Attitudes are complex to measure through questionnaire-based approaches, given that many factors influence a particular attitudinal response. In 2002, an alternate set of questions was utilised, mainly focusing on knowledge-related attitudes. This produced generally positive findings in relation to attitude. The questions used in the present survey attempted to explore more deep-seated attitudes and values.

SEXUAL DEBUT

Delayed onset of sexual activity (sexual debut) reduces incidence and prevalence of HIV in younger age groups.

Overall, very few children in the 12–14 year age group (1.9% males and 1.5% females) reported ever having had in sex.

Amongst 15 year olds surveyed, 11.7% of males and 7.9% of females had previously had sex. Amongst 20 year olds surveyed, 74.8% of males and 80.0% of females had previously had sex

Of those who had not had sex before, 71% said they were not ready, and 22.9% said they were not interested in sex

An inter-age analysis revealed a trend towards earlier sexual debut among younger respondents.

SEXUAL EXPERIENCE

The results showed that slightly more young females below 25 years of age (62.3%) were likely to have had sex before than their male counterparts (53.9%).

SECONDARY ABSTINENCE

Secondary abstinence refers to those individuals who have had sex before, but who have not had sex in the past year. Secondary abstinence reduces HIV infection risk.

Overall, nearly one-third of the respondents who were previously sexually experienced had not had sex during the previous 12 months.

Secondary abstinence was higher among young men aged 15–24 (23%) than among adult men aged 25–49 years (9.8%), but it was the same among women in both these age groups (20.0% and 21.3% respectively). Secondary abstinence was highest among elderly women (71.3%) and Africans (58.7%) aged 50 years and older.

SEXUAL PARTNERSHIPS

Unprotected sex with greater numbers of sexual partners increases risk of HIV acquisition and this risk is increased in the context of South Africa’s epidemic where there is high HIV prevalence. Most sexually active respondents reported that they had only one partner during the year with a higher proportion of females (97.4%) reporting this than males (83.7%).

The portions of sexually active respondents who had more than one partner in the past year were as follows:

• 27% for males and 6% for females aged 15-24

• 14.4% for males and 1.8% for females aged 25-49

• 9.8% for males and 0.3% for females aged ≥50

Overall rates were higher for informal settlements – 20.0% for males and 3.5% for females

HIV prevalence for those with more than 1 partner in past year was higher

• 20.6% for >1 partner, 16.3% for 1 partner

AGE MIXING

Having a partner 5 years or older poses high HIV infection risk for youth, as it exposes them to a higher HIV prevalence age group. Young females were more likely to have an older partner – 18.5% of sexually active females aged 15-19 had had male partners 5 or more years older, compared to 2% of males in this age group.

HIV prevalence of 15-19 year olds with older partners was higher. 29.5% of females with partner ≥5 years older were HIV positive, compared to 7.2% of females with partner within 5 years of own age. In the case of males, 19.0% with partner ≥5 years older were HIV positive, compared to 3.0% of males with partner within 5 years of own age.