Within South Africa's HIV epidemic, foreign migrant adolescent girls and young women (AGYW) face unique challenges in an environment typified by xenophobia and structural inequity. The intersection of age, gender, and migrant-related factors creates threats that may exacerbate their HIV risk, including discrimination, limited social capital, and economic dependency. This paper explores HIV-related determinants of risk from the perspective of foreign migrant AGYW who participated in a Girls' Club project implemented by Community Media Trust. Within clubs, foreign migrant AGYW met weekly with a female mentor to discuss HIV, safety planning, financial literacy, and other topics. Focus group discussions (FGDs) were conducted with club members and parents to learn about pressing challenges in a context characterized by early sexual debut, high rates of teenage pregnancy, and relationships typified by material exchange. FGDs addressed HIV risk factors such as social isolation and limited access to services, exacerbated by migrant-related stigma and discrimination and lack of identity documents. The foreign migrant AGYW appreciated the role of the Girls' Clubs and mentors in helping them overcome barriers to school and health services as well as building their social and other assets. FGD results indicate that HIV prevention in South Africa should prioritize action to address the specific determinants of foreign migrant AGYW's HIV risk, as well as inclusive policies that recognize migrants' heterogeneity based on gender and age.
Teenage pregnancy still remains high in low and middle-income countries (LMIC), as well as in high-income countries (HIC). It is a major contributor to maternal and child morbidity and mortality rates. Furthermore, it has social consequences, such as perpetuating the cycle of poverty including early school dropout by the pregnant adolescent, especially in sub-Saharan Africa (SSA). Few studies in SSA have investigated the trends in teenage pregnancy and the associated factors, while this is critical in fully understanding teenage pregnancy and for promotion of reproductive health among adolescents at large in SSA.
the adolescent 4th edition gouws pdf 18
There is clearly a lot of literature on teenage pregnancy, but its scope is limited to the causes of teenage pregnancy [21], the implications of pregnancy to the young mother (and her baby) [22, 29], and to school dropout related factors [22, 24]. There are however, very limited studies published that report on recent trends in teenage pregnancy in SA [29]. Even less is known about the factors associated with trends in teenage pregnancy. Analysis of teenage pregnancy trends and the associated factors is of paramount importance, as it will help to understand fully the factors surrounding teenage pregnancy in SA. It provides useful information towards understanding the magnitude of teenage pregnancy among the South African youth and helps determining areas that require serious intervention efforts in order to reduce the rates of teenage pregnancy. Understanding the factors or determinants associated with teenage pregnancy is crucial because it is this understanding that will enable development of intervention programmes needed to address teenage pregnancy in the country. Thus, the aim of this particular study is to examine the trends in teenage pregnancy as well as related health risk behaviors, including unsafe sex, substance use, partner violence, and psychological well-being; which might act as contributory factors associated with teenage pregnancy among school-going adolescents between 11 and 19 years of age in different settings of the country.
Data of the three Umthente Uhlaba Usamila: South African National Youth Risk Behaviour Surveys (YRBS) are used in this study. Three cross-sectional surveys were conducted among nationally representative samples of grades 8 to 11 secondary school adolescents in South Africa in 2002, 2008, and 2011.
A total of 31 816 school-going adolescents were surveyed during the three surveys (2002, 2008, and 2011). The combined sample consisted of 47.6 % males and 52.4 % females between the ages of 11 to 19 years of age, with (78.4 %) being Black Africans, (13.0 %) Coloured, (1.3 %) Indian, (6.3 %) White, and (1.0 %) other. Less than half of the adolescents have a father (39.0 %) or a mother (31.3 %) who had a paid job.
About 17.9 % of the adolescents reported having been hit on purpose by a boyfriend or girlfriend, while 15.9 % reported to ever hit their boyfriend or girlfriend on purpose. During the three survey years, 9.8 %, 9.9 %, and 9.4 % of the adolescents reported that they had been forced to have sex, respectively. In the combined sample, 9.7 % of adolescents reported having been forced to have sex, while 8.3 % reported to have forced someone else to have sex.
Ever smoked cigarettes was reported by 22.5 % of the adolescents, ever having used alcohol by 53.4 % and 28.5 % admitted to binge drinking. Smoking dagga (marijuana) was reported by (14.6 %) adolescents, followed by sniffed glue (10.3 %), heroin (7.3 %), and injection drugs (6.6 %). Mandrax, cocaine and other drugs were the least used drugs by the adolescents at 6.5 %, 5.9 % and 5.7 % respectively.
