Background: Despite a variety of contraceptives being available for women in South Africa, a considerable number of adolescent girls and young women still face challenges in using them. This paper examines socio-demographic and behavioral predictors of using contraceptives among adolescent girls and young women (AGYW) aged 15 to 24 years.Methods: A secondary data analysis was conducted based on the 2012 population-based nationally representative multi-stage stratified cluster randomised household survey. Multivariate backward stepwise logistic regression model was used to examine socio-demographic and behavioural factors independently associated with contraceptive use amongst AGYW aged 15 to 24 years in South Africa.Results: Out of 1460 AGYW, 78% (CI: 73.9-81.7) reported using some form of contraceptives. In the model, contraceptive use was significantly associated with secondary education [OR = 1.8 (1.2-2.7), p = 0.005], having a sexual partner within 5 years of their age [OR = 1.8 (1.2-2.5), p = 0.002], and sexual debut at age 15 years and older [OR = 2.5 (1.3-4.6), p = 0.006]. The likelihood of association decreased with other race groups-White, Coloured, and Indians/Asians [OR = 0.5 (0.3-0.7), p = 0.001], being married [OR = 0.4 (0.2-0.7), p = 0.001], never given birth [OR = 0.7 (0.5-0.9), p = 0.045], coming from rural informal [OR = 0.5 (0.3-0.9), p = 0.010] and rural formal settlements [OR = 0.5 (0.3-0.9), p = 0.020]. Conclusions: Evidence suggest that interventions should be tailor-made to meet the needs of AGYW in order to, promote use and access to contraceptives. The results also suggest that family planning interventions should target those who had not given birth in order to reduce unplanned and or unintended pregnancies and associated risk factors. These findings contribute to public health discourse and reproductive health planning for these age groups in the country.

The subject of human well-being continues to gain traction in disciplines as diverse as psychology, sociology, development studies, and economics. Current scholarship, however, is still largely framed by normative assumptions about what being well means, and the overwhelming majority of conceptual approaches to well-being being have been conceived and applied by researchers in the industrialized, wealthy contexts of the global North. We critique the current conceptualizations of well-being and assess their applicability to research in the global south, particularly in contexts marked by poverty and inequality.

Background Sexual risk behaviours that occur among young men are based on dominant notions and practices that prevail in cultural contexts. As such, understanding the intersection of cultural norms and sexual risk behaviours among young men is very important. Methods The study used a qualitative design and conducted four focus group discussions with 36 male students who were purposively selected from different levels of study at the University of KwaZulu-Natal. Data were analysed through line-by-line coding, and grouped into emerging themes and sub-themes facilitated by the use of Atlas.ti. Result The findings emphasize that socialisation agents such as the family, peers and community play an important role in prescribing acceptable and unacceptable sexual behaviour of young men. Some of the young men seemed to adhere to prescribed gender norms of what it means to be a man while some rejected them for alternative versions of being a man. In the context of the university environment, these findings reveal that male students cannot make informed decisions regarding condom use when they are intoxicated, and thus expose themselves to sexually transmitted infections and other risks. Conclusion University sexual risk reduction programs should be developed considering the specific cultural context, using strategies that empower young men to challenge the widely accepted cultural norms that may predispose them to sexual risks. Plain English summary Sexual behaviours and cultural norms are interconnected, it is through culture that people learn how to behave and understand the world around them. In many cultural contexts, young men are taught from a very young age how to behave based on dominant notions of what it means to be a man in that particular context. As such, in some cultural context sexual risk-taking such as having multiple sexual partners and unprotected sex are perceived as normal behaviour for men. Some young men embrace such normalised sexual behaviours which often has negative implications on their future. This study explored the influence of cultural norms on the sexual behaviour of young men. This qualitative study was conducted at the University of KwaZulu-Natal. Four focus group discussions were conducted among first-year students to postgraduate students who were between the ages of 18 to 30 years. Our findings revealed that there other influences on the sexual behaviours of the young men, which included family, community and peers. It also emerged that gender norms regarding what it means to be a man still prevailed which some of the young men in the study adhered to, notably such notions seemed to be rejected by some of them. The university setting appeared to be space where a lot of sexual risk-taking took place, which potentially exposed the young men in the study to many sexual risks. In conclusion, targeted programs for the university setting should aim to challenge gender norms that expose young men to sexual risks.

Adolescent health and behaviours have received increasing attention in the last decade, with several studies considering the impact of risk behaviours on adolescent health and wellbeing. [1,2] Adolescents are defined by the World Health Organization as young persons between 10 and 19 years old. [3] Two issues of particular concern in South Africa include the harmful use of alcohol and illicit drugs, and risky sexual practices, by adolescents. Surveillance statistics indicate that 49.2% of South African school-going youth have used alcohol and 25.1% of these youth have engaged in binge drinking. [4] Furthermore, 26% of all persons admitted to substance abuse rehabilitation facilities in 2016 were under the age of 20 years. [5] Risky sexual behaviour is defined as sexual activities that potentially expose an individual to sexually transmitted infections (STIs), including the human immunodeficiency virus (HIV), and unplanned pregnancy. [6] These include unprotected sex, early sexual debut, inconsistent condom use, alcohol or drug use before sexual intercourse, multiple sexual partners, forced or coerced sexual intercourse for reward, and low frequency of contraceptive use. [7,8] More than a quarter of South African school-going youth have had sex, 12% of whom had sexual debut before 14 years of age. [4] Early sexual debut increases the risk of HIV infection at a very early age. [9] Of those who had sex, only 32.9% reported consistent condom use and 18% indicated that they had been pregnant or had made someone pregnant. [4] Almost half of those who had sex reported having had multiple sexual partners, while 17% reported having used alcohol and 13% having used drugs prior to having sex. [4] In South Africa, KwaZulu-Natal Province has the highest prevalence of HIV, consistent across all age categories, including 15-24-year-olds. [10] KwaZulu-Natal is often characterised as the epicentre of the South African HIV epidemic. While studies have explored the epidemiology of adolescent risk behaviours in South Africa, [11] fewer studies have canvassed the opinions of adolescents in peri-urban communities. A previous longitudinal study on the wellbeing of children conducted in Vulindlela, KwaZulu-Natal, [12] identified serious overlapping risk behaviours, particularly drug use and sexual behaviour among children. These observations highlighted the need for a more comprehensive understanding of how adolescents assess and negotiate risk in high-poverty, high-HIV-prevalence communities. Using a photovoice methodology, the current paper describes adolescents' representations of substance misuse and risky sexual practices in a low-resource, high-HIVprevalence peri-urban community (Vulindlela) in KwaZulu-Natal. Background. Adolescent risk behaviours, such as substance abuse and unprotected sex, are leading social and health challenges in South Africa (SA). Objective. To investigate adolescents' perspectives on the prevalence of adolescent risk behaviours in rural settings in SA. Method. Using a qualitative photovoice methodology, th...