Given the fact that HIV/AIDS in South Africa is fueled by heterosexual intercourse, it is essential to monitor trends in sexual behavior among young adults in order to identify and understand those sexual behaviors that are fueling the epidemic. It tracks trends in sexual behavior, and determines the predictors of risky sexual behavior among these young adults. The study also reveals that the percentage of young adults who engage in risky sexual behavior, such as having multiple sex partners, decreased between 2002 and 2005.
This suggests that to equip young adults to act in a sexually responsible manner later in life, protective factors such as family involvement, schooling, peer influence, and self-esteem must be strengthened before sexual initiation. I confirm that an external editor was not used. It is submitted for the degree of Master of Arts in the Faculty of Humanities, Development and Social Sciences, University of KwaZulu-Natal, Durban, South Africa.
CHAPTERl INTRODUCTION
- The Transition to Adulthood
- Background to the Study
- Aims and Objectives
- Theoretical Framework
- Organisation of the Dissertation
Most studies of sexual behavior in South Africa focus primarily on the determinants of sexual behavior. The theory was based on research conducted on the sexual behavior of young people in South Africa. Social cognitive theories fail to reveal the factors that shape the sexual behavior of young people in South Africa.
Research conducted in South Africa shows that proximal factors play a major role in shaping the sexual behavior of young people. Personal, proximal and distal factors play a role in shaping young people's sexual behavior.
LITERATURE REVIEW
Introduction
- Number of Sexual Partners
Studies conducted in the United States using the National Survey of Adolescents (NSAM), the National Survey of Family Growth (NSFG), the Youth Risk Behavior Survey (YRBS), and the National Longitudinal Study of Adolescent Health (Add Health) attempted to assess trends in sexual behavior among young people. Surveys in the United States reported trends in condom use at last intercourse among young adults aged 15 to 17 years. Having two or more sexual partners remained relatively unchanged in surveys from the United States.
In all surveys, women were less likely to report having had two or more sexual partners in the past 12 months (Cutis & Sutherland, 2004). Ultimately, changes in sexual behavior must be traced back to changes in the determinants of sexual behavior.
Factors influencing sexual behaviour
- Socio-economic and Demographic Factors
- Peer Influence and Sexual Coercion
- Family Influence
- Culture and Gender
A study conducted by Brook et al. 2006) indicated that family poverty was significantly associated with adolescent risky sexual behavior. Knowledge and sexual self-efficacy moderate the relationship between risk factors, such as peer pressure, and sexual behavior (Bachanas et al., 2002). A study conducted by Bachanas et al. 2002) indicated that sexual self-efficacy was not associated with risky sexual behavior.
Thus, in some societies, risky sexual behavior improves men's social status while jeopardizing that of women (Ott et al., 2006). In these societies, women's sexual behavior is influenced by their male counterparts (Blanc, 2001; Fenton et al., 2000).
Summary
According to a community survey conducted by Statistics South Africa, the estimated population of the Western Cape is StatsSA, 2007). According to StatsSA only 3% of the population of the Western Cape does not have access to a telephone (telephone or mobile) (StatsSA, 1996). The Western Cape also has the highest education ratings compared to other provinces in South Africa, with about 10% of the population being elderly.
The Cape Town Metropolitan Area, from which the dataset is derived, is the economic center of the province and serves as the legislative capital of the Republic of South Africa and has an estimated population of StatsSA, 2006). The Cape Areas Panel Study (CAPS) survey is a longitudinal survey of young adults and their households. The sample design was weighted to be representative of the sample households and of all different races in the Cape Town Metropolitan area based on the 2001 population census.
The analytic sample to be used consists of young adults and their households. The household sample, which collected information on parents of the 4,752 young adults, will be used to assess family economic status and family characteristics. The use of ages 14–22 in CAPS as opposed to 15–24 (UN designation for young adults) had to do with research goals and the timing of events in young adults' lives.
The sample design used by the CAPS team is based on the Cape Town Metropolitan Enumeration Areas (EAs) from the 1996 census. A two-stage stratified sample was designed by working backward from the target number of young adults in each of the three population groups. The sample was weighted based on the 1996 census to be representative of the entire Cape Town metropolitan area and to correct for unequal probability of selection.
Analytic Framework and Measures .1 Method of Analysis
- Variables
- Variable selection summary
Married young adults were not included in the study because the motivations that inform the sexual behavior of married young adults may be different from those motivating unmarried young adults who are traditionally expected to abstain from sexual activities. Where is the probability of the presence of the characteristics of interest - the dependent variable. 3j are the coefficients of the independent variables, Xj which in terms of this study is the indicator variables: SES index, gender, population group, age group, educational level,.
