Transitions to Adulthood: Adolescent Behavior in the Context of AIDS in South Africa

"Transitions to Adulthood in the Context of AIDS in South Africa" examines the reproductive and sexual behaviour of South African adolescents living in KwaZulu-Natal. The researchers explore the impact of education and employment experiences, family and environmental conditions, and other factors in adolescents' lives that may influence their sexual behaviour and choices. The goal of the study is to contribute to the design and refinement of policies and programs to help young people make healthy transitions from adolescence to adulthood, including the National Life Skills Programme.

The study design includes two rounds of data collection from adolescents (ages 14-22), data on their households and communities, and an exploration of some of the principal results from the survey data based on focus groups and other qualitative approaches. Additional data is collected at baseline and follow-up from all schools in the study area regarding the teaching of the Life Skills Programme in those schools.

The resulting working paper is based on the first round of data collection from the Transitions study. In subsequent analyses the interrelationships among study variables will be explored and, following a second round of data collection with the same respondents, an evaluation of the impact of the Life Skills Programme will be conducted.

Opportunities for adolescents

Researchers assessed the association between risk-taking behavior and opportunities for schooling, work, and other activities. They looked at information collected from a representative sample of 2,992 young people aged 14-22 years who live in Durban Metro and Mtunzini Districts of KwaZulu-Natal Province. The population of KwaZulu-Natal comprises four main population groups: African (80 percent), Indian (10 percent), white (7 percent), and a population group of mixed ancestry known as coloured (3 percent).

This study revealed that gender is far more important than population group in predicting adolescent risk taking. For example, girls who live in communities where there is a high level of sports activity or who live where schooling is easily obtained tended to report that they had not had sex in the past year. These factors do not significantly influence whether boys reported having had sex in the past year.

One factor, the prospect of employment, was correlated with less risk-taking behavior among both boys and girls. Girls in areas where earning potential was high were almost two and a half times more likely to report having used a condom the last time they had sex than were girls living in communities where fewer adolescents were working. Boys from higher-wage communities were about 50 percent more likely to report having used a condom the last time they had sex than were boys from lower-wage areas.

Attitudes toward pregnancy

In communities where early age of childbearing is common and HIV prevalence is high, adolescent boys and girls may place themselves at risk of HIV to realize their childbearing preferences. Researchers wondered whether adolescents' attitudes toward pregnancy were affected by perceptions of the risk of HIV transmission in their communities and among their peers. Investigators used evidence gathered during the first round of data collection from 1,426 sexually active young people. They found that boys were more concerned about how having a child would affect their opportunities for schooling, job training, and personal development than they were about the fact that unprotected sex might expose them to HIV.

Among girls, the higher the level of school enrolment in their community,the more likely they were to want to delay pregnancy. African girls were more than three times as likely as white or Indian girls to say pregnancy would be a big problem. Even after controlling for income, girls' childbearing preferences were significantly correlated with the perceived risk of HIV infection among their peers.

Although it is not possible to determine cause-and-effect relationships from this research, the data highlight points of opportunity for interventions. Programs focusing on increasing livelihood opportunities for boys and girls could be important in encouraging safer sex practices--for example, abstinence, being faithful, and condom use. Programs that assist adolescents in making an accurate assessment of their HIV risk would also be beneficial. Analyses comparing the first and second rounds of data collection are expected in mid-2003.

This study is a collaboration among the Population Council, Tulane University, the University of Natal-Durban, and Development Research Africa (a South African research organisation).