Plain English summary
Background
Theoretical underpinnings
Methods
Research study design
Quantitative methods
Measurement tools
Variables
Outcome variable
Exposure variable
Effect modifiers and other variables
Missing data
Analysis
Qualitative methods
Data collection
Analysis
Results
Participant demographics
Socio-demographic characteristics | Sexually active (column %) |
---|---|
Age of young woman (n = 693) | |
13–15 | 151 (21.8) |
16–20 | 542 (78.2) |
Per capita household consumptiona (n = 693) | |
Low | 220 (31.7) |
Medium | 279 (40.3) |
High | 194 (28.0) |
Number of household members (n = 693) | |
2-3members | 87 (12.5) |
4-5members | 233 (33.6) |
6-7members | 220 (31.7) |
> =8members | 153 (22.1) |
Type of primary caregiver (n = 692) | |
Mother | 471 (68.1) |
Father | 22 (3.2) |
Brother/sister | 65 (9.4) |
Other blood relative | 134 (19.4) |
Educational level of primary caregiver (n = 692) | |
None | 176 (25.4) |
Primary | 196 (28.3) |
Secondary | 164 (23.7) |
Matric or tertiary | 128 (18.5) |
Adult basic education | 28 (4.1) |
Orphan status (n = 684) | |
Parents alive | 475 (69.4) |
One parent dead | 168 (24.6) |
Both parents dead | 41 (6.0) |
Young women’s perceived food insecurityb (n = 684) | |
No | 412 (60.2) |
Yes | 272 (39.8) |
Partnership characteristics and sexual behaviours | |
Currently have a boyfriend (n = 693) | |
No | 151 (21.8) |
Yes | 542 (78.2) |
Sexual partners the past 12 months (n = 660) | |
1 | 520 (78.8) |
2 | 97 (14.7) |
> 3 | 43 (6.5) |
Age of first sex (n = 634) | |
Before 15 years | 127 (20.0) |
15 years and above | 507 (80.0) |
Transactional sex | |
Transactional sex (n = 693) | |
No | 596 (86) |
Yes | 97 (14) |
Breakdown of percentages by money or gifts or bothc (n = 97) | |
Sex in exchange for money only | 58 (59.8) |
Sex in exchange for gifts only | 24 (24.7) |
Sex in exchange for both money and gifts | 15 (15.5) |
Quantitative findings
Factor analysis groupings
Overlap between groups
Mutually exclusive groups
Transactional sex and consumption of practical items (PRAI) and consumption of entertainment and birth control (EBC) items
Outcome: PRAI (n = 398)b | uOR | 95% CI | p-value | aORd | 95% CI | p-value#, |
---|---|---|---|---|---|---|
No | Reference | Reference | ||||
Yes | 1.32 | 0.72–2.44 | 0.37 | 1.09 | 0.57–2.12 | 0.79 |
Outcome: EBC (n = 486)c | ||||||
No | Reference |
Reference
| ||||
Yes | 1.67 | 1.03-2.72 | 0.04* |
3.03
| 1.12-8.23 | 0.03* |
Qualitative findings
The perception of “needs” and “wants”
Groupings | Items | Need | Want |
---|---|---|---|
Personal Enhancement Items | Expensive perfume | Need | |
Hair extensions | Need | ||
Lingerie (fancy underwear (such as Jockey) | Need | ||
Toiletries (scented soap, skin cream, body lotion, powder, roll-on deodorant) | Need | ||
Make-up (eyebrow pencil, mascara, false eye lashes, eye liner) | Want | ||
Cosmetics (Moisturising cream, nail polish (Cutex), skin-brightening cream, lip balm, bag, hair control) | Want | ||
Salon treatment (hairdressing/hair highlighting, relaxing, dyeing, manicure, waxing) | Want | ||
Accessories (watches/handbag) | Want | ||
Jewellery (bracelets, earrings, necklace, gold tooth) | Want | ||
Body piercings (belly-ring nose-ring, tongue-ring, tattoo) | Want | ||
Practical Items | Clothes | Need | |
Ordinary cell phone and airtime | Need | ||
Shoes | Need | ||
Female items (underwear, sanitary pads) | Need | ||
Food, groceries | Need | ||
School uniforms/supplies | Need | ||
Transport to school/work | Need | ||
Birth control/condoms | Need | ||
Expensive Items | Expensive clothes (skinny jeans, hlokoloza (mini skirt), tekkies (trainers), branded clothes | Need | |
Fancy shoes (high heels, Carvela (expensive Italian branded shoes) | Need | ||
Expensive phones (blackberry/camera phone/Nokia/×2) | Want | ||
Expensive foods (chocolate, yoghurt, grapes, restaurant) | Want | ||
Entertainment/leisure | Beer/alcohol | Want | |
Cold drinks and chips, Ultramel (ready-made custard), Lays (potato crisps) | Want | ||
Movies/music and travelling | Want | ||
Pocket money | Want |
P3: Even if you can bath and wear nice clothes but if you didn’t put make-up aah…you are not really (young woman’s name].P4: It is just because most of the young women nowadays they like fashion, that is why if you don’t have make-up you will not feel good.Focus group 4, high socio-economic status
I: I heard someone say that Blackberry is unnecessary. Can you please tell me why?P2: Blackberry is too expensive and I’m still a school child, and parents cannot afford to buy me Blackberry. I will be fine if I can have cell phone worth R150 [£9]. The most important thing is to communicate.P3: It is necessary to have Blackberry, because you will chat for free on Facebook and Blackberry messenger.P1: It is not necessary because even if you don’t chat it doesn’t mean that you are not a human being.P3: That is why I said my need is not your need.Focus group 4, high socio-economic status
The role of peer pressure and socio-economic status
P3: Even if you can bath and wear nice clothes but if you didn’t put make-up aah…you are not really [role model’s name].P4: It is just because most of the young women nowadays they like fashion, that is why if you don’t have make-up you will not feel good.Focus group 4, high socio-economic status
P: [I want these items] because they are needed and that everyone wish they can have it...that if I found myself having this I will be ‘the’ person among the people and when people see me coming from there they will turn their heads and look at me.In-depth interview 2, aged 21y
I: Ok. What happens if you do not have one of the items that you need?P2: Like school uniform, I won’t go to school without enough uniform. And when I wear a skirt that is tearing [torn] and then my friends laugh at me.Focus group 3, low socio-economic status.
