Adolescents Through the Lifecourse: Variation in Sexual Risk among Adolescent Men and Women in Rural South Africa

Abigail Harrison, HIV Center for Clinical and Behavioral Studies

South Africa is experiencing one of the world's most severe HIV epidemics, with more than ten percent of youth aged 15-24 infected. Important differences exist in sexual risk according to age, gender, rural-urban residence, and other contextual factors. However, most studies view adolescents as a homogeneous group. In rural KwaZulu/Natal province, qualitative and quantitative methodologies were used to examine factors associated with sexual risk outcomes, including sexual initiation, partnership characteristics, condom and contraceptive use among younger (ages 14-15) and older (ages 16-18) adolescent women and men. Although men and women experienced a similar age at first sex, patterns of sexual activity differed. For women, religious affiliation, schooling, community participation and age were associated with all outcomes. For men, younger age at first sex was associated with heightened sexual risk; schooling and parental residence were independent predictors of condom use. Qualitative findings demonstrated the importance of educational achievement and community norms.