Reshma Sathiparsad

Effects of a Teenage Pregnancy Prevention Program in KwaZulu-Natal, South Africa

Researchers aimed to determine the effects of a teenage pregnancy (TP) prevention program for 816 high school students attending 16 KwaZulu-Natal, South African schools through a randomized control trial. Data were collected at baseline and at the 8-month follow-up in 2009. Results were calculated using multivariate analyses of program effects employing Mplus 6, and indicated significantly healthier attitudes, including intentions to abstain from sex whilst at school, plans to communicate with partners about teenage pregnancy, and increased reports of condom use. Researchers thus provide some support for the effectiveness of a TP prevention program that should be further strengthened in a comprehensive approach that includes schools and families.

‘It is better to beat her’: male youth in rural KwaZulu-Natal speak on violence in relationships

abstract Various forms of gender-based violence exist among South African youth. While boys and girls may be victims of violence, male perpetrated violence against females is reported to be significantly higher. In arguing for the inclusion of males in addressing gender inequalities, this article explores male perspectives on gender roles and violence in relationships. Findings of research conducted in Ugu North, a rural area in southern KwaZulu-Natal on youth attitudes with regard to love, sexual activity, power and control, and the use of violence in relationships are presented and discussed. Using focus group interviews, data were collected from groups of male students attending secondary schools. The interviews were conducted in Zulu and were audio-taped, translated and transcribed. The themes that emerged from the transcripts form the basis for discussion. Based on the findings, the article concludes with ideas and challenges regarding interventions to address gender inequalities and to promote healthier relationships.

Masculine Identity and HIV Prevention among Male Youth in Rural South Africa

Abstract This article explores the construction of masculine identities in relation to sexual behaviours and HIV in the rural Ugu District, KwaZulu-Natal, South Africa. The research was conducted with groups of school-going male youth selected from three rural high schools and three urban high schools. In total, 12 focus group interviews were conducted in which 72 male youth participated. The objectives of the study were to investigate the relationship between health education on HIV and AIDS and sexual risk behaviours. Through the focus group interviews, the research sought to provide insights into the knowledge levels, attitudes, beliefs and behaviours of the participants and to ascertain how they positioned themselves in relation to the epidemic. More importantly, we sought to understand these attitudes and behaviours against a background of students having been exposed to lifeskills and HIV/AIDS educational programmes, both at school and through the media. The data was analyzed using thematic analysis, and the categories that were identified, form the basis for discussion in this article. The discourses of the participants pointed to the need to assert masculinity, largely through sexual intercourse with females being given priority over health and safety. The article concludes with suggestions to address gender inequities as one way to curb the spread of HIV

Changing sexual behaviour to reduce HIV transmission - a multi-faceted approach to HIV prevention and treatment in a rural South African setting.

Abstract This community household survey undertaken in Melmoth, a rural area in KwaZulu-Natal, South Africa, investigated the influence of cumulative exposure of complementary interventions by a non-governmental organisation, LoveLife which aimed to bring changes in beliefs about HIV and AIDS prevention and treatment, and to reduce sexual risk behaviour. Amongst the 1294 respondents (15–40 years of age) increasing the number of exposures to different LoveLife interventions included use of television and radio messages, billboards, a free monthly magazine for youth, special school sports and community events, involvement of youth peer educators, and support for schools through classroom programmes and by linking clinic staff and peer educators. Cumulative exposure to LoveLife interventions resulted in more respondents believing that HIV could be prevented (p<0.005) and treated (p=0.007) and that people should test for HIV (p=0.03). Half of the respondents reported using a condom at last sex and cumulative exposure to LoveLife was associated with increased condom use (p<0.005). However, despite exposure to LoveLife, only 41.9% respondents had ever tested for HIV and cumulative exposure to LoveLife did not significantly influence respondents going to hospital for anti-retroviral treatment. The dose-response effect of cumulative LoveLife exposure appeared to have a positive influence on some beliefs and practices, but did not discriminate the extent of LoveLife exposure nor exposure to other HIV/AIDS interventions.

The association between HIV testing and sexual behaviour amongst rural Zulu high school students in Kwazulu-Natal, South Africa

This cross-sectional study investigated the prevalence of HIV testing amongst South African high school students, their perceptions about HIV testing, and the influence of HIV testing on their sexual behaviour. Grade 10 students at 28 high schools completed a questionnaire based on the I-Change Model. Of 1,192 students, 57 (4.8%) had been tested for HIV. More tested students knew a person with HIV/AIDS (p<0.005), knew other people who had been tested (p<0.005), perceived support from family (p<0.005) and friends (p=0.003), and reported self-efficacy and further intentions to be tested (p<0.005). HIV counselling and testing can promote prevention messages to reduce the prevalence of HIV infection amongst HIVseronegative people, and decrease transmission amongst those HIV-seropositive. Early diagnosis and care can improve outcomes for HIV/AIDS. Encouraging HIV testing among school students may contribute to a reduction in HIV incidence and persuade students to reduce risky sexual behaviour.

