Tackling HIV among young women needs specific interventions

Feminists argue that young people possess agency and autonomy to learn to make individual decisions and choices regarding their sexuality and reproductive health. But there are hindrances to this process, including adverse contextual factors and big age differences between partners.

Scholars such as Amy Schalet and Catriona Macleod and Nolwazi Mkhwanazi suggest that the adolescent phase should preferably occur in the presence of safe adult guidance. But, the South African situation for young people widely incorporates the very facets that feminists warn against where agency could fail. Academic Deevia Bhana states that the development of agency is constrained in the South African context because choices and opportunities available to young women are reduced as a result of structural effects, including a combination of culture, economic and gender power inequalities as well as the subordination of women.

The contextual factors for the majority of young South Africans are adverse, with 60% of 15- to 24-year-olds living in low-income households, 71% of youth being unemployed and 30% not being in education, employment or training, according to 2012 figures from Statistics South Africa.

A study has shown that more than half of teenage mothers’ partners are not their peers, but belong to the next age category or above — highlighting the high level of age discordant couples. With the popularity of the blessee/blessed life spreading, such relationships exist in all socioeconomic settings, with evidence of high-profile individuals being blessee partners also.

I strongly believe that our societal perceptions regarding respect for women have decreased and evidence of male entitlement to women’s bodies exists. These contextual factors need to be addressed in more effective ways. Our individual experiences are a reflection of the society we live in and therefore we cannot try to address the state of HIV without addressing gender-based violence, patriarchy and gender inequality because these are very much linked. Our policies are progressive, but this translates to the lives of only a few because of their hampering environments and societal values.

It is therefore no surprise that the most vulnerable group to HIV remains young women aged 15 to 24. Issues such as rape, gender-based violence, patriarchy, coercion and power dynamics in relationships are major problems in the lives of young South African women. A total reformation, by intentionally approaching these complex crises through stakeholders working together across contexts, is needed. Specifically, it is important to address the structural disparities that predispose young people to negative consequences. We need to rectify the disparity in contexts, class, health service provision and types of partners to ensure more optimal sexual and reproductive health outcomes, including decreasing the spread of HIV among young women.

Consequently, it is necessary to address the social as well as familial problems to secure a safe and bright future for young women.

Dr Sibusiso Mkwananzi is a lecturer in the department of psychology at the University of the Witwatersrand

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