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Title: Adolescent sexual behaviour, knowledge and attitudes to sexuality among school girls in Transkei, South Africa.
Author: Buga GA, Amoko DH, Ncayiyana DJ.
Journal: East Afr Med J; 1996 Feb; 73(2):95-100. PubMed ID: 8756047.
Abstract:
Teenagers make up a quarter of all mothers in Transkei, South Africa, and well over 75% of them are unmarried. Such a high rate of teenage pregnancy is indicative of a high level of unprotected adolescent sexual activity. We examined sexual behaviour, knowledge and attitudes to sexuality among adolescent school girls in Transkei, using a self-administered questionnaire, in order to establish the incidence of sexual activity, and associated risk factors. Of the 1072 respondents, 74.6% were already sexually experienced, and 21.0% were not. The majority of sexually experienced girls (SEGs) and sexually inexperienced girls (SIGs) were living with both their parents. There were no religious differences between the two groups of girls. The age of SEGs at first coitus correlated positively with the age of menarche, and the age at the first date, suggesting that sexual maturation and onset of dating were possible risk factors for initiation of sexual activity. Contraceptive use was low, and a third of SEGs had been pregnant at least once. The knowledge of reproductive biology among both groups of girls was generally poor, although SEGs were significantly more knowledgeable than SIGs. The majority of girls in both groups did not approve of premarital sex, and adolescent pregnancy. They also did not approve of the idea of introducing sex education in schools, or the provision of contraceptives by schools. Nearly a third of the respondents in both groups did not wish to get married in future. In conclusion, there is a high level of unprotected sexual activity among school girls in Transkei. The risk factors for this include early sexual maturation, early onset of dating, and poor knowledge of reproductive biology and contraceptives. In Transkei, South Africa, 25% of births are to teenagers, 75% of whom are unmarried. To investigate the factors associated with adolescent sexual activity and facilitate the design of preventive programs, a self-administered questionnaire was provided to 1025 females from 21 secondary schools. 800 (74.6%) were already sexually active; 18.7% had initiated coitus before menarche. Only 182 (23.5%) of these teens had ever used a modern method of contraception and 241 reported at least 1 pregnancy. Among sexually active teens, mean ages at menarche, first date, and first coitus were 13.91, 14.47, and 14.86 years, respectively. Major reasons cited for initiating coitus included forced by partner (28.4%), peer pressure (20.0%), carried away by passion (15.1%), to prove normality (11.7%), and to prove love of boyfriend (10.1%). The reasons provided by sexually inexperienced girls for delaying intercourse included religious values (25.4%), fear of pregnancy (23.8%), wish to wait for marriage (20.0%), fear of acquired immunodeficiency syndrome (AIDS) (15.6%), not emotionally ready (8.6%), and fear of sexually transmitted diseases and AIDS (6.4%). Knowledge of reproduction was low, with only 19% able to identify the fertile phase of the menstrual cycle. The majority of experienced (64.0%) and inexperienced (73.5%) girls disapproved of premarital sex while still in school; only 27.6% and 11.4%, respectively, supported the inclusion of sex education in the school curriculum. Overall, these findings indicate that early sexual maturation, early onset of dating, and poor knowledge of reproductive biology and contraception represent risk factors for unprotected sexual activity in this population and suggest a need for school-based family life education introduced before girls initiate sexual activity.

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