Academic journal article Gender & Behaviour

HIV Risk Behaviour among Orphaned and Non-Orphaned Female and Male Youths in South Africa

Academic journal article Gender & Behaviour

HIV Risk Behaviour among Orphaned and Non-Orphaned Female and Male Youths in South Africa

Article excerpt

Risky sexual behaviour and HIV infection among the youth in South Africa are a major concern (Meghdadpour, Curtis, Pettifor, & MacPhail, 2012). A growing body of literature suggests that compared with non-orphans, orphans are more vulnerable to HIV infection (Birdthistle et al., 2008; Gregson et al., 2005; Nyirenda, McGrath, & Newell, 2010; Operario, Pettifor, Cluver, MacPhail, & Rees, 2007; Thurman, Brown, Richter, Maharaj, & Magnani, 2006).

While all youths are susceptible to high risk behaviour, related to their life stage, parental death often leads to poor mental health, absence of role models and lack of caregiver social and economic support (Cluver, Gardner, & Operario, 2007). These circumstances may lead orphans to engage in early sexual debut (Foster & Williamson, 2000; Nyirenda et al., 2010). A study conducted in Zimbabwe found an association between gender and early sexual debut among orphaned female adolescents (Gregson et al., 2005). A study in the United States showed that living in a one-parent household instead of a two-parent household was linked to early sexual intercourse (Kirby, 1999). As orphans may be driven into sex to ensure their economic survival, early sexual debut is usually coupled with risky sexual behaviour such as inconsistent condom use, unprotected sex, or transactional sex and multiple concurrent partners (Mataure et al., 2002; Palen, Smith, Flisher, Caldwell, & Mpofu, 2006; Birdthistle et al., 2008), and higher likelihood of sexual exploitation (Foster & Williamson, 2000). Studies in Malawi (Muula et al., 2003), Nyanza district in Kenya (Juma, Askew, & Ferguson, 2007) and South Africa (Swart-Kruger & Richter, 1997) highlight the link between orphanhood and transactional sex as a means of meeting orphans' basic socioeconomic needs. Substance use among youth in South Africa may also be contributing to transmission of HIV (Meghdadpour, Curtis, Pettifor, & MacPhail, 2012). In a study among 15 to 24 year-old South Africans, Meghdadpour et al. (2012, p.1329) found that "compared with nonorphans, paternal and double orphaned males were more likely to have consumed alcohol, and paternally orphaned females had significantly greater odds of having used drugs."

To better understand the association between parental death and HIV risk behaviour among male and female youths in South Africa, we examined data from a cross-sectional population survey which included persons of ages 18 to 24 years in four selected provinces in South Africa. This paper explored (1) the prevalence of parental death among 18- to 24-year-olds in the four provinces, including death attributable to the loss of a father, a mother, or both parents; and (2) the associations between parental death and youths' HIV status, early sexual debut, sex with someone older and hazardous or harmful alcohol use and illicit drug use.

Method

Sample and procedure

A cross-sectional population-based household survey was conducted using a multi-stage stratified cluster sampling approach. The survey included persons of ages 18 to 24 years living in South African households of the four (out of nine) selected provinces, KwaZulu-Natal, Mpumalanga, Eastern Cape and Gauteng Province, providing an urban-rural representation of South Africa. The selection of the provinces was guided by the selecting two provinces with the highest HIV prevalence in the countiy, KwaZulu-Natal and Mpumalanga, and one most urban province (Gauteng) and one rural province (Eastern Cape). Ethical approval for the study was obtained from the Human Sciences Research Council Research Ethics Committee. Participants signed informed consent forms.

Measures

Orphan status: Orphans were categorized as "maternal orphan" (only mother has died), "paternal orphan" (only father has died), or "double orphan" (both parents have died). If the participant did not know if a parent was alive, the parent was considered to have died (Meghdadpour et al. …

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