questionnaire after testing HIV-positive during home or community-based HIV testing between May and July 2015. Multivariate logistic regression was used to test the association between HIV fatalism and transactional sex and multivariate linear regression was used to identify demographic, psychosocial, and structural correlates of HIV fatalism. HIV fatalism was significantly associated with a greater likelihood of transactional sex (AOR = 3.07, 95% CI = 1.02­9.23, p = 0.04), and structural barriers to HIV care (e.g. distance to clinic) were significantly associated with HIV fatalism (ß = 0.26, SE = 0.12, p = 0.04). Our findings highlight HIV fatalism as a contributor to transactional sex in Ugandan fishing communities, and as a product of broader social and contextual factors, suggesting the potential need for structural HIV interventions in this setting

A weighted bootstrap approach to logistic regression modelling in identifying risk behaviours associated with sexual activity

The latest population estimates released by Statistics South Africa indicate that 25.03% of all deaths in 2017 in South Africa were AIDS-related. Along with these results, it is also reported that 7.06% of the population were living with HIV, with the HIV-prevalence among youth (aged 15­24) at 4.64% for 2017 (STATSSA. (2018). Retrieved from Statistics South Africa: http://www.statssa.gov.za/publications/P0302/P03022017.pdf). The data used in the study contained information related to the risk-taking behaviours associated with the sexual activity of entering first-year students at the University of the Western Cape. In this study, a logistic regression modelling procedure was carried out on those students that were determined to be sexually active, therefore, in the modelling procedure significant risk behaviours of sexually active first-year students could be identified. Of the 14 variables included in the modelling procedure, six were found to be significantly associated with sexually active students. The significant variables included; the age and race of the student, whether the student had ever taken an HIV test, the importance of religion in influencing the sexual behaviour of the student, whether the student consumed alcohol and lastly whether the student smoked. This study further investigated the impact of introducing sample weighting, bootstrap sampling as well as variable selection methods into the logistic regression modelling procedure. It is shown that incorporating these techniques into the modelling procedure produces logistic regression models that are more accurate and have an increased predictive capability. The bootstrapping procedure is shown to produce logistic regression models that are more accurate than those produced without a bootstrap procedure. A comparison between 200, 500 and 1000 bootstrap samples is also incorporated into the modelling procedure with the models produced from 200 bootstrap samples shown to be just as accurate those produced from 500 or 1000 bootstrap samples. Of the five variable selection methods used, it is shown that the Newton­Raphson and Fisher methods are unreliable in producing logistic regression models. The forward, backward and stepwise variable selection methods are shown to produce very similar results

Risky sexual behaviors and associated factors among high and preparatory school youth, East Wollega, Ethiopia, 2017: A cross-sectional study design

Most of the sexual initiation and sexual practice of the youth begins at secondary school level. At this stage student assumed to be exposed to many risky sexual behaviors. However, little research had been explored in the Oromia region particularly in East Wollega zone on this area. A cross-sectional study design was used to assess risky sexual behavior and associated factors among high school and preparatory school students from 1st October 2016 till October 30, 2016. Data was collected using self-administered questionnaire. Focus group discussion was conducted to support the quantitative data. Probability proportionate to sample size (PPS) was used to determine the sample size for each grade 9-12. The data was coded and entered into a computer using SPSS version 16.0. Final model was fitted and P value less than 0.05 considered as statistical significance and independent predictor of risky sexual behavior. The results revealed that three hundred and twenty-four students participated in the study (response rate of 97.7%). In the past 12 months, 25.3% of students had sexual intercourse, 17.07% of them had more than one sexual partners and 11.9% of male students visited commercial sex workers. Family connectedness [AOR, 95%CI 0.73(0.67-0.89)], attitudes toward sex [AOR, 95%CI 1.22(1.04-1.43)], khat chewing [AOR, 95%CI 9.25(2.51-34.07)] and those that had been forced by classmates for sex [AOR, 95%CI 7.63(2.36-24.66)] were independent predictors of risky sexual behaviors. The study thus revealed that risky sexual behavior of school youth was increased by khat chewing, sexual coerciveness from classmates or teacher, positive attitudes toward sexual intercourse and reduced by high family connectedness alongside attending religious services regularly. In addition to parental connectedness and parental supervision intervention targeted on school youth like positive peer influence to encourage safer sexual behaviors among school youth is very important in reduction of risky sexual behaviors

