Multiple Levels of Influence in Predicting Sexual Activity and Condom Use Among Adolescents in Soweto, Johannesburg, South Africa

Abstract

HIV prevalence amongst 15–19 year olds in South Africa is 6.7% and 2.5% in females and males respectively. Using an interviewer-administered cross-sectional survey, we examined individual, interpersonal, family and community factors associated with sexual activity and condom use among 506 adolescents 16–18 years from Soweto, Johannesburg. The sample was mainly female (59%, n = 298). Using multivariate logistic regression, males (OR:2.6, CI: 1.4–4.8), older partners (OR:4.5, CI: 1.5–13.8), hazardous alcohol use (OR:2.4, CI: 1.1–5.2) and permissive attitudes about sex (OR:1.6, CI: 1.3–2.1) predicted sexual activity. A first partner at a younger age (OR:1.2, CI: 1.1–1.4) and having older partners (OR:0.29, CI: 0.13–0.68) predicted lack of condom use. For females, increasing age (OR:2.7 CI:1.4–5.5), older partners (OR: 3.3 CI:1.4–7.6), and permissive attitudes about sex (OR: 1.6 CI:1.2–2.1) predicted sexual activity. Multiple levels have to be addressed in developing HIV prevention programs for adolescents in Soweto.