P1: Like if you go to school you need to wear proper school uniform because the school children will laugh at you.P3: Even if you can bathe and wear nice clothes but if you didn’t put make-up aah…you are not really (certain role model in the village).Focus group 4, high socio-economic status
P1: We want to make ourselves beautiful so that people can recognise us.P3: That’s what I was saying if you didn’t put make-up people say you’re a traditional girl [I:we laughed], if you have put make-up people recognise you that you are South African.P1: Because people from Mozambique they don’t put make-up, so if you don’t put make-up they will compare you with them.Focus group 4, high socio-economic status
P: If you use make up it wastes your time, some years back at school l could see that something was wrong about me using make up. You find that we are in class at school and people have put their make up; you have finished your make-up and you don’t have money to buy. You will feel like you are very poor. So l stopped using make up because it was not good to use make up when you are still a student.I: How do they (make-up) make you feel?P: It made me feel like other children because I can see that I’m different to them, but I feel ok about the way l am. l believes that one day l will be successful.In-depth interview 14, aged 19 years
P: I don’t care even if I don’t have Cutex (nail polish) ...but my heart is painful when I go to school and didn’t braid my hair and others will laugh at me saying that I’ve aged......Even if they don’t laugh at me they gossip about my hair.....I have an afro hair so I just braid it without using hair extension.. I feel good (when they gossip) because I told myself that whom are they going to gossip about, if they don’t gossip about me. You must accept because people are gossiping.In-depth interview 14, aged 19 years
Funding consumption patterns
Parents
P3: And our parents say that when they were young they were not using fancy cream that smells good they were using “Nhlampfura” (Oil of nut or fruit) in older days… [I: they laughed] and why do they have to spend money for us on fancy creams whereas in older days they were using “Nhlampfura” and men proposed them even if they don’t smell good….Focus group 2, high socio-economic status
P2: And some our situation is different it might happen that my friend is coming from the richer family and I from poorer family and they will able to buy her fancy things and at home they will not afford to buy me something because they cannot afford it because we don’t get things easily because of not having money.Focus group discussion 2, high socio-economic status
P: Like when their mom got a piece [part-time] job from other households, like to sweep the yard then when she get paid she buy these items like food for their children and things that they can make them look able [healthy].Focus group discussion 3, low socio-economic status
P5: Because like when they buy them make-up they will think she will start to be a prostitute.I: Mmm…Ok, so what about those who like it?P3: They want their children to be beautiful and be recognised.Focus group discussion 3, low socio-economic status
Sugar daddies
P2: Because youth want expensive thing and parents won’t afford it like hair-piece, a parent won’t take you to the salon to do your hair, but if you are involved with an old man he can be able to take you to salon and do your hair.Focus group discussion 2, high socio-economic status.
P2: Sugar daddies have money and I want their money… [I: we laughed]. So nowadays girls want to make themselves beautiful, look nice and wear nice clothes. Some other girls when you give them money they go to the shop and buy snacks… [I: we laughed] but look at me I eat well because I have a relationship with a sugar daddy.Focus group discussion 5, low socio-economic status.
P: [I don’t want sugar daddies] because he is too old and on the other hand I abuse my body. ….. Some they want clothes and expensive cell phone like ‘Samsung Galaxy’ [expensive smartphone]. You find that they like it and sometimes this is cause by peer pressure. You find that my friends are having a relationship with a sugar daddy and she had sex with him then he buys her some items or expensive clothes like label clothes or an expensive cell phone. I like it then I start to involve myself [with a sugar daddy] to get the items that I need.In-depth interview 10, aged 20y.
P: Sugar daddy is a person who has a family. If you are in relationship with him is like he is abusing you because he is older than you and has his wife.In-depth interview 11, aged 19y.
P1: Like you find that she’s in a relationship with a sugar daddy and you don’t know his [HIV] status and he’s just buying her so he can sleep with her and leave her with diseases.Focus group discussion 3, low socio-economic status
Boyfriends
P: [the reasons I am with him] are because I like things… it’s a status. He buys me airtime. I call him and friends. And boast on them that I have been bought airtime. I feel good, something like that.I: What would you do if he didn’t buy you things you want like airtime?P: I will just leave him, why doesn’t he buy me airtime it will mean he buy it for someone else…In-depth interview 17, aged 20y.
P2: Yes it happens. To have a relationship with someone who own a nice car because when I am sitting with my friends I will tell them that I ride with a nice car. And then I will influence them not to have relationships with school boys. They have to date those who are working.Focus group discussion 1, low socio-economic status.
I: Mmm… the one you had a relationship with, where did you meet him?P: At school. I wanted him to help me. Like when I need money to use he was able to help me things like hair extensions. When I wanted it he was able to give me money to buy it… I was feeling happy about it [receiving money].I: Tell me did you feel like you had to have sex with him to receive money or gifts.P: No. It was the issue of love.In-depth interview 18, aged 20y.