Date Published: February 13, 2019
Publisher: Public Library of Science
Author(s): Joel Msafiri Francis, Bronwyn Myers, Sebenzile Nkosi, Petal Petersen Williams, Tara Carney, Carl Lombard, Elmarie Nel, Neo Morojele, Rachel A. Annunziato.
Alcohol and other drug use (AOD) and risky sexual behaviours remain high among adolescents in South Africa and globally. Religiosity influences, mitigates and provides resilience against engaging in risky behaviours among young people but few South African studies have explored potential associations between religiosity, AOD use and risky sex. We report the prevalence of religiosity and association between religiosity and AOD use and risky sexual behaviours among learners in the Western Cape Province, South Africa.
Between May and August 2011, a cross sectional survey was conducted among 20 227 learners from 240 public schools randomly selected through a stratified multistage sampling design to determine the prevalence of AOD use and sexual risk behaviours. We performed univariate and multivariate logistic regression analyses to assess the association between religiosity, AOD use and risky sexual behaviours.
The learners were aged 10–23 years. Almost three quarters (74%) of learners reported high religiosity (defined as attending religious services or activities at least 1–2 times a month). More female than male learners had high religiosity. The prevalence of past 30 day reported alcohol, tobacco and cannabis use was 23%, 19% and 8% respectively. Compared to learners with low religiosity, those with high religiosity were less likely to engage in AOD use: specifically alcohol use, (AOR = 0.86, 95%CI: 0.76–0.97), tobacco use (AOR = 0.76, 95%CI: 0.67–0.87), cannabis use (AOR = 0.57, 95%CI: 0.48–0.68) in the last 30 days. They were also less likely to engage in risky sexual behaviours (AOR = 0.90, 95%CI: 0.81–0.99).
Religiosity was associated with lower odds of reported AOD use and risky sexual behaviours among learners in the Western Cape. This calls for further exploration on how to incorporate religiosity into AOD use and risky sexual behaviour interventions.
Adolescence is viewed as a period of experimentation and heightened risk of engaging in risky behaviours [1–4]. In this period, the most common risk behaviours are alcohol and other drug (AOD) use and risky sexual behaviours that often persist into adulthood [5, 6].
To the best of our knowledge, this is the first large study in South Africa to report on the prevalence of high religiosity and the association of high religiosity with AOD use and risky sexual behaviours. Most learners reported high religiosity (i.e. attendance of religious activities at least once-twice per month) and this was higher among female learners than among male learners. The results also indicate high levels of AOD use and risky sexual behaviours. These results are consistent with the literature on substance use and sexual risk behaviour in sub-Saharan Africa [11, 12, 14–16]. Our findings show that learners with high religiosity had significantly reduced odds of AOD use in the last 30 days, and risky sexual behaviours. Furthermore, similar to other studies among adolescents and young people in South Africa and other parts of Africa, poor academic performance, higher scores of mental health status and aggressive behaviours, being male and having witnessed a crime were associated with AOD use [12, 54–57].