By Kimberly Absher, guest youth blogger, www.howmany.org.

In many parts of South Africa, condoms are free and widely available, and local clinics offer free birth control, HIV tests and treatment. Brochures and signs can be seen throughout the country encouraging safe sex.

Despite these public health efforts, survey after survey indicates high numbers of unprotected sex, oftentimes with multiple partners, and low rates of STD testing. Why? Gender dynamics are a major contributing factor, amplified by a lack of education and economic opportunity. Together the choices of youth are greatly constrained, all too often resulting in severe consequences such as unplanned pregnancies, sexual assault, and HIV infection.

Effects of Halted Education

In the village where I worked, in Kurland, South Africa, many teenagers stop attending school after junior high because the nearest high school is over 30 minutes away by car and there is no public transportation. Their concept of a future, of hope for a better life, becomes diminished. As a result, these teens have a lot of free time on their hands with little economic opportunity, leading to risky behaviors like drinking, taking drugs, and engaging in sexual activity. And relationships, particularly with romantic partners, become increasingly important, especially for girls.

Gender Inequality in Action

Young women are 17 percent more likely to be HIV positive than their male counterparts, and overwhelmingly victims of sexual violence. A survey by Community of Information, Empowerment and Transparency (CIET) surveyed 15-24 year olds on sexual behavior. Perceptions included that males should initiate sex and not refuse any sexual encounters regardless of risk. Manhood is judged by amount of sexual experience. Many respondents reported having multiple partners, a large factor in HIV transmission; and males reported this more often.

Females have their own set of expectations. Women should not have sex outside of committed relationships but within those should never refuse sex. Female behavior is reinforced by the threat of emotional or physical punishment by partners. There are societal expectations of female passivity, linked to HIV transmission and unplanned pregnancy due to decreased likelihood of a woman insisting on using protection in sex.

Sexual Assault and the “Choice-Disabled” **TRIGGER WARNING**

Dangerous gender dynamics and a lack of comprehensive sex education also contribute to sexual assault rates, which are the highest in the world in South Africa, particularly for youth. In the CIET study, nearly 30 percent of adolescents said their first sexual encounter was forced, and 1 in three women reported experiencing raped in the past year. Victims of forced sex, called “choice-disabled” in the report, were more inclined to believe they were HIV positive, have no intention of taking an HIV test, to believe that sex with a virgin could cure HIV or AIDS (a pervasive myth), and to say they would intentionally spread HIV.

Becoming Choice-Enabled through Sex Education

Obviously these statistics are disturbing, and many changes need to occur to halt unhealthy behaviors. Sexual education is a crucial piece. As it stands, Kurland and other community’s sexual education consists of discussing HIV prevention and teaching students how to use a condom. These methods are largely ineffective because of problematic gender dynamics and inaccurate beliefs about sex, pregnancy, and disease transmission.

Typical sexual education curricula in South Africa and globally assumes the audience is made up of the “choice-enabled”. When we look at sexual violence statistics and other constraints on choice, we see this is not true . An effective sexual health curriculum teaches communication, boundaries, and allows students to guide the discussion with their experiences, whether they are positive, negative, or mere associations.

An important piece is to practice scenarios, a strategy of Katie Rutherford, founder of Dollars for Change, an organization that runs a highly effective afterschool program in Kurland. Katie began talking to teens about what to do when making critical decisions, and helps them practice communicating their boundaries.

Another part of a comprehensive sexual health curriculum, especially in impoverished communities, is to encourage self-esteem building and tie healthy decision-making into community pride. The youth I worked with were proud of their village, and wanted to contribute to it, despite barriers to economic empowerment. A comprehensive sexual health foundation will assist in building up the youth so they can tackle the many challenges where they live and beyond.

Kimberly is a youth guest blogger with the Institute for Population Studies. She is currently a freelance writer on topics relating to health, women’s rights, and social change. You may reach Kimberly at kimberlyabsherwrites@gmail.com.