Young people in desperate search for safer sex

For young people in southern Africa a lack of access to condoms is putting them at risk of unwanted pregnancies and HIV, and could ultimately jeopardise their lives.

For young people in southern Africa a lack of access to condoms is putting them at risk of unwanted pregnancies and HIV, and could ultimately jeopardise their lives.

Amanda*, a 16-year-old from Malawi, is mother to identical twins. She stays with her poverty-stricken grandmother in Chitipa district, which borders with Tanzania, and has no financial support.

Amanda was attending boarding school in the Southern region of Malawi, and recalls how, after deciding to have sex with her fiancé, she went in search for condoms.

As the school requires all students leaving school boundaries to wear uniforms, she did not have the courage to go to a shop, as students who buy condoms are usually perceived as sex workers. Knowing that the school tuck shop did not stock condoms, she asked some fellow borders if they had any, but no one did.

It was then that Amanda made a decision that she deeply regrets. She decided to sleep with her finance without a condom.

“I was conviced by my fiancé that he would ejaculate his sperm outside of my body. But alas this did not work and, from that single act, I got pregnant and was expelled from school,” says Amanda.

Lack of condoms

In Malawi young people account for more than 40 per cent of the country’s total population. Yet despite the clear need to protect young people from sexually transmitted infections, as well as unwanted pregnancies, there is an inadequate supply of condoms especially in educational institutions.

Amanda’s story is not unusual. According to Dr Lucius Kalonga, head of the health unit at Chancellor College, part of the University of Malawi, the rate of sexual activity among students is high but the number of condoms the college is able to supply is very low. The inadequate supply of condoms means some students engage in unprotected sex.

In its quest to tackle HIV on campus, Chancellor College, holds HIV counselling and testing sessions as well as exchange visits with counterparts from Zambia and Namibia which offer students a platform to share experiences on the how to fight the pandemic.

However, despite having 4,500 students and close to 600 members of staff, Dr Kalonga says the unit is allocated just 1,000 condoms every month. It mainly supplies male condoms, while female condoms “remain a challenge”.

Dr Kalonga says: “We are missing a lot of students because we don’t provide a lot of condoms. We need at least 3,000 condoms per month.”

Adolescents are more vulnerable

Blessings Bupe Mwamba, a midwife from Cape Town, South Africa, believes adolescents globally are more vulnerable for a number of reasons.

She says: “A large proportion of adolescents are not socially and economically independent, making them vulnerable to manipulation and abuse and that existing health services may not adequately address their specific health needs.”

Mwamba, who is now in her 30s, was taught the ABC approach to HIV prevention when she was at school: abstinence; being faithful to one sexual partner; and condom use for those who cannot abstain.

Mwamba believes the ABC approach is still relevant in addressing the problems people like Amanda face and that this approach should be strengthened.

“Adolescents need all the necessary information, including contraceptives, in order to have informed choices. Condoms should be available especially to young people living with HIV,” she says.

Community involvement in sex education

Young people want and need access to integrated sexual and reproductive health and HIV services – and providers, policy makers and programmers need to listen, and provide quality services that respond to their diverse needs.

Mwamba adds that families need to take an active role in educating adolescents at home. Churches should also promote discussions on sexual issues, as they guide people, and schools should formulate peer education programmes because adolescents tend to listen more to their peers than adults.

“Health facilities should strengthen health promotion activities with the involvement of all stakeholders who play a pivotal role in adolescent health. This should be done in collaboration and with full participation of influential adolescents. Health facilities should also provide youth friendly services at all times,” says Mwamba. “This may be helpful for management of all health problems affecting adolescents, including safer sex.”

Around the world AIDS-related deaths are declining in all age groups, except among 10-19 year olds. And in Africa AIDS has become the number one leading cause of adolescent deaths (UNAIDS).

As the new global sustainable development goals (SDGs) come into force in 2016, we need a tailored and targeted response that must not leave anyone behind in preventing unintended pregnancies, reducing maternal mortality, and ending AIDS by 2030.

The need to ensure adequate supplies of condoms for young people like Amanda, especially in schools and colleges, cannot be overemphasized. It’s time for governments and health authorities to step up and ensure the SDGs can become a reality.

*Name changed to protect identity

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