Open letter to young women: Sex education is everything — so stop shouldering so much of the HIV burden

13 Dec 2022

Meaningful, comprehensive sex education is an important lever in ensuring that girls and young women are fully empowered to exercise their sexual and reproductive health rights. Thanks to a lack of it, many South African young women and girls lack bodily autonomy.

Dear adolescent girl,

I understand you. I grew up in a house full of people, a tar road littered with potholes, and often no electricity or water for days on end.

I am a township girl.

Growing up, I remember feeling that there were no role models I could look up to – no guidance to help me navigate the way from childhood into young adulthood.

Adolescent girl, I understand your frustrations, and I am here to tell you we need to be our own role models and to empower ourselves and our friends with knowledge and skills to live healthy and fulfilled lives.

As I’m sure you know, young women in South Africa continue to be at risk, with high rates of adolescent pregnancy, HIV, Sexually Transmitted Infections (STIs), and rights violations such as gender-based violence. Girls are still more than four times more likely to contract HIV than boys of the same age, and unplanned early pregnancies can limit a girl’s choices and future economic opportunities.

The lived realities of many girls

Ahead of World Aids Day (on 1 December) I sat down to talk with some of the teenagers in my township, Kagiso on the West Rand of Johannesburg. I wanted to hear their thoughts about the future, and on their sexual and reproductive health rights. The conversations were both enlightening and heartbreaking.

Like me, the girls emphasised the lack of role models.

For many of them, however, the way out of the trenches of suffocating township life was through romantic relationships, where they are supported financially.

These conversations showed me that the government is still not doing enough to offer girls alternatives to these transactional relationships – where many girls cannot negotiate condom use, and pregnancy is just one of the “perks” of being in a relationship.

Let me tell you about Katlego*.

Katlego is 18 years old. She told me, “Falling pregnant early was not my initial plan, but I decided to give him a child because I love my boyfriend. He will not leave me, and we have a baby together. We will always be tied together.”

She then admitted that it was difficult for her to focus on her goals, after falling pregnant at the age of 15. She was supposed to be in matric this year, but due to her pregnancy, she is now in grade 10.

The risks are high for a girl like Katlego because a third of teenage mothers never finish their education. Research also shows that many girls who fall pregnant at a young age are also vulnerable to HIV infection.

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Early sexual debut risk

An early sexual debut, having sex for the first time at a young age, continues to be widespread. Early sexual debut is considered a risk factor for both teenage pregnancy and HIV transmission.

Take Lerato*, for example – another girl who shared her story during our conversations. She believes that having been sexually assaulted at a young age was the catalyst for her sexual behaviour.

“I started having sex at the age of 12 or 13 years,” Lerato told me. “I think the reason is that I was raped at a young age. I saw no value in saving myself. I started drinking alcohol. I am 18-years-old, doing grade 11, and staying with a 31-year-old who is a drug dealer.”

Poverty, unemployment, and inequality make women such as Lerato vulnerable to violence, which, in turn, threatens their health. We cannot shy away from the continued reality of South Africa’s high rape numbers. Keeping in mind that many rapes often go unreported, 9,516 rape cases were opened with SAPS between April and June 2022. The linkages between gender-based violence and health are complicated, but women who have been sexually assaulted are at higher risk of contracting HIV, TB and STIs.

Knowledge empowers

There are many factors behind adolescents, especially young women, not fully exercising their sexual and reproductive health rights.

One of the factors is the lack of comprehensive sexuality education at schools for young people. Although comprehensive sexuality education was introduced to South African schools in the early 2000s through the compulsory subject of Life Orientation, it has not been effective at reducing the number of teenage pregnancies and HIV infections among teenagers. Due to a lack of meaningful sexuality education, many South African young women and girls lack bodily autonomy. They cannot make decisions about their bodies, including about whether to have sex, use contraception, or access health care.

Some of the girls I spoke to did not know much about contraceptives, condoms or pre-exposure prophylaxis. Where I work, at SECTION27, we also receive calls from young people because they don’t know where to get a safe abortion. All these questions could be answered at schools.

But it’s widely known that in addition to these issues with education, access to reproductive health services, especially for teenagers, is still limited. Stockouts of contraceptives, pregnancy tests, condoms and HIV medications, as well as negative healthcare worker attitudes, contribute to teenage girls not being able to access sexual and reproductive health services.

Girls like Katlego and Lerato are often judged harshly for their choices and face stigma, when they need help. In 2022, it is frustrating that stigma still acts as a barrier to young women accessing the services that we need.

There is a lot that needs to and can be done to empower young girls.

Learners spend a lot of time at school, and teachers should encourage and guide young girls towards better life choices.

Young girls such as Katlego, Lerato, and myself need comprehensive sexual education to prevent unplanned pregnancies and the contracting of sexually transmitted infections or HIV. There is a brighter future out there for us – and to claim it, we must empower ourselves with the knowledge to access our sexual and reproductive health rights. It is up to us. To quote former President Nelson Mandela: “Education is the most powerful weapon which you can use to change the world.” DM/MC

*Not their real names

Fikizolo is an intern at SECTION27.

This article was published by Spotlight – health journalism in the public interest.

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South Africa

The lived realities of many girls

Early sexual debut risk

Knowledge empowers