PRETORIA, SOUTH AFRICA - Children and young people continue to lack accurate and comprehensive knowledge of HIV and how to avoid transmission. There continues to be little, if any, data on younger children’s knowledge of HIV and how to avoid transmission. The silence around sexuality in general and children’s sexuality in particular generates misconceptions, myths and misinformation which contribute to children’s risky sexual practices.
Until recently, implementation efforts have been limited by a tendency to focus HIV prevention and sexual and reproductive health initiatives on children 15 years and older. Younger children are rarely asked their opinion on the information and services they receive. In addition, the difficulties faced by adults in accepting children’s sexuality and the social taboos and attitudes regarding sex, gender, contraception and HIV prevention itself have not been addressed adequately, if at all.
A new report, released here today, seeks to improve the lives of children by strengthening a regional programme promoting comprehensive sexuality information and education that would improve children’s access to knowledge and information about HIV, sexual and reproductive health and information relating to HIV prevention. Save the Children commissioned the HSRC to undertake a pioneering approach to examine the level of accurate and comprehensive knowledge of HIV, how to avoid transmission and understanding of sexuality and access to sexual and reproductive health among children 5-17 years of age. The research showed how vulnerable children between 5 – 8 years old are vulnerable to sexual risks, as emphasised by their limited knowledge, attitudes and skills in relation to sexual behaviour. They also had only a rudimentary understanding of the concepts of sex, gender and human rights. Most children interviewed in this age range could not describe how pregnancy occurred. As a result, they did not know how pregnancy could be prevented.
The picture with regard to 9-11 year old children was not much better. Only a few understood the meaning of sexuality in relation to the human life cycle, with many misconceptions. Children at this age are at the cusp of puberty but reproductive health was not well understood, with only 51% knowing how pregnancy occurred, its impact on their lives (schooling, lack of love by parents, etc.), and ways to prevent unintended pregnancy (condoms, abstaining from sex, contraceptive pills).
Most children believed that they could not get AIDS, which is likely a function of the absence of formal or informal discussion of HIV transmission. Fifty seven percent could not cite a single way to prevent sexual transmission of HIV (for example, condom use). Neither were they familiar with their own vulnerability to HIV and AIDS, which makes this age cohort especially vulnerable to risky sexual behaviour.
The age group 12 – 17 had a better knowledge of HIV and AIDS and its transmission, which was largely obtained through the school and peers. Girls and boys started to have sex at about the same age (14 years), with some acknowledgement of concurrent partners by both boys and girls.
Vulnerability to risk of sexual transmission in this age group was reinforced by the fact that over half of the parents (52%) were not aware that their child was sexually active. Sexual and reproductive health for children was primarily accessed through local clinics and hospitals, though issues of stigma and the lack of support of parents in assisting children to access services was notable.
While parents had good levels of knowledge and ways to protect against sexual transmission of HIV, the primary communication between parents and children focused essentially on protecting children from abuse and less with information about sexual risk for HIV and AIDS.
The work is important in charting an approach to sexual education showing that much still needs to be done in providing accurate information and education about HIV and AIDS and ways to promote sexual health among children.
[An executive summary of the report, “Regional Baseline Survey to Establish Children’s KABP In Relation to Sexuality and Gender, Access to Sexuality and HIV Information and Sexual and Reproductive Health Services In South Africa”, Arvin Bhana, Karl Pelzer, Refilwe Phaswanamafuya, Monde Makiwane, Adlai Davids, Gladys Mlambo, Shaneel Bachoo, Mohammed Yacoob Vawda is available on http://saf.savethechildren.se/saf. For further information or interviews, contact Arvin Bhana at abhana@hsrc.ac.za]
