RISKY SEXUAL BEHAVIOUR AMONG YOUTHS: A CASE OF MUFAKOSE, HARARE BY RONALD MUSIZVINGOZA (R077591Y) A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS OF THE MASTER OF SCIENCE IN POPULATION STUDIES CENTRE FOR POPULATION STUDIES FACULTY OF SOCIAL STUDIES UNIVERSITY OF ZIMBABWE 2015 0 DEDICATION To the Glory of the Almighty God, and to my parents who have continued to be a source of inspiration in my life. i ACKNOWLEDGEMENTS First and foremost, I would like to thank the Almighty God author of my faith in him our hope rest. By the power of the Holy Spirit and his grace I have managed to complete this thesis. To my supervisor Dr N Wekwete, I express my deepest gratitude for her unwavering support, guidance, comments, criticism, and encouragement throughout the duration of this research. I would like to thank my family members for being there for me. Special thanks go to the data collection team Lameck (Doc), Munashe and Callister thank you guys. To S't Peter's Guild Mufakose Anglican Church, thank you very much guys for your prayers, indeed you stood with me in one accord, rambai makadaro vakomana vechita. Infinite thanks to the Centre for Population Studies staff and students, and also to my workmates at the Department of Statistics and Operations Research at NUST who motivated me to finish my studies. To Garikai, you are a star; thank you young man. ii ACRONYMS AIDS Acquired Immune Deficiency Syndrome ASRH Adolescent Sexual Reproductive Health CSW Commercial Sex Workers DALYS Disability Adjusted Life Years EA Enumeration Area FGD Focus Group Discussion HH Household HIV Human Immunodeficiency Virus ICPD International Conference on Population and Development NAC National AIDS Council PRB Population Reference Bureau STI Sexually Transmitted Infection UN United Nations UNAIDS United Nations Programme on HIV and AIDS UNFPA United Nations Population Fund UNICEF United Nations Children Fund WHO World Health Organisation ZDHS Zimbabwe Demography and Health Survey ZNFPC Zimbabwe National Family Planning Council ZIMSTAT Zimbabwe National Statistics Agency HBM Health Belief Model TPB Theory of Planned Behaviour MICS Multiple Indicator Cluster Survey SRH Sexual Reproductive Health iii LIST OF TABLES Table 4:1 Socio-Demographic Characteristics of Respondents by Sex ................................................ 33 Table 4:2 Percentage Distribution of Sexual Intercourse by Sex of Respondent ................................. 35 Table 4:3 Percentage Distributions of Selected Sexual Variables ........................................................ 36 Table 4:4 Percentage Distribution of Youth's Knowledge of Contraception by Sex ............................ 40 Table 4:5 Self efficacy and the Intention to Practice Safe Sex ............................................................. 47 Table 4:6 Bivariate Analysis of Demographic Characteristics and Sexual Risk Behaviour ................. 50 Table 4:7 Socio-Cultural and Living arrangements by Sexual Risk Behaviour ................................... 53 Table 4:8 Parental Characteristics and Sexual Risk Behaviour ............................................................ 54 Table 4:9 Results of Multivariate Analysis of the Factors Facilitating Risk Sexual Behaviour ........... 56 iv LIST OF FIGURES Figure 2:1 Percentage of Youths who had sex before age 15, DHS 2003-2008 ..................................... 8 Figure 2:2 Current use of modern methods of contraception among married and unmarried women age 15-19, DHS 2003-2008 .................................................................................................................. 12 Figure 2:3 Condom use at last high risk sex act, DHS 2003-2008 ....................................................... 13 Figure 2:4:A diagrammatical representation of the Health Belief Model ............................................. 20 Figure 2:5: The Theory of Planned Behaviour ..................................................................................... 22 Figure 2:6:A conceptual framework for the study of risky sexual behaviours of youths ..................... 23 Figure 3:1 Schematic Presentation of the Procedure Used to Select Study Participants. ..................... 29 Figure 4:1 Percentage Distribution of Respondents by Sex.................................................................. 32 Figure 4:2Percentage distribution of Living Arrangements among Respondents. ............................... 34 Figure 4:3.Percentage distributions of Reasons for not engaging into sex ........................................... 37 Figure 4:4Sources of Information on HIV ............................................................................................ 39 Figure 4:5 Percentage Distribution of Most Suitable Contraceptives Methods among Youths ........... 41 Figure 4:6.Percentage Distribution of Knowledge of Contraceptives methods by Sex ........................ 42 Figure 4:7 Condom Use at Last Sexual Encounter ............................................................................... 43 Figure 4:8 Reasons for using Male Condoms ....................................................................................... 44 v TABLE OF CONTENTS DEDICATION ......................................................................................................................................... i ACKNOWLEDGEMENTS .................................................................................................................... ii ACRONYMS ......................................................................................................................................... iii LIST OF TABLES ................................................................................................................................. iv LIST OF FIGURES ................................................................................................................................ v CHAPTER ONE: INTRODUCTION ..................................................................................................... 1 1.1 Introduction ............................................................................................................................. 1 1.2 Background of the Study......................................................................................................... 1 1.3 Statement of the Problem ........................................................................................................ 3 1.4 Justification of the Study......................................................................................................... 4 1.5 Objectives of the Study ........................................................................................................... 4 1.6 Scope of the Study .................................................................................................................. 5 1.7 Organisation of the Study ....................................................................................................... 5 2 CHAPTER TWO: LITERATURE REVIEW ................................................................................. 6 2.1 Introduction ............................................................................................................................. 6 2.2 Risk Sexual Behaviour among Youths ................................................................................... 6 2.2.1 The Global Overview ...................................................................................................... 6 2.2.2 Risk Sexual Behaviours among Youths in Zimbabwe .................................................... 8 2.2.3 Indicators of Risky Sexual Behaviour............................................................................. 9 2.2.4 Socio- Economic and Demographic factors for Risky sexual behaviours among youths 13 2.3 HIV and AIDS Knowledge and Risk Perception .................................................................. 16 2.4 Contraception Knowledge and Attitudes .............................................................................. 17 2.5 Condom Self Efficacy ........................................................................................................... 18 2.6 Theoretical Framework ......................................................................................................... 18 2.6.1 Health Belief Model ...................................................................................................... 18 2.6.2 Theory of Planned Behaviour ....................................................................................... 20 2.7 Conceptual Framework ......................................................................................................... 22 2.8 Summary of Literature Review ............................................................................................. 25 3 CHAPTER THREE: METHODOLOGY ..................................................................................... 26 3.1 Introduction ........................................................................................................................... 26 3.2 Study Area ............................................................................................................................ 26 3.3 Target Population .................................................................................................................. 26 vi 3.4 Research Design ...................................................................................................................