title: Health-seeking behaviours by gender among adolescents in Soweto, South Africa.
abstract: BACKGROUND
  Adolescents are an important age-group for preventing disease and supporting health yet little is known about their health-seeking behaviours.
  
  
  OBJECTIVE
  We describe socio-demographic characteristics and health-seeking behaviours of adolescents in Soweto, South Africa, in order to broaden our understanding of their health needs.
  
  
  METHODS
  The Botsha Bophelo Adolescent Health Study was an interviewer-administered cross-sectional survey of 830 adolescents (14-19 years) conducted in Soweto from 2010 to 2012. Health-seeking behaviours were defined as accessing medical services and/or being hospitalised in the 6 months prior to the survey. Chi-square analysis tested for associations between gender, other socio-demographic and behavioural characteristics, and health-seeking behaviours.
  
  
  RESULTS
  Of 830 adolescents, 57% were female, 50% were aged 17-19 years, 85% were enrolled in school, and 78% reported experiencing medium or high food insecurity. Males were more likely than females to report sexual debut (64% vs. 49%; p<0.0001) and illicit drug use (11% vs. 3%; p<0.0001). Approximately 27% (n=224) and 8% (n=65) reported seeking healthcare or being hospitalised respectively in the previous 6 months, with no significant differences by gender. Services were most commonly sought at medical clinics (75%), predominantly because of flu-like symptoms (32%), followed by concerns about HIV (10%). Compared to females, males were more likely to seek healthcare for condom breakage (8% vs. 2%; p=0.02). Relative to males, a significantly higher proportion of females desired general healthcare services (85% vs. 78%; p=0.0091), counselling (82% vs. 70%; p<0.0001), and reproductive health services (64% vs. 56%; p=0.02).
  
  
  CONCLUSIONS
  A quarter of male and female adolescents accessed health services in the 6 months prior to the interview. Adolescents reported a gap between the availability and the need for general, reproductive, and counselling services. Integrated adolescent-friendly, school-based health services are recommended to bridge this gap.
authors: Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; otwombek@phru.co.za.
authors: Kennedy
authors: K
authors: Otwombe
authors: Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.|Canada-Africa Prevention Trials Network, The Ottawa Hospital General Campus, Ottawa, ON, Canada.
authors: Janan
authors: J
authors: Dietrich
authors: Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors: Fatima
authors: F
authors: Laher
authors: Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors: Stefanie
authors: S
authors: Hornschuh
authors: Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors: Busisiwe
authors: B
authors: Nkala
authors: Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors: Lucy
authors: L
authors: Chimoyi
authors: Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
authors: Angela
authors: A
authors: Kaida
authors: Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors: Glenda E
authors: GE
authors: Gray
authors: Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
authors: Cari L
authors: CL
authors: Miller
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013019:South Africa; D019966:Substance-Related Disorders / Q000453:epidemiology; D055815:Young Adult
keywords: South Africa; adolescent health; health promotion; health-seeking; risk behaviours
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