In sub-Saharan Africa, adolescent girls and young women between the ages of 15-24 accounted for 25% of new HIV infections among adults in 2016. (2) Classically, this group undergoes a debut of freedom and experimentation. New pressures from peers around sex, relationships, alcohol and drugs can all put this population at higher risk of health complications, with sexual activities making them high risk of contracting STIs and HIV.
Peggy Tabata, a laboratory technician from the Desmond Tutu HIV Foundation and masters student with the Cape Peninsula University of Technology, discussed the preliminary results of her research exploring what factors increase health risks amongst higher education students and how this group perceives their risk.
Adolescents are shown to be more risk-seeking than children as a result of neurocognitive changes around puberty. Many areas of the brain develop, one example is the parts of the brain that release dopamine – a chemical that helps us see rewards and take action towards them, develops at this time. For example, at a college party, there are plenty of rewards on offer: alcohols, sex and drugs for example, and the part of the brain that rewards indulging in these pleasures is in full swing, uninhibited by the part of the brain that controls self-regulation. (This part is fully developed in adulthood). (4)
This new reward-seeking behaviour, along with other biological and social factors, increase an adolescent’s risk of sexually risky behaviour and, therefore, sexually transmitted infections.(1, 5). STIs also increase an individual’s risk of HIV infection. Areas affected by STIs become inflamed and there is higher concentration of immune cells fighting the infection. These immune cells are the ones that HIV target.
Tabata comments that “South Africa is one of the countries that has the largest number of HIV infections.” (2) The National Strategic Plan estimated that 16.6% of young people have HIV. (3) These young people are high school learners, university students, employed and unemployed people.
The research used focus group discussions conducted by a trained interviewer at selected higher education institutions in the Western Cape to gather data on university students. In total there were 40 participants. Whilst the results are not yet processed, they are hoped to inform Higher Education Institutions which may benefit from the mainstreaming of the importance of HIV/AIDS prevention.
Additionally, Tabata has already noted that whilst the threat of HIV is real, and students are often knowledgeable of HIV, students are fatigued about the virus. “They are tired of hearing about HIV,” Tabata said, “In their minds, they regard themselves as safe.“
Tabata added that “they think that HIV and AIDS are a health and wellness issues, whereas it’s a social issue. They have their social life and they only meet HIV in their social life.” Finding ways to engage adolescents with HIV prevention without giving them information overload is essential to stopping the virus.
This also indicates the importance of new interventions, such as the new PrEP availability in seven South African universities. The universities that will have access are Nelson Mandela University‚ Rhodes University‚ University of Limpopo‚ University of the Free State‚ University of Venda‚ University of Zululand and Vaal University of Technology. The Higher Education and Training HIV & AIDS (HEAIDS) national programme announced that HIV-negative students will have access to Truvada, an oral PrEP.
This roll out is actually a trial from the National Health Department to assess how PrEP is accessed and whether there is a university-wide demand. The results will direct how PrEP is distributed in other places around South Africa.
- STDs in Adolescents and Young Adults – https://www.cdc.gov/std/stats13/surv2013-print.pdf
- Global AIDS update 2016 – http://www.unaids.org/sites/default/files/media_asset/global-AIDS-update-2016_en.pdf
- National Strategic Plan for HIV, STIs and TB, 2012-2016 – https://heaids.org.za/site/assets/files/1267/national-strategic-plan-for-hiv-stis-and-tb-2012-2016.pdf
- A Social Neuroscience Perspective on Adolescent Risk-Taking – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2396566/
- Centres for Disease Control and Prevention – https://www.cdc.gov/std/stats13/adol.htm