·       Only 38% of adolescents always use condoms

·       Approximately 30% of teenagers in South Africa fall pregnant in the  3 – 19 year age group

·       South Africa’s Children’s Act 38 of 2005 (as amended by Act 41 of  007) gives adolescents 12 years and older the right to access reproductive health services

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This article deals with condoms, adolescents and unsafe sex. It is a  controversial issue that has provoked intensive discussions amongst  government departments, civil society, academics, the media, religious  groups and children’s rights groups. A solution that speaks to young  people has yet to be found.

Adolescents at HIV risk

Globally, sub-Saharan Africa is the region with the highest rates of HIV infections (UNAIDS, 201     Issues such as poverty, lack of education and resources, and gender  inequalities exacerbate the challenges to implement successful behaviour change programmes. This is especially true in South Africa, where the  most common mode of HIV transmission is heterosexually (Dorrington et  al., 2006). Young people, especially females in the 15-24 year age group are at higher risk of HIV infection. The high rate of teenage  pregnancies in South Africa, approximately 30% in the 13-19 years age  group, is a visible indicator of the prevalence of unprotected sex(Wilan, 2013).

Learners, adolescent boys and girls, exchange unprotected sex for money and gifts from older men who, at times, have a history of multiple relationships. This practice of age-mixing or intergenerational sex has been identified as a major factor  in the spread of HIV (Katz and Low-Beer, 2008).

Condom use
Condom use is considered one of the most effective preventive measures against HIV and sexually transmitted infections, if used correctly and consistently (UNAIDS, 2012;  Kabiru and Orpinas, 2009).

Various studies have been  conducted to establish the extent of condom use in South Africa. Findings by Abdulraheem and Fawole (2009), reported that 38.1% of adolescents in  their study always used condoms while the rest did not. Another study by  Hartell (2005) found that more than 50% of the sexually active learners  never used a condom. Condom use declined among all groups in South  Africa, according to the latest household survey released by the Human Sciences Research Council (van der Linde, 2013). This same trend of decline in condom use has been reported by the UNAIDS (2012).

According to Silva (2007), one  of the reasons for adolescent pregnancies, with regard to provision of  services, includes lack of access to family planning services (including  access to male and female condoms). Some adolescents are sexually active and indulge in unsafe sex, most of which have to do with individual attitudes and perceptions.

Unsafe sex
In addressing the problem of unsafe sex as the main mode of HIV-transmission, it becomes important to inculcate into the minds of adolescents the value of self, so as to discourage them from taking risks that will jeopardise their health and  impact on their futures. Hopkins et al. (2007) suggested that prevention of high risk behaviour should include determining adolescents’ ability to understand who they are and what their purpose in society is, through self-appraisals.

The concept of valuing self means that adolescents should give first priority to issues concerning  self above all else. This is important, as girls with high self-esteem  demonstrated positive attitudes towards condom use and are less fearful to negotiate condom use. They also communicate more frequently with their sex partners and parents (Salazar et al., 2005).

Lyon and D’angelo (2008) found  that adolescents, whose parents openly discussed sex, delayed their sexual debut. This strategy further empowered adolescents to withstand  negative peer influences.

Empowering the youth and their parents with information, education and counselling can contribute to  reduced unsafe sexual practices. It has been suggested that a comprehensive approach emphasizing both abstinence and safer sex practices should be adopted in sex education and that the programme  should be adjusted according to the development stages of learners (Panday et al., 2009).

South Africa’s Children’s Act  38 of 2005 (as amended by Act 41 of 2007) gives adolescents 12 years and  older the right to access reproductive health services.  Section 134 of the Act states that no person may refuse to sell condoms to a child over the age of 12 years; or sell condoms that were provided free of  harge (Government Gazette, 2006). A person who disregards these  provisions is guilty of an offence and can be fined or imprisoned for 10 years, or be given both a fine and a term of imprisonment. A child who  obtains condoms, contraceptives or contraceptive advice in terms of this  Act is entitled to confidentiality. However, this is subject to section  110(1) of the Act, which obliges health professionals to report cases of physical or sexual abuse, or deliberate neglect of a child to the  Department of Social Development, a designated child protection organisation or the police.

Bearing in mind the rights of the child as embedded in the South African Constitution, empowering the youth and their parents with information, education and counselling may be beneficial in discouraging the practice of unsafe sex.

It has been suggested that a comprehensive approach emphasising both abstinence and safer sex practices should be adopted in sex education and that the focus of the school’s sexuality education programme should be adjusted according to the stage of learners’ development (Panday et al.,2009).  Controversial and difficult as it may be for parents, teachers,  government, civil society, religious groups and child rights groups, there is a need to consider making condoms available to learners in  secondary schools, accompanied by counselling and life skills to mitigate  the problems of adolescent unsafe sex, pregnancy and school drop outs.

In an effort to enable  adolescents to make informed and better decisions regarding their sexual health in the future, should condoms be handed out at schools? However, whose responsibility is it? The parents? The teachers? The health department? The education department? Community leaders?”


Posted bystella

October 8, 2013