Population Council Projects | South Africa: Transitions to Adulthood in the Context of AIDS

PROJECT
South Africa: Transitions to Adulthood in the Context of AIDS

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.

Location

KwaZulu-Natal Province, South Africa

Duration

January 1999–December 2007

Population Council researchers

Kelly K. Hallman, Naomi Rutenberg

Non-Council collaborators

Lisanne Brown, Paul Hutchinson, Ali Mehyrar Karim, Kate Macintyre, Robert Magnani (Tulane University School of Public Health and Tropical Medicine)

Anthea Dallimore, Ruanne Fensham, Stavrou Stavros (Development Research Associates, South Africa)

Monica Grant (University of Pennsylvania)

Nina Hunter, Ntsiki Manzini, Julian May, (School of Development Studies, University of Natal, Durban, South Africa)

Carol Kaufman (University of Colorado Health Sciences Center)

Donors

UK Department for International Development

US Agency for International Development (through Horizons, Focus on Young Adults Project, MEASURE-Evaluation Project, and Population Council Program III)

Publications/Resources on this project