AIDS and Behavior

, Volume 18, Issue 9, pp 1661–1674 | Cite as

Sexual Risk Behavior, Alcohol Use, and Social Media Use Among Secondary School Students in Informal Settlements in Cape Town and Port Elizabeth, South Africa

  • Z. A. Kaufman
  • E. N. Braunschweig
  • J. Feeney
  • S. Dringus
  • H. Weiss
  • S. Delany-Moretlwe
  • D. A. Ross
Original Paper


South Africa’s HIV prevalence among young people remains among the highest in the world. A cross-sectional study was carried out in 2012 to estimate prevalences of sexual risk behavior and hazardous alcohol use (HAU) (via the Alcohol Use Disorder Identification Test) as well as to investigate potential associations between these outcomes and social media use. In all, 4485 students (mean age 15.66 years, SD 1.39) at 46 secondary schools in informal settlements in Cape Town and Port Elizabeth completed mobile-phone-assisted, self-administered baseline questionnaires within a cluster-randomized trial. In all, 312 females (12.5 %) and 468 males (23.5 %) screened positive for HAU (AOR = 1.98, 95 % CI 1.69–2.34). 730 males (39.9 %) and 268 females (11.8 %) reported having had two or more partners in the last year (AOR = 3.46, 95 % CI 2.87–4.16). Among females, having a Facebook account was associated with reported multiple partnerships in the last year (AOR = 1.81, 95 % CI 1.19–2.74), age-disparate sex in the last year (AOR = 1.96, 95 % CI 1.16–3.32) and HAU (AOR = 1.97, 95 % CI 1.41–2.74). Using Mxit—a popular mobile instant messaging application—was associated with higher odds of reported multiple partnerships in the last year among both males (AOR = 1.70, 95 % CI 1.35–2.14) and females (AOR = 1.45, 95 % CI 1.07–1.96) and with HAU among both males (AOR = 1.47, 95 % CI 1.14–1.90) and females (AOR = 1.50, 95 % CI 1.18–1.90). Further longitudinal and qualitative research should explore in more depth the observed links between social media and risk behavior.


HIV South Africa Adolescents Alcohol Social media 



This study was carried out as part of the GOAL Trial, which is a collaboration between the London School of Hygiene and Tropical Medicine, the Wits Reproductive Health and HIV Institute, and Grassroot Soccer, jointly funded by Comic Relief and the MAC AIDS Fund. We would like to thank the Western Cape and Eastern Cape Departments of Education, along with the teachers and students at the 46 participating schools for their cooperation.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Z. A. Kaufman
    • 1
    • 2
  • E. N. Braunschweig
    • 1
  • J. Feeney
    • 3
  • S. Dringus
    • 1
  • H. Weiss
    • 1
  • S. Delany-Moretlwe
    • 2
  • D. A. Ross
    • 1
  1. 1.Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUK
  2. 2.Wits Reproductive Health and HIV InstituteJohannesburgSouth Africa
  3. 3.University of California San FranciscoSan FranciscoUSA

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