HIV prevalence and related behaviours of older people in Botswana ­ secondary analysis of the Botswana AIDS Impact Survey (BAIS) IV

The focus of HIV interventions in Botswana, a country with the second highest prevalence of HIV in the world, remains targeted at those aged 15­49 years despite a growing cohort of older people living with the disease ­ driven largely by the successful roll-out of antiretroviral therapy (ART). Primarily utilising the Botswana AIDS Impact Survey IV, we set out to examine HIV related characteristics and behaviours of this often ignored older cohort (50­64 years) relative to younger (25­49 years) adults. Analysis revealed that more than 80% of older people living with HIV were on ART. HIV prevalence among this older cohort was 24.6% in 2013 compared to 35.1% among the younger cohort, p < 0.0001. Prevalence in older adults was higher among older males (27.8%) than females (21.9%), p = 0.02. Furthermore, 58.9% of older adults acknowledged being sexually active, with 59.0% of these admitting to inconsistent condom use during sexual intercourse. In addition to this low condom usage, older men (6.0%) were significantly more likely to be unaware of their HIV-positive status than older women (3.0%), p = 0.002. While HIV prevalence showed a dramatic increase among older men over time (17.2% in 2004, to 23.4% in 2008, to 27.8% in 2013), the trend was flatter among older women (16.3% in 2004, to 22.4% in 2008, to 21.9% in 2013). These trends are likely attributable to a large increase in ART coverage and uptake. Going forward, more targeted interventions acknowledging the ageing epidemic are important to consider

Determinants of risky sexual behaviours among adolescents in Central African Republic, Eswatini and Ghana: evidence from multi-indicator cluster surveys

Despite the declining HIV/AIDS prevalence globally, nearly half of all new HIV infections still occur among youth, especially in sub-Saharan Africa. While determinants of risky sexual behaviour have received copious attention in the literature, we still lack multi-country studies that track regional changes in sexual risk among youth in sub-Saharan Africa. This study seeks to fill part of this gap by identifying the determinants of risky sexual behaviours among adolescents in Ghana, Central African Republic (CAR) and Eswatini (formerly Swaziland). We used nationally representative sample data from the Multi Indicator Cluster survey, round four (MICS4). Results of the descriptive analysis show that overall consistent condom use is still extremely low in sub-Saharan Africa. In Ghana, only 8.5% of male youth and 7% of female youth consistently use condoms. In CAR this figure is 8% and 4% in male youth and female youth respectively. In Eswatini, with one of highest HIV prevalence in the world, the prevalence of consistent condom use is at 29% in males and 20% in females, higher than both in Ghana and CAR. Results of hierarchical models show that age at first sex does not predict risky sexual behaviour in Ghana, but it does predict risky sexual behaviour in CAR although only among young males. In Swaziland, age at first sex predicts risky sexual behaviour in both male and female youth but the relationship is not in the expected direction. Low socio-economic status predicts inconsistent condom use in all the three countries, but only among young females. This paper provides relevant policy lessons and recommendations

The influence of marital status on HIV infection in an HIV hyperendemic area of rural South Africa, 2000­2017

Marital status is one of the factors whose impact on HIV infection has always been studied but contradictory findings have been reported. The drastic changes in marriage patterns in South Africa influences the role of marital status on HIV infection. This study aims to give evidence-based information on the association between marital status and HIV infection in a hyperendemic HIV area in rural South Africa. This study was conducted on longitudinal data collected from the African Health Research Institute (AHRI) based in northern rural KwaZulu-Natal from 2000 to 2017 using multivariable Cox regression. The multivariable Cox regression results found marital status to be a significant factor of HIV infection. Compared to those who were married, the risk of HIV infection was approximately two times in those who were never married while those who were widowed presented as much as twice the risk of HIV infection. In addition, less educated participants were at more risk of HIV infection than those with tertiary education. Furthermore, as expected, the risk of HIV infection increased with age (20­24 HR: 3.05 (2.32­4.02); 25­34 HR: 3.98 (3.12­5.07) and 35­49 HR: 4.36 (3.36­5.67). Women were more susceptible to HIV infection than men were. This study found marital status to be an influential factor of HIV infection together with other socio-economic and demographic factors. This finding will help guide policy makers on empowerment programmes and policies targeting HIV and other health related issues in rural South Africa

