USAID SOUTH AFRICA SCHOOL-BASED SEXUALITY AND HIV PREVENTION EDUCATION ACTIVITY SUMMARY REPORT OF SEXUAL RISK, PREGNANCY AND HSV-2 AMONG FEMALE ADOLESCENT

The study is set in KwaZulu-Natal (KZN) and Mpumalanga (MP) provinces, targeting schools in the three lowest socioeconomic status (SES) quintiles. A total of 106 schools were included in the sample, of which 60 were located in KZN and 46 located in MP. The final sample size was 2802 female learners, 1408 from KZN and 1394 from Mpumalanga. Adolescent girls in the study had a mean age of 13.5 years at baseline, with most living with their biological mothers (81.1%). A minority (13.3%) of learners indicated they have a family member who is HIV positive, while 26.4% indicated they don't know if they have a family member who is HIV positive. Nearly one-tenth (8%) of adolescent girls had engaged in sexual activity at the baseline survey, which nearly doubles in two years as almost one fifth (19.2%) of girls had engaged in sexual activity by the endline survey. The data highlights the significant need for sexual reproductive health services among female learners. The proportion of adolescent girls who became sexually active increased by more than two-fold over two years. Inconsistent condom use was high, which means that teenage pregnancy, STIs, and HIV will be a serious problem amongst this cohort of adolescent girls as more of them become sexually active. An additional concern is the proportion of girls who have partners who are five or more years older than them, which is an additional risk for HIV contraction amongst the adolescent girls as older men are more likely to be HIV positive and to engage in risky sexual behaviours than younger men. The study found that just over one-tenth (10.7%) of girls were positive for HSV-2 at the study endline. The focus for the sexuality education programme should be on improving condom use and making sure that the adolescent girls get tested for STIs and HIV from an early age. Sexuality education needs to be augmented with the provision of direct health services to learners in schools. To improve the chances of achieving stated aims expressed through policy, specifically reducing unwanted pregnancy, lowering the incidence of HIV, and retaining learners in school, a layered and multi-dimensional approach is required.