South Africa is home to the world’s HIV/AIDS epidemic. Mid-year population estimates published by Statistics South Africa showed an increased rate of infection from 4 million in 2002, to an estimated 5.26 million in 2013.⁽²⁾ Grim, is the title of the portrait that these data-sets paint. ‘Infection’ has become synonymous with ‘sex’, which - to the detriment of our society - has made both, and not only the latter, a now censored affair.

Similarly, knowing your HIV status, practicing safe sex and preventing secondary transmissions from mother to child does not make any South African citizen immune to gender based violence, tradition and or socio-economic inequality – some of the major risk factors that enable the spread of the disease. In other words, the act of prevention is no longer just a rational choice made solely by individuals. It has become the act of attempting to create a collective intelligence that can only emerge through a revolutionary change in behaviour.

It is on this premise that this CAI paper discusses the results of a recent sex opinion poll that showed just how switched on South Africa’s youth are to safe sex behaviour, which traditional conventions still influence their decisions today and how they feel about their future.

Awareness and action: The self-imposition of behaviour change

On World Aids Day (1 December 2013), Praekelt Foundation ⁽³⁾ launched its Youth Sex Poll, a perceptions index that is hosted on its Young Africa Live (YAL)⁽⁴⁾ platform on Vodafone Live. “While not a scientific survey, the opinion poll provides a powerful snapshot into important aspects of sexual knowledge and behaviour in the lives of YAL’s users, a not [so] inconsequential group of young South Africans,” says Gustav Praekelt, Founder of Praekelt Foundation.

Created in 2009 as a place for entertaining and educating young people around the issues of love, sex and relationships, YAL has grown its user-base to over 1.8 million, who access the platform in order to ask for expert advice and seek out peer support. A reflection of YAL’s impact amongst South Africa’s youth is the 90% increase in unique responses to the questions that made up the poll. Responses grew from 170,000 in 2012 to 322,857 in 2013, all coming from 17,713 unique participants with each question generating on average 5,000 answers.⁽⁵⁾

The majority of respondents were female (68.9%). With South Africa’s female population being at higher risk of infection and with 17% of the country’s women of reproductive age being HIV positive,⁽⁶⁾ the response to the poll from this exact demographic shows a promising change from general awareness to engaged conversation around HIV/AIDS.

An overwhelming result of the 2013 YAL poll is the respondents’ enlightenment around safe sex behaviour. Of the total respondents, 70% know their HIV status and in response to a question about concurrent multiple sexual partners, 65.3% said they had a single, long-term partner or were abstaining from sex (while 25% said they were engaged in multiple concurrent sexual relationships but always used a condom).

The large response to the question “Would you rather have sex or money?” being money, with 83.9%, and just 16.1% selecting sex as their answer is indicative, in this author’s experience, of the desperation that YAL users feel as a result of their lack of income. Furthermore, when asked to identify the single largest challenge facing the youth of today, 35% of all respondents chose unemployment, followed by teen pregnancy (27%), alcohol and drug abuse (21%) and lastly, HIV (10%).

With reference to the findings above and with data from the poll illustrating that a large portion of the respondents live in townships (37.5%), followed by rural areas (29.8%), then cities (17.8%) and lastly, small towns (14.8%); the possible interplay of factors between urban and rural environments leading to infection, as well as single or multiple partnerships should not be underplayed nor should these factors be considered in isolation. Although living in urban areas poses particular challenges like higher risk of infection, as is evident in the discussion of factors below, HIV/AIDS is not an urban-only issue.

Firstly, migration is often linked to a livelihood strategy (which is common practice in South Africa), and is associated with higher levels of risk of HIV infection, due to the associated disruption of spousal relationships.⁽⁷⁾ Migratory workers often leave rural areas in search of employment in urban areas with periodic visits to their rural homes or, in the case of truck drivers for instance, spend time across the country. Secondly, endemic unemployment in South Africa's urban sector is likely to increase feelings of social disillusionment, frustration and boredom, which could discourage safe sex practices, for example, young women engaging in sexual relationships with older, financially secure men for the resources that they consequently gain access to.

The stray from safe sex practices in both rural and urban environments are therefore not separate issues and the findings above show that both rural and urban contexts are represented by a fair percentage of respondents in this poll. Therefore, the understanding of the poll’s respondents around the importance of condoms in safeguarding their sexual and individual health is promising in the 39.9% of respondents who said they always use a condom compared to the 11.9% who said they never do, as well as the 85.7% respondents who believe that it is both a man and a woman’s responsibility to carry condoms.

Taking into account that the majority of poll respondents fall into the high-risk age brackets - 19-24 years (38%) and 25-35 years (30%) - the fact that 45.2% of respondents indicated that they had had between 1 and 5 sexual partners in their lifetime points to a possible decrease in hypersexuality amongst South Africa’s youth.⁽⁸⁾

Respondents also showed a maturity of understanding around HIV/AIDS with a large majority (89.4%) describing the disease as not being a death sentence, while a significant majority (59.8%) further indicated that they would use both an Anti-Retroviral (ARV) programme and prayer if faced with an HIV positive status. An objective streak in liberal perceptions is also seen by way of the respondents’ firm conviction that a hospital circumcision (69.7%) is preferable to a traditional one (20.6%) and that being gay should most definitely not be a crime (83.1%).

