Narratives around sexual behaviour and decisions regarding treatment-seeking of adolescent females who contracted a sexually transmitted infection: Birth to Twenty cohort

Abstract

Adolescent sexual behaviour related to low condom-use and early sexual debut has been a concern in the transmission of sexually transmitted infections (STIs) and HIV. Treatment-seeking behaviour is a problem in adolescents due to embarrassment and unfriendly health care services. The Birth to Twenty study group (Bt20) is a cohort of singletons born in 1990 with approximately 10% having tested positive for STIs at an early age. Their sexually activity and unprotected sex practices have increased their risk for HIV infection. The objectives of this study were to explore the perceptions, sexual behaviour and treatment-seeking behaviour of a sample of girls who had a previous STI, through their narratives. One-on-one narrative interviews were done on 19 girls with the aid of an interview schedule. A life history of their sexual encounters was documented. The interviews were taped and transcribed. Thematic analysis was performed. The majority of the girls had no knowledge of STIs before they were counselled by the Bt20 nurses yet 50% of the girls used condoms in their first sexual experiences. Once counselled, almost all the girls went on to seek treatment for their STI. A third of the girls reported poor service at the clinic and would prefer to be treated either privately or at Bt20 if possible. Information regarding the role of STIs in the transmission of HIV seems to be unclear. Improving the life orientation programme at schools with a focus on STIs and pregnancy would positively impact on HIV transmission. One-on-one counselling is effective but may not be feasible in under-resourced communities and the continued education of nurses in clinics, whilst increasing the number of adolescent friendly clinics, must be prioritised.