de Bruin W E, Panday-Soobrayan S
a Faculty of Earth & Life Sciences , VU University, The Athena Institute , Amsterdam , The Netherlands.
b United Nations Children's Fund , Pretoria , South Africa.
AIDS Care. 2017 Dec;29(12):1529-1532. doi: 10.1080/09540121.2017.1327647. Epub 2017 May 16.
A stubborn health challenge for learners in South African public schools concerns sexual and reproductive health and rights (SRHR). In 2015, the Department of Basic Education (DBE) proposed the provision of condoms and SRHR-services to learners in schools. This study aimed to contribute to the finalisation and implementation of DBE's policy by exploring learners' perspectives on the provision of condoms and SRHR-services in schools. Sixteen focus group discussions were conducted with learners (n = 116) from 33 public schools, to assess their attitudes, social influences, and needs and desires regarding condom provision and SRHR-services in schools. The majority of learners did not support condom provision in schools as they feared that it may increase sexual activity. Contrarily, they supported the provision of other SRHR-services as clinics fail to offer youth-friendly services. Learners' sexual behaviour and access to SRHR-services are strongly determined by their social environment, including traditional norms and values, and social-pressure from peers and adults. Learners' most pressing needs and desires to access condoms and SRHR-services in school concerned respect, privacy and confidentiality of such service provision. Implementation of DBE's policy must be preceded by an evidence-informed advocacy campaign to debunk myths about the risk of increased sexual activity, to advocate for why such services are needed, to shift societal norms towards open discussion of adolescent SRHR and to grapple with the juxtaposition of being legally empowered but socially inhibited to protect oneself from HIV, STIs and early pregnancy. Provision of condoms and other SRHR-services in schools must be sensitive to learners' privacy and confidentiality to minimise stigma and discrimination.
对南非公立学校学生来说，一个棘手的健康挑战涉及性健康和生殖健康及权利（SRHR）。2015年，基础教育部门（DBE）提议为学校中的学生提供避孕套及SRHR服务。本研究旨在通过探索学生对学校提供避孕套及SRHR服务的看法，为DBE政策的最终确定和实施做出贡献。与来自33所公立学校的学生（n = 116）进行了16次焦点小组讨论，以评估他们对学校提供避孕套及SRHR服务的态度、社会影响以及需求和愿望。大多数学生不支持在学校提供避孕套，因为他们担心这可能会增加性行为。相反，他们支持提供其他SRHR服务，因为诊所未能提供适合年轻人的服务。学生的性行为及获得SRHR服务的情况很大程度上取决于他们的社会环境，包括传统规范和价值观，以及来自同龄人和成年人的社会压力。学生在学校获取避孕套和SRHR服务最迫切的需求和愿望涉及此类服务提供的尊重、隐私和保密性。在实施DBE的政策之前，必须开展基于证据的宣传活动，以破除关于性行为增加风险的误解，倡导为何需要此类服务，促使社会规范转向公开讨论青少年的SRHR，并应对在法律上有能力但在社会上却受到限制以保护自己免受艾滋病毒、性传播感染和早孕影响的这种矛盾状况。在学校提供避孕套和其他SRHR服务必须考虑到学生的隐私和保密性，以尽量减少污名化和歧视。
