Substance use and sexual risk behavior among orphaned and nonorphaned youth in South Africa Public Deposited

Downloadable Content

Download PDF
Last Modified
  • March 19, 2019
  • Meghdadpour, Susanne
    • Affiliation: Gillings School of Global Public Health, Department of Maternal and Child Health
  • Substance use carries many health risks for youth and has also been associated with high risk sexual behavior. Risky sexual behavior is the primary means by which human immunodeficiency virus (HIV) is transmitted in sub-Saharan Africa. Adult deaths due to HIV contributed to over three million orphaned children and adolescents residing in South Africa in 2007. There has been ongoing concern that parental absence and potentially altered family, school, community, and peer relationships may leave orphaned youth at greater risk of engaging in substance use and risky sexual behaviors, thereby increasing their exposure to HIV. This dissertation utilized data from a nationally representative survey of 11,904 South African youth conducted in 2003. Gender-stratified multivariable models were fitted in order to: 1) examine the relationship between factors, from five domains (individual, peer, school, family, and community) with substance use among South African youth, and to determine whether orphaned youth were more likely to engage in alcohol or drug use, compared with non-orphans and 2) examine the relationship between substance use and risky sexual behavior among South African youth and, again, consider whether orphaned youth were more likely to have had multiple partners, or to have used condoms irregularly in the previous month. Findings showed that: a) along with individual factors, family and community domains were associated with substance use while risky sexual behavior was largely associated with individual factors b) females were more influenced by family factors while males were more influenced by community variables c) compared with non-orphaned youth, paternally orphaned males were more likely to have consumed alcohol and paternally orphaned females were more likely to have used drugs c) after controlling for substance use, maternally orphaned females were more likely to have had multiple partners and orphaned males were less likely to have used condoms regularly. Ongoing research is needed to better understand the pathways which increase the vulnerability of some orphaned youth. At the same time, policies and programs directed at reducing risky behavior among all South African youth should recognize male versus female differences and include families and communities, particularly when addressing substance use.
Date of publication
Resource type
Rights statement
  • In Copyright
  • Bloom, Shelah S.
  • Blanchard, Lynn
  • Curtis, Sian
  • Reynolds, Heidi
  • Pettifor, Audrey
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2010
  • This item is restricted from public view for 1 year after publication.

This work has no parents.