Informal transit, socio-spatial exclusion, and changing geographies of HIV/AIDS in urban Malawi

The role played by the transport sector in the regional spread of HIV in sub-Saharan Africa is well known, yet attention has remained confined to entertainment hotspots and stopping places along long-distance highways and cross-border transport corridors. This paper draws attention to informal modes of transit prevalent in sub-Saharan African cities, by linking the rise of two-wheeled, manually operated bicycles, known as "Sacramento", to the potential spread of HIV and AIDS in Malawi. The findings of a qualitative study from Mzuzu city show that Sacramento operators are prone to demanding or accepting sexual favours from female commuters as payment for a ride. We draw on complementary theories of the political ecology of health (PEH) and feminist political ecology to show how a popular belief that Sacramento is an inferior mode of urban transit underpins risky sexual behaviour among men hired to operate this informal mode transport. The findings further show that operators' responses to this perceived inferiority are themselves also driven by gender discourses that seek to validate their identities as powerful go-getters. These scripts also create an environment that fosters multiple sexual partners and venerates unprotected sex. Because Sacramento is both a source of livelihood and an HIV risk milieu, it epitomises the contraction inherent in HIV and AIDS vulnerability in sub-Saharan Africa

Intimate partner violence and human immunodeficiency virus infection among married women in Addis Ababa

Background: Human immunodeficiency virus is a public health problem in sub-Saharan countries, with complex determinant factors. Intimate partner violence, although known to associate with acquiring human immunodeficiency virus understanding how it relates to sexual risk behaviors is important.Objective: To assess the relationship of human immunodeficiency virus with intimate partner violence as related to risky-sexual behaviors.Methods: A facility based case control study was conducted among human immunodeficiency virus positive and negative women visiting antenatal care. A total of 128 positive and 382 negative women from the prevention service of mother-to-child transmission of human immunodeficiency virus in selected health facilities in Addis Ababa were included. A standardized and pretested questionnaire was used to assess the experience of intimate partner violence, and sexual behaviors of women and their spouses.Result: Physical violence during lifetime is associated with human immunodeficiency virus infection status. Besides, sexual violence by strangers is associated with human immunodeficiency virus infection. Risky sexual behaviors, represented by having multiple partners, transactional sex and having a casual partner, were associated with intimate partner violence as well as human immunodeficiency virus infection status. Similarly, report of experiencing symptoms of sexually transmitted infection and having suspected unfaithful spouse were associated with intimate partner violence and human immunodeficiency virus infection status.Conclusion: The study showed that intimate partner violence could be associated directly and in directly with human immunodeficiency virus infection by increasing exposure to risky sexual behaviors and considered as a resolution for disparate sexual behavioral. Therefore, prevention and control interventions against intimate partner violence could play significant role in prevention and control of human immunodeficiency virus infection

Unpacking the 2-year age-gap provision in relation to the decriminalisation of underage consensual sex in South Africa

Over the past 24 years, the South African criminal justice system has undergone major transformations in relation to sexual offences,including sexual violence against children. More recently, there have been a number of developments to certain provisions in the law relating to sexual offences involving children. In response to the Teddy Bear Clinic Court Case and Constitutional Court ruling, sexual offences legislation related to underage consensual sex amended.In this regard, the legislation now decriminalises underage consensual sexual activity between adolescent peers aged 12 - 15-year-olds. In addition, the law provides broader definitions for consensual sexual activity including decriminalising consensual sex and sexual activity between older adolescents (above age of consent for sex, i.e. 16 - 17-year-olds)and younger adolescents (below the age of consent for sex, i.e. 12 - 15-year-olds), granted that there is no more than a 2-year age gap between them. One of the reasons for decriminalising consensual sexual activities between adolescent peers was because the expanded legislation cast the net for sexual offences so wide that the effects had far-reaching harmful impacts, particularly for girls, who would then be exposed to the criminal justice system. This paper focuses on unpacking the 2-year age-gap provision in SA legislation relative to selected better-resourced countries, including the rationale and the potential implications for adolescents (outside of the 2-year age gap provisions),for researchers, service providers and policy-makers. It concludes with recommendations for law reform and further research