Transitions to Adulthood in the Context of AIDS
Council researchers explored the determinants of adolescent risky sexual behavior and educational attainment in South Africa, an environment characterized by high HIV prevalence and high income inequality.
Adolescent fertility in South Africa is high, with about 30 percent of girls giving birth before age 20. Childbearing and marriage are loosely linked, and childbearing often precedes school completion and marriage by several years. This pattern of childbearing adds to girls’ vulnerability to HIV, as currently there are no means for those who wish to become pregnant to protect themselves from infection. The rapid spread of HIV is having a major impact on young people: National population-based data show that over 15 percent of females aged 15–24 are living with HIV. This high-risk environment is likely to be affecting key adolescent outcomes.
A longitudinal study of youth was conducted in KwaZulu-Natal, South Africa, the province hardest hit by the HIV/AIDS epidemic. Wave 1 was fielded in 1999; wave 2 in 2001. The project included interviews with young people and their parents; community surveys examining infrastructure, services, and safety; and interviews with secondary school principals to assess the extent of coverage of the government-mandated school-based life-skills curriculum and its impact on the sexual risk-taking behaviors of young people.
As the first panel study of adolescents in the country, it is filling important gaps in knowledge about the determinants of adolescent risky sexual behavior and educational attainment in an environment characterized by both high HIV prevalence and highly unequal access to opportunities and services, including schooling, employment, and health care.
Highlights of recent findings include:
- Among schoolgirls who become pregnant, those who had previous nonpregnancy-related school delays were much more likely to drop out of school, and among those who dropped out because they became pregnant, coresidence with females ages 25–49 (proxy child care providers) increased their chances of returning to school.
- HIV risk perception among adolescents is influenced by connectedness to parents and the community, self-efficacy to use a condom (among males), and residing with a chronically ill household member (among females).
- Experience of nonconsensual sex is associated with more accumulated schooling delays and lower educational attainment among females.
- Evaluation of the school-based life-skills curriculum reveals that coverage is rapidly increasing; adolescents exposed to the life-skills curriculum had modest increases sexual and reproductive health knowledge, greater perceived condom self-efficacy, and higher chances of condom use at first and last sex.
Pregnancy-related school dropout and prior school performance in KwaZulu-Natal, South Africa (abstract)
Grant,Monica J.; Hallman,Kelly
Studies in Family Planning 39(4): 369-382
Publication date: 2008
Pregnancy-related school dropout and prior school performance in South Africa (PDF)
Grant,Monica J.; Hallman,Kelly
Policy Research Division Working Paper (no. 212)
Publication date: 2006
Sexual risk behavior among South African adolescents: Is orphan status a factor? (abstract)
Thurman,Tonya R.; Brown,Lisanne; Richter,Linda; Maharaj,Pranitha; Magnani,Robert
AIDS and Behavior 10(6): 627-635
Publication date: 2006
The impact of life skills education on adolescent sexual risk behaviors in KwaZulu-Natal, South Africa (abstract)
Magnani,Robert; Macintyre,Kate; Karim,Ali Mehyrar; Brown,Lisanne; Hutchinson,Paul; Transitions Study Team; Kaufman,Carol E.; Rutenberg,Naomi; Hallman,Kelly; May,Julian; Dallimore,Anthea
Journal of Adolescent Health 36(4): 289-304
Publication date: 2005
Communities, opportunities, and adolescents' sexual behavior in KwaZulu-Natal, South Africa (abstract)
Kaufman,Carol E.; Clark,Shelley; Manzini,Ntsiki; May,Julian
Studies in Family Planning 35(4): 261-274
Publication date: 2004
Transitions to adulthood in the context of AIDS in South Africa: The impact of exposure to life skills education on adolescent knowledge, skills, and behavior (PDF)
The Transitions to Adulthood Study Team
Horizons Final Report
Publication date: 2004
Understanding perceptions of HIV risk among adolescents in KwaZulu-Natal (abstract)
Macintyre,Kate; Rutenberg,Naomi; Brown,Lisanne; Karim,Ali Mehyrar
AIDS and Behavior 8(3): 237-250
Publication date: 2004
Condom use and abstinence among unmarried young people in Zimbabwe: Which strategy, whose agenda? (PDF)
Marindo,Ravai; Pearson,Steve; Casterline,John B.
Policy Research Division Working Paper (no. 170)
Publication date: 2003
Pregnant or positive: Adolescent childbearing and HIV risk in KwaZulu Natal, South Africa (abstract)
Rutenberg,Naomi; Kaufman,Carol E.; Macintyre,Kate; Brown,Lisanne; Karim,Ali Mehyrar
Reproductive Health Matters 11(22): 122-133
Publication date: 2003
The impact of life skills education on adolescent sexual risk behaviors (PDF)
Magnani,Robert; Macintyre,Kate; Karim,Ali Mehyrar; Brown,Lisanne; Hutchinson,Paul
Horizons Research Summary
Publication date: 2003
'Bus fare, please': The economics of sex and gifts among adolescents in urban South Africa (PDF)
Kaufman,Carol E.; Stavrou,Stavros E.
Policy Research Division Working Paper (no. 166)
Publication date: 2002
How community structures of time and opportunity shape adolescent sexual behavior in South Africa (PDF)
Kaufman,Carol E.; Shelley,Clark; Manzini,Ntsiki; May,Julian
Policy Research Division Working Paper (no. 159)
Publication date: 2002
Pregnant or positive: Adolescent childbearing and HIV risk in South Africa (PDF)
Rutenberg,Naomi; Kaufman,Carol E.; Macintyre,Kate; Brown,Lisanne; Karim,Ali Mehyrar
Policy Research Division Working Paper (no. 162)
Publication date: 2002
Transitions to adulthood in the context of AIDS in South Africa: Report of Wave I (PDF)
Rutenberg,Naomi; Kehus-Alons,Cathrien; Brown,Lisanne; Macintyre,Kate; Dallimore,Anthea; Kaufman,Carol E.
Horizons Final Report
Publication date: 2001
Project Stats
Location: South Africa (KwaZulu-Natal Province)
Program(s):
HIV and AIDS
Poverty, Gender, and Youth
Topic(s):
Adolescence/transitions to adulthood
Behavior change
Sexuality and sexual behavior
Duration: 1/1999 - 12/2007
Population Council researchers:
Kelly Hallman
Naomi Rutenberg
Non-Council collaborators:
Ali Mehyrar Karim (Tulane University School of Public Health and Tropical Medicine)
Anthea Dallimore (Development Research Associates, South Africa)
Carol Kaufman (University of Colorado Health Sciences Center)
Julian May (School of Development Studies, University of Natal, Durban South Africa)
Kate Macintyre (Tulane University)
Lisanne Brown (Tulane University School of Public Health and Tropical Medicine)
Monica J. Grant (Department of Sociology, University of Wisconsin)
Nina Hunter (School of Development Studies, University of Natal, Durban, South Africa)
Ntsiki Manzini (School of Development Studies, University of Natal, Durban South Africa)
Robert Magnani (Tulane University School of Public Health and Tropical Medicine)
Ruanne Fensham (Development Research Associates, South Africa)
Stavrou Stavros (Development Research Associates, South Africa)
Donors:
UK Department for International Development
US Agency for International Development
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