Adolescents and Parents’  Perceptions of Condom Distribution in Selected Secondary Schools in the High Density Suburbs of Bulawayo, Zimbabwe

Abstract

Condoms have been highlighted as one of the most effective strategies to prevent the spread of HIV and AIDS. This study assessed how adolescents and parents perceive the condom distribution programme in selected secondary schools in the highdensity suburbs of Bulawayo. A concurrent mixed method survey was conducted on three selected secondary schools. Three hundred adolescents and three hundred parents responded to a pre tested semi structured questionnaire. Likert scales were developed to assess knowledge and attitude levels. The χ 2 test and multiple logistic regression were used to associate different demographic characteristics with attitudes and levels of knowledge regarding condom distribution at schools using STATA Version 13. Practices and beliefs were assessed using unstructured interviews on purposively selected adolescents and parents. Qualitative data collected was thematically analysed on MAXQDA. The response rate was 100% and 81% for adolescents and parents/guardians respectively. There were more females than males in both response groups. About 67% of adolescents and 60% of parents/guardians were knowledgeable about condom usage and its implications on prevention of spread of sexually transmitted infections and pregnancies. A large proportion of parents/adolescents (72%) had good attitudes towards condom distribution in schools compared to adolescents (27%). Age was strongly associated with knowledge in adolescents, with older adolescent 102 times more likely to be knowledgeable compared to younger adolescents. Religion was the strongest predictor of attitudes in parents/guardians with Catholic having an odds of 227. The concerned sexual health institutions should increase awareness among adolescents, targeting their attitudes towards condom distribution and usage. Targeting attitudes will hopefully foster safe sexual practices.

Health System Strategies and Adolescent Sexual Health: Systematic review using Rodgers Concept Analysis Framework

“…The definition of sexual health has evolved over the years leveraging on the 1975 World Health Organization that defined sexual health as "Integration of the somatic, emotional, intellectual and social aspects of sexual being in ways that are positively enriching and that enhance personality, communication and love" [14,21,22].The change in these definitions have been influenced by political, social, historic events and human right considerations [3,21]. After the sexual revolution in the 1960s, there has been an on-going struggle over reproductive rights, rights for homosexuals and abortion rights for adolescents [21].…”

“…Adolescents are placed at heightened risks for poor sexual health outcomes due to non-compatibility of HSSs with their developmental needs in relation to their specific age groups [3,27,42]. There is need to contextualise strategies in such a way that it takes into consideration the different developmental stages and the needs of these adolescents thereby ensuring that the strategy used is appropriate to attain desired goals [5,[27][28][29].…”

“…Different strategies therefore are used in relation to different population groups. There are proposals that SH issues should be infused into curriculum at schools so as to ensure that all adolescents get relevant information on SH [3,29]. Outside the school setup, some conservative communities might not permit SH information sharing between parents and their adolescents [45,46].…”

“…There have been quite a number of factors that have led to negative Sexual Health (SH) outcomes in adolescents. Different authors have noted these as: unfriendly sexual health care services for adolescents, poor health care financing just to mention a few [2,3]. An adolescent in this study would be defined as a young person who is in the age group of 10 to 19 years and is in the process of transitioning into adulthood [4,5].…”

“…Strategies in this study will be defined as a plan that is implemented within a HS so as to impact on SH outcomes of adolescents [13]. Despite implementation of quite a number of strategies adolescents still remain highly vulnerable, with high prevalence of Sexually Transmitted Infections (STIs), high incidence of teenage pregnancy resulting in high numbers of adolescents dropping out of schools [3,10,14]. Dropping out of formal schools subjects adolescents to poverty particularly in Low and Middle Income Countries (LMCIs) where employment opportunities are hard to come by and there is stiff competition for the few…”