Gender differences in positive sexual behaviour among a young adult cohort in South Africa: A cross-sectional study

Risky sexual behaviour among young adults continues to rise in South Africa, but aggregated data on positive sexual behaviours by sex are often ignored. Using the 2016 South Africa Demographic and Health Survey dataset, this study examined the gender differences in positive sexual behaviour among young adult cohorts in South Africa. One thousand, seven hundred and twenty-four male and female adult cohorts (aged 15-34) who had engaged in positive sexual behaviours (condom use at last sex and single sexual partnership) were included in this study. Frequencies, cross-tabulations and logistic regression models were described and were fitted to the data between sociodemographic factors and the outcome variable at rho<0.05. Respondents' mean age was 16.3 +/- 2.4 years (female-15.6 +/- 2.2 years and male-15.2 +/- 2.3 years). The determining factors associated with positive sexual behaviours varied by gender were age 15-34 years, education, working status and HIV knowledge. The logistic regression results showed that age 25-29 (AOR = 2.21) and 30-34 (AOR = 3.34), exposure to media (AOR = 1.28, HIV knowledge (AOR = 1.18), and provinces (Northern Cape-AOR = 1.12 and Limpopo-AOR = 1.34) were found to be predictors of positive sexual behaviours among male respondents. While education (primary: AOR = 1.02; secondary: AOR = 1.57), rich wealth status (AOR = 2.68), Coloured population group (AOR = 2.49), delayed sexual debut (AOR = 4.42), and those from KwaZulu-Natal province (AOR = 4.56) were found to have higher odds of predicting positive sexual behaviour among female respondents. There were significant gender differences in the predictors of positive sexual behaviours. There is an urgent need to develop sexual and reproductive strategies that promote the adoption of positive sexual behaviour prevention among young adults in South Africa. (Afr J Reprod Health 2023; 27 [7]: 43-55).