Substance use between boys and girls were notably different. Nearly twenty nine per cent of boys (28.6 %) smoked cigarettes one or more days, while only 16.9 % of girls smoked cigarettes. More boys (58.3 %) than girls (49.0 %) ever used alcohol in this study. Similarly with binge drinking during the past month, 34.1 % boys and 23.3 % girls reported binge drinking. When comparing the three surveys, there is a slight decrease in alcohol use from 2002 (53.7 %), 2008 (52.6 %) to 2011 (46.2 %). The overall use of alcohol in the combined sample is 50.8 %. The percentage of binge drinkers was 26.1 % in 2002, but increased in 2008 (30.8 %) and slightly decreased in 2011 (28.6 %). The overall percentage of binge drinking in the combined sample was 28.5 %. Marijuana, the drug most commonly used by the adolescents in this study was reported by 20.9 % of the boys and by 8.7 % of the girls. Sniffed glue (13.5 %), mandrax (8.4 %), cocaine (7.9 %), heroin (9.1 %), injection drugs (8.6 %), and other illegal drugs (7.5 %) were reported by the boys. While girls reported to have ever sniffed glue (7.2 %), used mandrax (4.5 %), cocaine (3.7 %), heroin (5.4 %), injection drugs (4.5 %), and other illegal drugs (3.8 %).
The first important finding in this study is that sexual intercourse among adolescents has decreased. However, among those adolescent girls who reported to engage in sex, teenage pregnancy has increased. These findings are in line with increasing evidence demonstrating the magnitude of teenage pregnancy among sexually active adolescents, especially in the sub-Saharan African countries [1, 2, 4, 19, 20]. This is worrying, particularly the fact that it suggest that there is little progress made in reducing teenage pregnancy over the past few decades, despite its importance as highlighted in the Millennium Development Goals (MDG) and its association to maternal mortality and morbidity rates [5]. Teenage pregnancy in developing countries has been reported to be worse than in developed countries [4, 5]. The lack of data on teenage pregnancy trends among South African adolescents poses a serious public health threat, as the magnitude of the problem is relatively hidden for consideration into intervention programs that aim to reduce teenage pregnancy, and improve maternal and child health outcomes. The fluctuating rates of sexual intercourse at the age of 13 years or younger among girls is also concerning. Early sexual debut is not uncommon in SA. Recent research shows that more and more adolescents are sexually active by the time they are 14 years and older [25, 38].
A limitation of the study at hand is that it is undertaken in the school setting. This excludes those adolescents who were not schooling at the time of data collection. Teenage pregnancy has been reported to be the most common reason for school-dropout in SA [26, 28]. Therefore, some adolescents might be out of school as a result of pregnancy and that does not invalidate the findings of this study, which confirms teenage pregnancy is still prevalent among adolescents in SA. Another limitation is that the results of this study cannot prove causality of teenage pregnancy by these risk behaviours, but only associations with teenage pregnancy. Thus, future research should aim to mitigate the risk behaviours associated with teenage pregnancy, as reported in this study. The pattern in teenage pregnancy is clearly increasing among those who engage in sexual activities, and that is a cause for concern. This suggests the further need to address health risk behaviours, including early sexual debut, unsafe sex, substance use and encouraging the correct and consistent use of contraceptives among adolescents; as well as promote their sexual and reproductive health in SA.
Sexual intercourse among adolescents is decreasing, but teenage pregnancy continues to increase among those who are sexually active. Teenage pregnancy continues to be a growing public health concern and adolescent sexual and reproductive health behaviours, such as contraceptives and safe sex practices has to be acknowledged in the health care system as an important health issue in SA. Risky behaviours, such as substance use, also need to be recognized and intervention programmes aiming to reduce teenage pregnancy and sexual and reproductive behaviours among adolescents need to include prevention of substance use. This study highlights the need for more comprehensive research on adolescents SRH needs particularly among the vulnerable adolescents aged 16 years and under, but not excluding those aged above 16 years old, to identify risk factors and develop specific interventions tailored for their needs. Regular monitoring of teenage pregnancy trends and the associated factors also aid in determining the effectiveness of programmes put in place by government and other related institutions, as well as highlighting areas where extra effort is needed to curb the rates of teenage pregnancy. 2ff7e9595c
Comments