Addressing barriers to sexually transmitted infection information and care for adolescent girls and young women in South Africa: A health promotion approach within universal health systems
1
South African Medical Research Council, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1530
ABSTRACT
INTRODUCTION:
Adolescent girls and young women (AGYW) in South Africa experience a disproportionately high burden of sexually transmitted infections (STIs), shaped by gender inequality, stigma, and structural barriers within health services. Despite high prevalence, STI prevention and care remain marginalised within HIV-centric programming, limiting comprehensive sexual and reproductive health (SRH) promotion. Strengthening health promotion within universal health systems is essential to improve equitable access to information, prevention, and timely treatment for AGYW
METHODS:
This study draws on data from the HERStory3 mixed-methods study conducted across eight South African provinces. Quantitative data were collected through a household survey with over 5,000 AGYW aged 15–24 years. Qualitative data was generated through in-depth interviews with 68 AGYW. The analysis explored STI knowledge, communication practices, health-seeking behaviours, and experiences of accessing public healthcare services.
RESULTS:
Although many participants reported experiencing STI-related symptoms, only 16% had been diagnosed with an STI. Among those under 18 years, more than a quarter did not seek treatment. When clinics were perceived as unwelcoming, some AGYW turned to peers, the internet, or traditional healers. Participants described embarrassment and fear of judgement, with reports of negative provider attitudes. However, others experienced care, support, and dignity when treated respectfully in clinics or pharmacies. Most indicated willingness to seek clinic-based care if assured of privacy, confidentiality, and non-judgemental services.
CONCLUSIONS:
Embedding health promotion within universal, youth-friendly health systems is critical to addressing barriers to STI information and care. Integrated SRH services that prioritise confidentiality, non-judgmental care, and health literacy—supported by schools, families, peers, and digital platforms—can reduce stigma, strengthen care-seeking, and advance equitable, people-centred primary healthcare for AGYW.
Adolescent girls and young women (AGYW) in South Africa experience a disproportionately high burden of sexually transmitted infections (STIs), shaped by gender inequality, stigma, and structural barriers within health services. Despite high prevalence, STI prevention and care remain marginalised within HIV-centric programming, limiting comprehensive sexual and reproductive health (SRH) promotion. Strengthening health promotion within universal health systems is essential to improve equitable access to information, prevention, and timely treatment for AGYW
METHODS:
This study draws on data from the HERStory3 mixed-methods study conducted across eight South African provinces. Quantitative data were collected through a household survey with over 5,000 AGYW aged 15–24 years. Qualitative data was generated through in-depth interviews with 68 AGYW. The analysis explored STI knowledge, communication practices, health-seeking behaviours, and experiences of accessing public healthcare services.
RESULTS:
Although many participants reported experiencing STI-related symptoms, only 16% had been diagnosed with an STI. Among those under 18 years, more than a quarter did not seek treatment. When clinics were perceived as unwelcoming, some AGYW turned to peers, the internet, or traditional healers. Participants described embarrassment and fear of judgement, with reports of negative provider attitudes. However, others experienced care, support, and dignity when treated respectfully in clinics or pharmacies. Most indicated willingness to seek clinic-based care if assured of privacy, confidentiality, and non-judgemental services.
CONCLUSIONS:
Embedding health promotion within universal, youth-friendly health systems is critical to addressing barriers to STI information and care. Integrated SRH services that prioritise confidentiality, non-judgmental care, and health literacy—supported by schools, families, peers, and digital platforms—can reduce stigma, strengthen care-seeking, and advance equitable, people-centred primary healthcare for AGYW.
| eISSN: | 2654-1459 |
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