Exploring the socio-ecological levels for prevention of sexual risk behaviours of the youth in uMgungundlovu District Municipality, KwaZulu-Natal

With high-risk sexual behaviours evident among many South African youth aged 14–24 years, numerous interventions have been implemented intending to promote their sexual health.1,2 The ability of youth to protect themselves from unplanned pregnancy,3 intergenerational sex, intimate partner violence,4 human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) and sexually transmitted infections (STI) remains a challenge.5 The risk factors that have been found to increase this vulnerability to HIV, other STIs and unplanned teenage pregnancy include poor decision-making and peer pressure,6 social norms and gender-based violence,7 early sexual debut without protection,5 concurrent partners,8 intimate partner violence9 and intergenerational sex.10 Owing to the complexity of changing the above-mentioned factors influencing these risky behaviours among the youth, the South African government, civil organisations and non-governmental organisations have developed numerous educational programmes.1,11 However, most of these programmes12 mainly revolve around provision of information about sexual health.13,14 These programmes have used a variety of communication approaches such as different media, including television, radio, billboards and newspapers, as well as face-to-face information sharing and teaching strategies such as HIV peer education programmes and the Life Orientation learning area, which was introduced in South African public schools in 1995. Evaluation of the impact of the current interventions on risk reduction among the youth in southern Africa has shown limited success.15 Most of the face-to-face education programmes for the youth are implemented in school settings, where youth spend most of their time, and evidence shows that many HIV peer education programmes and Life Orientation learning area are operating in a vacuum,16 not linked to collaborative community structures and government services.17,18 The challenge arises when the situation requires youth to be proactive to get health and social services; they struggle to navigate within the clinics, schools and department of social development and non-governmental organisations to obtain the required services. The high prevalence of HIV and STIs among youth, and high rates of teenage pregnancy indicate a Background: Prevention of youth sexual risk behaviour among the youth in uMgungundlovu District Municipality continues to be a primary challenge for public health and health promotion. Current prevention interventions are targeted at an individual level, whilst youth behaviour is influenced by many social and environmental factors.