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Introduction: South African women bear an intersecting burden of HIV, sexually transmitted infections (STIs) and unintended pregnancy. Multipurpose prevention technologies (MPTs) are a class of products that address multiple needs and have the potential to improve uptake and use of prevention products. Methods: Analysing survey data from 703 HIV-negative women 18--40 years in three provinces in South Africa, collected between July and November 2022, this study explores their preferences for prevention methods and factors influencing choice of hypothetical prevention methods, including MPTs. Descriptive statistics and multinomial regression analyses were conducted to determine prevention method preferences and factors associated with choosing a pill, injectable or MPT-implant type prevention method. Results: Most women wanted to prevent HIV, STIs and pregnancy. The most important factors when choosing a prevention product were whether it provided dual and long-term protection and if side effects were manageable. If choosing only one method, half of women would choose any MPT-implant and a quarter each would choose a pill or an injectable method, with method choices differing by population group. Discussion: Prevention method choices were influenced by sexual-behavioural factors and current and prior contraceptive method use. Providing a choice of prevention methods and a population specific approach to new method development and introduction with access to accurate information could enhance their ability to fill a gap in prevention needs. [ABSTRACT FROM AUTHOR]

Background: South African adolescents experience barriers to sexual and reproductive health (SRH) knowledge and uptake. This study provides insight into contraceptive and other SRH service knowledge, perceptions, and uptake among adolescents in high HIV prevalence settings., Methods: A baseline cross sectional survey was conducted among 3432 grade 8s enrolled into the Girls Achieve Power (GAP Year) trial from 26 public high schools across three South African townships (Soweto, Thembisa and Khayelitsha) (2017 - 2018). An interviewer-led survey collected information on SRH knowledge and perceptions; an audio computer-assisted self-interviewing technique gathered SRH service uptake. Descriptive analysis indicates frequency distribution of socio-demographics and knowledge, uptake and perceptions of SRH services. Chi-square test tested for associations between age and sex and selected variables that measure SRH knowledge and uptake., Results: In total, 2383 participants completed both survey components. Of these, 63.1% (n=1504) were female and 81.4% (n=1938) aged 12-14. Almost a fifth (18.3%, n=436) had ever had sex and less than 1% had accessed SRH services in the last year. Of the 157 females who had ever had sex, 50.9% had ever used contraception. Of those who had sex in the last three months, 59.0% reported using a contraceptive method. Condom use was inconsistent: almost all females said they had not used or could not remember if a condom was used at last sex., Conclusion: This paper contributes to the evidence strengthening learner SRH education, including the national Integrated School Health Programme. Key themes include the need for age-appropriate, differentiated comprehensive sexuality education (CSE) for the range of ages found in the same grade in South African schools. Education on different contraceptive methods, informed decision-making, and emergency contraception is key. School-based interventions should embrace integrated HIV, STI, and pregnancy prevention messages. Closer links with health services need to be constantly fostered and reinforced., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Pleaner M et al.)

Background: Despite progressive policies and frameworks on school safety by the Department of Basic Education, safety remains a concern in South African schools., Methods: A cross-sectional descriptive design was employed using the National School Safety Framework (NSSF) 152-question learner survey, exploring perceptions and experiences pertaining to eight safety domains: dangerous objects, drugs and alcohol, bullying, verbal abuse, physical violence, discrimination, sexual violence, and journey to and from school. Grade 9-11 learners from 15 government-funded high schools in the Girls Achieve Power trial in Khayelitsha, Soweto, and Thembisa townships were surveyed (March 2018 - April 2019), sampling 10% of the school population. Data analysis included Principal Component Analysis (PCA), reducing correlated variables into fewer questions, then analysis on a scree plot by calculating eigenvalues; repeated PCA with those that had a minimum eigenvalue of 1 and Cronbach Alpha test for internal reliability. Eleven composite variables were included in the final analysis., Results: In total, 1034 learners completed the NSSF learner survey; 52.9% were female and the mean age was 16 years (SD=1.36). Results show statistically significant associations between four of the 11 composite variables in relation to sex. Over half (55%) of males have experienced peer provocation and relational aggression (p<0.001). Fifty-eight percent of females reported feeling unsafe on their way to and from school (p<0.003). Over half of males reported that their school was not effective in enforcing discipline (p=0.002) while 58% of females noted they could comfortably report any form of experienced or witnessed violence at school, to their educators (p<0.000)., Conclusions: Violence continues to be a concern in South African schools. Interventions should work across the ecological model to effectively prevent and reduce violence at school and community levels. Strengthened NSSF implementation is critical to achieving this. We recommend NSSF learner survey adaptations to increase utility and implementation., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Kutywayo A et al.)

Climate change poses a major threat to the future of today's youth. Globally, young people are at the forefront of climate change activism. Their ability to engage, however, depends on the level of knowledge of climate change and concern about the topic. We sought to examine levels of knowledge and concerns about climate change among youth in South Africa, and their experiences of heat exposure. Ten questions on climate change knowledge, concerns and experiences were nested within a cross-sectional survey conducted in a cluster randomised trial among 924 secondary school learners in 14 public schools in low-income Western Cape areas. Learners' mean age was 15.8 years and they were predominately female. While 72.0% of respondents knew that climate change leads to higher temperatures, only 59.7% agreed that human activity is responsible for climate change, and 58.0% believed that climate change affects human health. Two thirds (68.7%) said that climate change is a serious issue and 65.9% indicated action is needed for prevention. Few learners indicated climate change events had affected them, although many reported difficulties concentrating during hot weather (72.9%). Female learners had lower knowledge levels than male learners, but more frequent heat-related symptoms. Learners scoring high on knowledge questions expressed the most concern about climate change and had the highest heat impacts. Many youth seem unaware that climate change threatens their future. Heat-related symptoms are common, likely undermining educational performance, especially as temperatures escalate. More is needed to mainstream climate change into South African school curricula., Competing Interests: A.K., M.F.C., N.N., F.S. and S.M. hold investments in the fossil fuel industry through their pension funds. The University of the Witwatersrand holds investments in the fossil fuel industry through their endowments and other financial reserves., (© 2022. The Authors.)