For example, a household that contains none of the items listed will have a score of zero indicating extreme poverty, and a household that has all five items will have a score of 5, indicating a high SES (the concept adopted by Thurman et al., 2006). Sexual behavior in all three waves is measured using four indicators: ever sex, age at first sex, condom use at first sex, and number of sexual partners in the last 12 months. Personal factors were measured using the variable: 'assess your risk of HIV infection' with four possible options: 'no risk', 'low risk', 'medium risk' and 'high risk'. Education was measured using the level of education of a young adult, ranging from grade 0 to tertiary education.
Family involvement was measured using time parents spend with their children and communication between parents and young adults. Time spent with parents was measured using the variables 'how often did mother spend time with you?' and 'how often did father spend time with you?', with both variables having four possible answers: never, rarely, sometimes and often. Parent-child communication was measured using the variables 'discuss personal relationships with mother?' and 'discuss personal relationships with father?'.
This section examines trends over time in sexual behavior from Wave 1 to Wave 3. In cases where results are missing, only Wave 1 and Wave 3 are used. All young adults in the study had some level of education and lived in a household with two parents. Thus, the study fails to determine trends in sexual behavior among orphans and homeless youth residing in the Cape Town metropolitan area.
Ethical Issues
Summary
RESULTS
- Descriptive Analyses
- Sexual Behaviour Variables
- Summary
- HIV Risk perception
- Trends in Sexual Behaviour
Only a few white young adults (6.1%) reported never spending time with their mothers in 2002. The percentage of tertiary-level young adults who perceived themselves to be at risk for HIV infection, was 58.7% in 2002 and fell slightly to 55.2% in 2005. The proportion of young adults in the low SES category who perceived themselves to be at risk of HIV infection increased from 45.4 % in 2002 to 63.2% in 2005.
For the high SES category, the percentage of young adults who felt they were at risk of HIV infection remained relatively unchanged between and. The percentage reporting two or more sexual partners in the past 12 months is higher among black African and black young adults (36.9% and 31.6%, respectively) and lower among white young adults (27.7%) in 2002. Black African youth adults report a 14.7 percent decrease in those reporting two or more sexual partners in the past 12 months.
In 2005, the odds of having two or more sexual partners are 2.37 times higher for young people who perceive themselves to be at average risk of HIV infection than those who perceive themselves to be at no risk. In this study, black African youth who perceived themselves not to be at risk of HIV infection exhibited risky sexual behaviors, such as having at least two or more sexual partners in the past 12 months . A contrast is that among white youth the percentage who perceive themselves to be at risk of HIV infection is higher and risky sexual behaviors such as using a condom at the last sex and having two or more sexual partners in the previous 12 months are lower.
The percentage of young adults who think they are at risk of HIV infection is higher in Cape Town than in KwaZulu-Natal. Condom use at last sex is higher among white young adults, followed by black Africans. Condom use at last sex appears to be low among young adults of low SES status, both in 2002 and 2005.
Overall, all young adults reported a decline in the percentage of those having two or more sexual partners between 2002 and 2005. This indicates that as young adults age, they are more likely to having two or more sexual partners.
Center for Actuarial Research, South African Medical Research Council and Actuarial Society of South Africa. A review of current literature on the impact of HIVAIDS on children in sub-Saharan Africa. AIDS 14(Suppl 3): S275-S284. The relationship between school attendance, HIV infection in rural South Africa and sexual behavior among young people.
Early sexual onset among young men in rural South Africa: increased vulnerability to sexual risk. Level of education is associated with condom use in extramarital partnerships in four sub-Saharan African cities. AIDS. Ethnicity and sexual lifestyle among students in a high-risk environment, Durban, South Africa. AIDS care.
Forced first intercourse and selected reproductive health outcomes among young women in KwaZulu-Natal, South Africa. Rapid assessment of drug use and gender patterns of HIV risk among vulnerable drug-using populations in Cape Town, Durban and Pretoria, South Africa. Journal of Social Aspects of HIVAIDS 5: 52-58. Reproductive health and the condom dilemma: identifying situational barriers to HIV protection in South Africa.
Research on reproductive health issues among black youth in South Africa (final grant report). Transition to adulthood in the context of AIDS in South Africa: Report on wave 1. Pregnant or positive: adolescent fertility and risk of HIV infection in KwaZulu-Natal, South Africa. Barriers to protective behavior against HIV/AIDS among African youth in urban secondary schools in Durban, South Africa.
