Breaking the stigma: improving sexual and reproductive health services for youth in South Africa
In South Africa, the challenges facing young people when it comes to sexual and reproductive health are immense.
Veronica Molefe's story, once a 17-year-old girl seeking information and now a health advocate, highlights the deep-rooted issues that adolescents face when trying to access sexual health services.
“Hi, my name is Veronicca Molefe. I’m 28 years old, and I lead a team of youthful professionals providing sexual and reproductive health services to adolescent girls and young women through Shout-It-Now.
“I also serve as the second deputy chairperson on SANAC’s Health Professionals Civil Society Forum.
“My work revolves around supporting and advocating for young people, ensuring they have access to non-judgmental, youth-friendly sexual and reproductive health (SRH) services.
“But my journey to this point started much earlier and I’d like to share it with you.”
”When I was 17, I was a Grade 11 student. My friends and I often discussed life, love, and our dreams. One of my friends became pregnant and it wasn’t clear whether she had used contraception or not.
“It got me thinking: I wasn’t sexually active yet, but I wanted to be prepared for when the time came.
“So, I went to my local clinic, just a street away from my home, to ask for information on contraception and HIV prevention options.”
What followed was disheartening. The nurse asked me invasive questions: “Why do you want those things? Are you sleeping around? Children like you should be in school, not here.”
“I felt judged and ashamed. All I wanted was information, but I left empty-handed. Fortunately, my mom stepped in, and we found another clinic that provided the support I needed,” Molefe explained.
She added: “That was 10 years ago but sadly this is still the reality for many young people in South Africa today.”
The situation is dire, particularly for teenage girls in South Africa, who face a high risk of unintended pregnancy and HIV. According to data from 2022/2023, 150,000 girls between the ages of 10 and 19 became pregnant.
This shocking statistic highlights that many young girls are having unprotected sex, often without access to the necessary information or services to prevent pregnancy or sexually transmitted infections (STIs).
South Africa also has one of the highest HIV infection rates among young people, especially young women.
While young men are also at risk, the numbers show that girls are disproportionately affected.
Despite the availability of free services such as HIV prevention medication (including PrEP), contraception, and even counselling for cases of abuse, many young people shy away from these services. The reason? They are often met with judgement, scrutiny and shame.
Why are young people not accessing services?
The problem isn't a lack of services but rather the barriers to accessing them, shared Molefe.
Many health facilities are not welcoming to young people. Instead of providing care and support, some healthcare providers respond with judgmental attitudes, making it difficult for adolescents to seek help or ask questions.
This is especially true when it comes to sexual health, an area still shrouded in stigma in many parts of South Africa.
This leads to a vicious cycle where young people are left uninformed, unprotected, and at risk of unintended pregnancies and STIs.
To break this cycle, it’s crucial to provide youth-friendly health services that are accessible, non-judgmental, and supportive. Shout-It-Now, the organisation where Molefe now works, is an example of how this can be done.
By recruiting staff from the communities they serve, many of whom are under the age of 35, Shout-It-Now ensures that its team understands the unique challenges faced by today’s youth.
Their services include not only contraception and HIV prevention but also abuse support and comprehensive sexual health education.
Everything is provided in a judgment-free environment, where young people feel heard, respected, and comfortable asking questions.
Peer ambassadors who have been through the program themselves help to create a welcoming atmosphere, whether in mobile clinics or through digital platforms like their call centre or social media channels.
Achieving this change will require a collective effort from all sectors of society, including government, NGOs and the public.
We need to face the reality of the statistics and work together to shift the stigma surrounding sexual and reproductive health.
This means having open, honest conversations about sex, relationships and health, and creating an environment where young people feel empowered to take control of their health.