Recent data indicate that the worldwide rate of HIV infection in adolescents is steadily increasing. Internationally, more than 7000 youths between 15 and 24 years of age are infected with HIV daily, resulting in more than 2.5 million new infections annually. Almost two thirds (1.7 million) of these new infections occur in Africa. Estimates in 2000 showed that the number of South Africans between 15 and 49 years of age infected with HIV was 4.7 million. This number equates to a prevalence rate of 15.4% in those younger than 20 years. Adolescents form an important target group not only for preventative efforts but also for HIV vaccine trials. This article focuses on the social and psychological factors that affect adolescent decision making by considering adolescent risk-taking behaviors, problems associated with predicting adolescent behavior, peer relationships and decision making, sexual disinhibition, and the role of family relationships in adolescent decision making.
McClure CA, Gray G, Rybczyk GK, Wright PF. Challenges to conducting HIV preventative vaccine trials with adolescents. J Acquir Immune Defic Syndr. 2004;36:726-733.
2.
United Nations. Global crisis—global action: preventing HIV/ AIDS among young people. FactSheet. 2001;6:15-16.
3.
Delius P, Walker L. AIDS in context. Afr Stud. 2002;61:1-12.
4.
Department of Health. National HIV and Syphilis Sero-Prevalence Survey of Women Attending Public Antenatal Clinics in South Africa 2000. Pretoria, South Africa: Department of Health; 2001.
5.
Richter LM. A Survey of Reproductive Health Issues Among Urban Black Youth in South Africa. Final Grant Report. Society for Family Health— South Africa. Pretoria, South Africa: Medical Research Council, Center for Epidemiological Research in South Africa; 1996.
6.
Buga GA, Amoko DH, Ncayiyana DJ. Sexual behavior, contraceptive practice and reproductive health among school adolescents in rural Transkei. S Afr Med J. 1996;86:523?527.
7.
Health Systems Development Unit. Adolescent sexuality and reproductive health in the Northern Province. Acornhoek, South Africa: Health Systems Development Unit; 1998.
8.
Blecher MS, Steinberg M, Pick W, Hennick M, Durcan N. AIDS knowledge, attitudes and practices among STD clinic attenders in the Cape Peninsula. S Afr Med J. 1995;18:1281?1286.
9.
Brooks-Gunn J, Graber JA. What's sex got to do with it? The development of sexual identities during adolescence. In: Contrada RJ, Ashmore RD, eds. Self, Social Identity and Physical Health. New York, NY: Oxford University Press; 1999.
10.
Bhana A, Petersen I. Children and youth at risk: re-instituting the adult protective shield. Paper presented at: HSRC Research Conference; June 12-13, 2003; Johannesburg, South Africa.
11.
Flisher AJ, Ziervogel CF, Chalton DO, Leger PH, Robertson BA. Risk-taking behavior of Cape Peninsula high-school students, part IX: evidence for a syndrome of adolescent risk behavior. S Afr Med J. 1996;86:1090?1093.
12.
Flisher AJ, Chalton DO. Adolescent contraceptive non-use and covariation among risk behaviors. J Adol Health. 2001;28:235-241.
13.
Bibace R, Walsh ME. Development of children's concepts of illness. Pediatrics. 1980;66:912-917.
14.
Walsh ME, Bibace R. Children's conception of AIDS: a developmental analysis. J Pediatr Psychol. 1991;16:273-285.
Compas BE, Hinden BR, Gerhardt CA. Adolescent development: pathways and processes of risk and resilience. Annu Rev of Psychol. 1995;46:265-293.
17.
Sandler IN, Twohey JL. Conceptualization and measurement of coping in children and adolescents. Adv in Clin Child Psych. 1998;20:243?301.
18.
Lerner RM, Lerner JV, von Eye A, et al. Continuity and discontinuity across the transition of early adolescence: a developmental contextual perspective. In: Graber JA, Brooks-Gunn J, Petersen AC, eds. Transitions Through Adolescence: Interpersonal Domains and Context. Mahwah, NJ: Erlbaum; 1996.
19.
Cauce AM, Mason C, Gonzales N, Hiraga Y, Liu G. Social support during adolescence: methodological and theoretical considerations. In: Hurrelmann K, Hamilton SF, eds. Social Problems and Social Contexts in Adolescence: Perspectives Across Boundaries. New York, NY: Aldine de Gruyter; 1996.
20.
Sandler IN, Miller P, Short J, Wolchik S. Social support as a protective factor for children in stress. In: Belle D, ed. Children's Social Networks and Social Supports. New York, NY: Wiley; 1989.
21.
Perkel AK. Psychosocial Variables in the Transmission of AIDS [doctoral thesis]. Bellville, South Africa: University of the Western Cape; 1991.
22.
Chesney MA, Chambers DB, Kahn JO. Risk behavior for HIV infection in participants in preventive HIV vaccine trials: a cautionary note. J Acquir Immune Defic Syndr Hum Retrovirol. 1997;16:266-271.
23.
Douglas JM Jr, Judson FN, Parks JP, Buchbinder S, McKirnan D. Participation of homosexual/bisexualmen in preventive HIV vaccine trials: baseline attitudes and concerns and predicted behaviors during trials. AIDS Res Hum Retroviruses. 1994;10(suppl 2):S257-S260.
24.
Baeten JM, Richardson BA, Martin HL Jr, et al. Trends in HIV-1 incidence in a cohort of prostitutes in Kenya: implications for HIV-1 vaccine efficacy trials. J Acquir Immune Defic Syndr. 2000;24:458-464.
25.
Jackson DJ, Rakwar JP, Richardson KM, et al. Decreased incidence of sexually transmitted diseases among trucking company workers in Kenya: results of a behavioral risk-reduction programme. AIDS. 1997;11:903-909.
26.
Varga CA. Sexual decision-making and negotiation in the midst of AIDS: youth in KwaZulu/Natal, South Africa. Health Transit Rev. 1997;7:46-67.
27.
Wood KM, Maforah NF, Jewkes RK. “He forced me to love him”: putting violence on the adolescent sexual health agenda. Soc Sci Med. 1998;47:233-242.
28.
Wingood G, DiClemente RJ, Hubbard-McCree D, Harrington K, Davies SL. Dating violence and the sexual health of black adolescent females. Pediatrics. 2001;107:72-75.
29.
Leclerc-Madlala S. Infect one, infect all: Zulu youth response to the AIDS epidemic in South Africa. Med Anthropol. 1997;17:139-151.
30.
Wojcicki JM, Malala J. Condom use, power and HIV/AIDS risk: sex workers bargain for survival in Hillbrow/Joubert Park/Berea, Johannesburg. Soc Sci Med. 2001;53:99-122.
31.
Campbell C. Selling sex in a time of AIDS: the psychosocial context of condom use by sex workers on a Southern African mine. Soc Sci Med. 2000;50:479-494.
