Revista de SIDA e investigación clínica

The HIV and Sexual Reproductive Health Status of Young People in Swaziland: The Rationale for Focused Youth Investment

Abstract

Bongani Robert Dlamini, Phumzile Mabuza, Zandile Masangane, Thamary Silindza, Makhosami Dlamini and Phumzile Dlamini

Background: Youth are the future, and investing in the youth of today means a brighter future for the entire world. Nowhere is this truer than in Africa, where changing demographics are creating a unique opportunity to harness the potential of young people to accelerate development. Swaziland, with a large and growing youth population and a declining birth rate, is on the cusp of a critical demographic transition. Methods: The HIV and Sexual Reproductive Health Status of Young People in Swaziland analysis were prepared in stages: desk review and analysis, consultations/interview meetings with key stakeholders, data analysis and compilation of the report. Results and discussion: Early sexual debut, high adolescent fertility rate, unmet need for family planning, and on-going problems with sexual and gender based violence (GBV) are some of the key issues faced by young people in terms of reproductive health in Swaziland. Adolescent fertility did decline slightly from 89/1000 to 87/1000 between 2010 and 2014. HIV prevalence is much higher in young women than young men across all age groups, and marked increases in prevalence become apparent throughout the 20s for both sexes. Approximately 1 in 4 females in Swaziland experienced physical violence as a child and 9% of the youth aged 18-24 experienced coerced sexual intercourse before they turned eighteen. Conclusion: There seems to be some improvement in sexuality education and behaviour change interventions. There is gradual increase in age at sexual debut and in the proportion of adolescents reporting to be abstaining from sexual activity. This suggests that some interventions may have dissuaded some adolescents from sexual intercourse. Recommendations: A minimum standard for health facilities to be considered youth-friendly should be put in place, and all facilities should be assessed against the standard as well as linkages between schools, communities and health facilities should prioritized.