Predicting safe sex: Assessment of autoregressive and cross-lagged effects within the Theory of Planned Behavior

Despite its popularity, few studies have assessed the temporal stability and cross-lagged effects of the Theory of Planned Behavior factors: Attitude, subjective norms and self-efficacy. For this study, 298 adolescent learners from KwaZulu-Natal, South Africa, filled out a Theory of Planned Behavior questionnaire on teenage pregnancy at baseline and after 6 months. Structural equation modeling showed that there were considerable cross-lagged effects between attitude and subjective norms. Temporal stability was moderate with test–retest correlations ranging from 0.37 to 0.51 and the model was able to predict intentions to have safe sex (R2 = 0.69) Implications for practice and future research are discussed.

Exploring the Use of Role Play in a School-Based Programme to Reduce Teenage Pregnancy.

Can the use of a method such as role play help reduce sexual risk behaviour among KwaZulu-Natal learners? A study was undertaken of the use of role plays by Grade 8 learners, at eight urban and rural KwaZulu-Natal high schools, as part of a programme to reduce the prevalence of teenage pregnancy. Within the framework of Bandura’s Social Cognitive Theory, learners participated in role plays covering five topics – choice, self-respect and emotional abuse; partner coercion/negotiation about having sex; visiting the clinic for contraception; perceived and purchasing value of the child support grant; and testing for HIV. We report on the organisation, implementation and evaluation of the role plays. Data from facilitators, educators and learners were triangulated and suggest that role play has potential for building self-efficacy among learners with respect to sexual behaviour.

“DESERVING” CHILDREN, “UNDESERVING” MOTHERS? MULTIPLE PERSPECTIVES ON THE CHILD SUPPORT GRANT

Following the change from over 350 years of colonial and apartheid rule in South Africa, the first democratically elected government that came into power in 1994 was faced with the challenge of having to address vast levels of inequality and poverty. The distribution of wealth were extremely skewed in terms of race, gender and region, with children growing up in rural, black and female-headed households disproportionately affected by severe levels of poverty (Cassiem, Perry, Sadan & Streak, 2000; Landman, Bhorat, Van der Berg & Van Aardt, 2003; May, 1998; UNDP, 2004). Consequently, child mortality and levels of stunted growth in South Africa in general and amongst this group of children in particular were unacceptably high, and – by now constitutionally enshrined – children’s rights and basic needs were unmet for the majority of South African children (Manuel, 2007). Poverty continues to be the biggest challenge faced by the government: Brandon and Pather (2007) for example cite that 24 million South Africans are living below the poverty line, half of whom are dependent on government grants.

Young Rural Males in South Africa Speak on Teenage Pregnancy: “It's Really Her Problem”

The aim of this study was to explore the attitudes, beliefs and behaviours of school-going rural males in KwaZulu-Natal, South Africa on teenage pregnancy. Two methods of data collection were used, namely, a quantitative survey with a sample of 294 male youth from 10 schools. This was followed by focus group interviews with three groups, each comprising ten males, from three of the schools. Quantitative data examined self reported knowledge, behaviours, beliefs and attitudes of participants relating to teenage pregnancy. Qualitative data from the focus groups generated both an individual and ‘group think and provided insights into the relational construction of these beliefs and behaviours. Although the analysis revealed some mixed reactions, the majority response pointed to ‘dominant male-submissive female’ views of sexual relationships. Most participants supported the notion that the burden of pregnancy fell on the female, with males frequently denying paternity and criticizing females for careless sexual behaviour. Attributions for teenage pregnancy by boys are important for intervention to curtail impact on survivor girls.

Making meaning of teenage pregnancy among school-going youth: The case of selected eThekwini Municipality secondary schools

abstract eThekwini school learners in KwaZulu-Natal (KZN) are the focus of much debate in campaigns to prevent HIV infection and reduce teenage pregnancy. This article discusses research with a sample of male and female school-going youth, which aimed to explore their attitudes, behaviours and beliefs on teenage pregnancy. Two methods of data collection were used. A quantitative survey was conducted with Grade 11 teenagers (335) of average age 17 years from 10 urban schools in KZN, who completed a self-reporting questionnaire on their attitudes and beliefs related to teenage pregnancy and to their own sexual behaviours. After this, qualitative data were gathered from four separate focus groups of 10 participants each from among boys and girls at two of the schools. The focus groups explored the meanings attached to attitudes and behaviours noted in the survey. The survey data were analysed using the SPSS 17 statistical package and data gathered from the focus groups employed thematic analysis. Participant responses from both sources highlighted the perception that many young women fall pregnant by having unprotected sex in their eagerness to please and keep their partner. Both male and female participants agreed that male students compete among themselves to display their virility, and a pregnant partner was proof of their prowess. Other factors influencing sexual behaviour included alcohol consumption and insufficient sex education. The article concludes with some suggestions for interventions to address the issue of teenage pregnancy.