Sexual behaviour contraceptive practice and reproductive health among school adolescents in rural Transkei.

In South Africa 2108 Xhosa-speaking adolescent students from 26 schools in 22 districts outside Umtata district in the Transkei region of the Eastern Cape South Africa completed questionnaires designed to determine their baseline patterns of sexual maturation sexual behavior contraceptive practice and reproductive health. Menarche in girls occurred on average at 13.9 years. This age is 1.5 years earlier than it was in 1961. Semenarche in boys occurred on average at 15.12 years. 76% of the girls and 90.1% of the boys had already had sexual intercourse. Age at first intercourse had a positive association with age of first dating and the age of menarche and semenarche. Boys were more likely to have first intercourse at an earlier age and to have intercourse more regularly than girls (13.4 vs. 14.9 years and 61.6% vs. 42.3%; p < 0.00001). Boys had more lifetime sexual partners than girls (mean 3.27 vs. 1.35; p < 0.00001). They were more likely to have had a sexually transmitted disease (STD) than girls (48% vs. 25%; p < 0.00001). Among those with a history of an STD boys were more likely to have had a genital ulcer disease (19.1% vs. 6.5%). Only 23% of girls with sexual experience had ever used contraceptives. Boys were more likely to have used condoms than girls (62.1% vs. 19.4%). 31% of the boys who had used condoms enjoyed using them. 31.3% of the girls had ever been pregnant. 10.5% of boys claimed to have ever been involved in a pregnancy. These findings revealed an age of sexual maturation earlier than it was 30 years ago and which was linked to early first intercourse low contraceptive use (especially low condom use) high adolescent pregnancy and high STD rate. Thus rural Transkei adolescents are at high risk of HIV infection.