The value of values and the socio-structural support thereof

Despite the growing liberal sentiment emanating from South Africa’s youth, a strong conservative streak still remains. For example, 82% of the respondents agreed with the statement that abortion is murder (it is possible that the bulk of respondents are religious, especially when re-engaging their sentiment around the joint effort of ARV treatment and prayer). The assumption that religion is a significant influencer in young people’s lives is confirmed when taking into account that 35.9% of respondents stated that they would rely on God alone “to save you from HIV.”

Furthermore, while 36.9% believe that rape is an outcome of men physically dominating others, 25% still believe it to be because women wear clothes that are too revealing. The results also raise concerns around the issue of teacher-learner relationships, with 39.5% of YAL respondents believing that the sexual exploitation of learners by their teachers is a huge problem and just 16.4% saying they had never heard of any such instances. It is concerning to note that 66.5% of respondents believe that this abuse is a two-way street whereas only 33.5% believe that it is an abuse of power.

In this context, South Africa’s value and structural system stands as a potential threat to the decrease in factors that promote the spread of HIV/AIDS. Deviant sexual behaviour, drug and/or alcohol abuse are all examples of an individual’s behaviour, and as a result, they fail to represent and answer for the country’s socio-structural failures. Gender inequality can lead to sexual abuse and violence, poverty can lead to an exchange of sexual favours for money, a weak health care system fails to successfully treat all that are at risk or who are infected, and a corrupt judicial system fails to protect.⁽⁹⁾

Concluding remarks

Digital platforms such as YAL are increasingly becoming hubs for knowledge and understanding for those seeking to find out more about sex and its related issues. In response to a question about where users go for advice about sex, the majority (23.6%) said YAL itself, with another 13.2% turning elsewhere on the internet for this information; and interestingly, siblings (12.3%) play more of a role than parents/guardians (8.7%).

It is from these findings above, that Praekelt Foundation’s latest Youth Sex Poll shines a remarkable light on the attitudes and behaviour of South Africa’s youth. Not only does the platform as a whole prove its value in this information age, but the results of the recent Youth Sex Poll endorse the notion that younger generations are willing to engage with and are aware of the challenges and risks associated with HIV/AIDS.

What the dataset also shows is the complex exchange between an array of different values and the challenges facing government in order to successfully support these behavioural practices on a macro scale through sound economic, political and judicial structures. What matters here is not how this remarkable initiative has contributed towards a shift in perception and action, but rather how South Africa as a whole intends on upholding this platform’s success in achieving this obvious behavioural change; a hope that is most certainly ratified by the respondents answer to the last question in the questionnaire. When asked whether they were hopeful about the future, a positive 77% responded saying “yes.”

Written by Daniela Kirkby ⁽¹⁾

NOTES:

(1) Daniela Kirkby is the Elections and Democracy Unit Manager and a Consultant at CAI. Contact Daniela through Consultancy Africa Intelligence’s Optimistic Africa unit ( optimisticafrica@consultancyafrica.com). Edited by Liezl Stretton.
(2) ‘Mid-year population estimates 2013’, Statistics South Africa, July 2013, http://beta2.statssa.gov.za.
(3) Praekelt Foundation builds open source, scalable mobile technologies and solutions to improve the health and wellbeing of people living in poverty. Praekelt Foundation programmes have reached over 50 million people across 15 countries in Sub-Saharan Africa. It was founded in early 2007 by Gustav Praekelt and Robin Miller in response to the opportunities created by the rapid and unprecedented spread of mobile phones across Africa and the potential for mobile technologies to provide communities with access to services and information which had previously been inaccessible.
(4) Young Africa Live (YAL) is a mobile platform where a cross-section of young people from all over South Africa can share their feelings and thoughts on relevant issues around the conflicting (and often confusing) worlds of sex, love and relationships. The users post comments and in doing so generate discussions. YAL has been running for five years and was developed for young guys and girls by the Praekelt Foundation, supported by the Vodacom Foundation and USAID. Access to the mobile platform is free for Vodacom users and works even when users have no airtime. YAL was initially launched in South Africa but has recently expanded into Tanzania and Kenya as well.
(5) Dataset obtained from the Praekelt Foundation. For more information contact http://www.praekeltfoundation.org.
(6) ‘Mid-year population estimates 2013’, Statistics South Africa, July 2013, http://beta2.statssa.gov.za.
(7) Van Donk, M., ‘HIV/AIDS and urban poverty in South Africa’, Isandla Institute, August 2002, http://isandla.org.za.
(8) The accuracy of the dataset pertaining to the number of sexual partners is vulnerable to factors such as social desirability and or recall bias (sexual amnesia). Due to the fact that the poll was anonymous, it is likely that the latter of the two factors played a greater role (if any) in the number of sexual partners selected.
(9) A case in point is the legalisation of prostitution whereby the call for its decriminalisation is founded on the belief that in doing so, women’s and men’s human rights and dignity are protected, the health and wellbeing of both the sex worker and the client would be cared for, working conditions would be made safer and those in the fields employ would be protected from corrupt law enforcers.