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There is concern that orphans may be at particular risk of HIV infection due to earlier age of sexual onset and higher likelihood of sexual exploitation or abuse; however, there is limited empirical evidence examining this phenomenon. Utilizing data from 1,694 Black South African youth aged 14-18, of whom 31% are classified as orphaned, this analysis(More)
CONTEXT High levels of HIV/AIDS and unwanted pregnancy among young people are urgent public health problems in South Africa. Studies among youth have generally focused on protection against one or the other of these risks, but not both. METHODS Data collected in 2001 from 2,067 sexually active men and women aged 15-24 in KwaZulu-Natal were examined in(More)
OBJECTIVES To explore commercial sex workers' experiences with the female condom in Swaziland. METHODS This is a qualitative study that draws on two focus group discussions and ten individual in-depth interviews with female commercial sex workers in Lavumisa, Swaziland. RESULTS The findings suggest that the majority of female sex workers prefer to use(More)
Traditionally, the major focus of condom-promotion strategies has been on increasing use outside marriage. This study explores the extent and determinants of condom use within marital and cohabiting partnerships in KwaZulu-Natal, South Africa. In focus-group discussions, in-depth interviews, and individual survey responses, knowledge of condoms as an(More)
Coercion may play an important role in compelling young women to engage in sexual intercourse at an early age. With a decline in age at first intercourse and increased reporting of coercive first sex, concerns of adverse reproductive health outcomes such as unintended pregnancy and sexually transmitted infections (STIs), including HIV, have become important(More)
An integrated sexual and reproductive health package is widely regarded as essential for meeting the needs of both men and women. The practical realities of integration in KwaZulu-Natal, South Africa, were examined from the perspective of both providers and clients. Only minorities of clients received any assessment of reproductive and sexual health needs(More)
CONTEXT Most HIV prevention efforts focus on premarital and extramarital sexual behavior, but in areas with high HIV prevalence the protective needs of married and cohabiting couples are just as great and often go unmet. Condom use by these couples is generally low, with resistance from men and cultural norms commonly cited as barriers to increased use. (More)
INTRODUCTION Safer conception interventions should ideally involve both members of an HIV-affected couple. With serodiscordant couples, healthcare providers will need to manage periconception risk behaviour as well tailor safer conception strategies according to available resources and the HIV status of each partner. Prior to widespread implementation of(More)
Epidemiological evidence so far suggests that multiple sexual partnerships are an important factor driving the HIV epidemic. Recently, there has been renewed emphasis on fidelity and partner-reduction in preventing HIV infections. Like many countries in sub-Saharan Africa, Zambia is facing a severe HIV epidemic and young people are heavily affected. This(More)
Interpersonal relations between health care providers and young clients have long being cited as an important element for improving client up take of services, satisfaction and overall health outcomes. In an era of HIV and AIDS this forms a critical determinant to young people accessing sexual and reproductive health care. This study explores to what extent(More)