Gender norms, HIV risk, and attitudes towards pre-exposure prophylaxis and other HIV preventive interventions among South African adolescents.
Outcomes: Human Immunodeficiency Virus
View SourceKey Social Norms Take-aways The study highlights that simply providing information is not enough; efforts to combat HIV must also address the deeply embedded gender norms and social patterns that normalize male sexual dominance and place girls at greater risk. Strengthening positive parental communication, improving school environments, and expanding youth-centered community engagement are essential strategies to shift these norms and reduce adolescent HIV vulnerability.
Objectives This study aimed to assess HIV-related social norms among South African adolescents aged 15–18, investigate their awareness and attitudes toward HIV prevention methods (including condoms and pre-exposure prophylaxis or PrEP), and examine how social influences from family, school, and the community shape these views and behaviors.
Methods Researchers analyzed nationally representative cross-sectional data from 4,567 adolescents in the fifth South African National HIV Prevalence, Incidence, Behaviour and Communication Survey (2017–2018). They measured descriptive and injunctive norms around gender roles, sexual behaviors, and HIV risk; assessed knowledge and perceptions of HIV prevention; and used statistical models to explore associations between social influences (like parental sex education or school and community campaigns) and HIV-related attitudes and behaviors.
Results The study found that male adolescents were more permissive of multiple sexual partnerships for men, and girls were more frequently victims of sexual harassment at school. Condom use was the most well-known HIV prevention method (over 80% awareness), but a significant number of sexually active teens reported inconsistent use. Awareness of PrEP was very low (3.7%), yet nearly 70% of HIV-negative teens were open to using it after learning about it. Parental sex education and community campaigns were linked to greater HIV prevention awareness and openness to PrEP, while exposure to inappropriate sexual behaviors at school was associated with riskier sexual attitudes.
Conclusions While South African adolescents show interest in evidence-based HIV prevention methods, knowledge gaps and harmful gender norms persist. Social influences from home, school, and the community play a critical role in shaping adolescents’ perceptions and behaviors.
Norms Addressed
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