The cross-sectional study investigated South African rural high school learners' choice of sexual abstinence in order to be able to develop tailored health education messages. All Grade 9 learners from one class at each of 10 randomly selected rural high schools participated. The Integrated Model for Motivational and Behavioural Change was used to elicit attitudes, social influences, self-efficacy and intentions towards sexual abstinence. Chi-square and t-tests were used for bivariate analysis. In total, 454 learners, mean age 16.7 years (standard deviation 1.41) range 14–20 years, participated, of whom 246 (54.2%) were female. When comparing learners reporting abstinence (n = 252) with those not abstinent (n = 202), abstinent learners were significantly more often females (P < 0.005), younger (16.5 years versus 17.1 years, P < 0.005) and drank less alcohol (P < 0.005). Abstaining girls believed that their friends and parents think that they should abstain from sex, that their friends abstained from sex and that abstinence helped them to mature emotionally. Abstinent boys expressed intentions to abstain from sex until marriage. Targeted intervention research is required to encourage South African rural high school learners to delay their sexual initiation to reduce their risk of human immunodeficiency virus infection. Different abstinent messages are needed for boys and girls to address the different patterns of behaviour observed.

Background. Lung cancer remains the number one cause of cancer mortality estimated at 1.8 million deaths. There are limited studies in resource poor countries regarding knowledge, attitudes and practices towards lung cancer.Objective. This study aimed to describe the knowledge, attitudes and practices regarding lung cancer in selected communities in KwaZulu-Natal, South Africa. Methods. An observational, analytic cross-sectional study design was conducted using a standardized questionnaire. A stratified random cluster sampling method was applied across five communities. A regression model was developed to identify the predictors of the level of knowledge.Results. About 59.9% (95% CI 52.0 - 67.3) of the participants reported to have heard of lung cancer. The mean knowledge score was 41.8% (95% CI 35.7 - 47.9%). Coughing blood was the most recognized symptom (61.0%, 95% CI 52.1 - 69.1). About 17% (95% CI 14.7 - 21.5) of participants reported to be smokers. Many respondents reported that they would go to a health centre or clinic in case they were coughing blood (72.4%, 95% CI 93.9 - 79.5). Less than 10% (95% CI 3.9 - 8.1) of participants was screened for lung cancer at the time. Gender, history of working in the chemicals industry, screening for lung cancer, and time taken to seek health care when sick were significant predictors of lung cancer knowledge.Conclusions. Public health interventions should be explored to increase the levels of community awareness regarding lung cancer, particularly focusing on the importance of screening, early diagnosis and treatment.

Background: Adolescents’ risky sexual behaviours (RSB) are detrimental to their sexual and reproductive health (SRH) well-being and present a serious public health threat, particularly in low- and middle-income countries (LMICs). Aim: This study aims to assess RSB among Grade 12 school-going adolescents after exposure to comprehensive sexuality education (CSE). Setting: This study was conducted in Kitwe district, Zambia. Methods: This cross-sectional study included 807 Grade 12 pupils at 13 selected secondary schools. Data were collected using a structured questionnaire. Proportionate probability sampling involving 13 schools was employed. Risky sexual behaviours binary outcome variables were based on transactional sex, sex while drunk, multiple sexual partners, age-disparate sexual relationships, and condomless sex. We conducted univariate and bivariate analyses to summarise sociodemographic factors and fitted binary and multivariable logistic regression models. Results: The prevalence of RSB was 40.4%. Drinking alcohol (adjusted odds ratio [AOR] = 20.825; 95% CI [6.7–64.489]); ever had sex (AOR = 9.024; 95% CI [1.953–41.704]); school location (AOR = 6.50; 95% CI [1.61–26.24]); living with mother only (AOR = 4.820; 95% CI [1.328–17.493]); sex (male) (AOR = 2.632; 95% CI [1.469–4.713]), watching pornography (AOR = 1.745; 95% CI [1008–3.021]); religion (AOR = 0.472; 95% CI [0.250–0.891]) and attending religious functions (AOR = 0.317; 95% CI [0.118–0.848]) were significantly associated with RSB. Of the sexually active pupils, 221 (67.7%), 64 (19.6%) and 41 (12.5%) were in the low, medium and high-risk categories, respectively. Conclusion: Close to half of the respondents engaged in RSB. This is a significant number that needs intervention. The CSE programme needs to be linked with structural programmes that address the social drivers of RSB among adolescents. Contribution: The study provides a backdrop for evaluating current CSE strategies in LMICs.

Background: Lung cancer remains the number one cause of cancer mortality estimated at 1.8 million deaths. There are limited studies in resource poor countries regarding knowledge, attitudes and practices towards lung cancer.Objective: This study aimed to assess the effects of a lung can-cer awareness intervention in selected communities in KwaZulu-Natal, South Africa.Materials and Methods: A quasi-experimental study design was conducted in the selected communities in KwaZulu-Natal. A community intervention was administered in the communities after a baseline survey. The intervention effects were assessed a month after implementation.Results: There were statistical differences in the mean age (p0.001) and proportion of males and females (p0.001) at base-line and post-intervention. There were no differences in terms of smoking status (p=0.958), however, there was a reduction in the number of cigarettes smoked per day (p0.001) and the number of packs smoked per week (p=0.026). The mean knowledge score increased from 41.8% (95% CI 35.7 – 47.9) at baseline to 59.9 (95% CI 53.8 – 66.0) post-intervention (p0.001). The proportion of participants who were aware that lung cancer can be detected early increased from 46.5% (95% CI 39.1 – 53.9) at baseline to 81.1% (95% CI 71.7 – 87.9) post-intervention (p0.001). The intervention had a statistically significant effect (aOR 4.370, 95%CI 1.477-12.928) on the level of lung cancer knowledge in the selected communities (p0.001).Conclusions: Interventions increasing the recognition of signs and symptoms, focusing on the importance of early detection and health seeking behaviour (including screening), smoking cessa-tion, and addressing the perceived health system barriers are required.

This community household survey undertaken in Melmoth, a rural area in KwaZulu-Natal, South Africa, investigated the influence of cumulative exposure of complementary interventions by a non-governmental organisation, LoveLife which aimed to bring changes in beliefs about HIV and AIDS prevention and treatment, and to reduce sexual risk behaviour. Amongst the 1294 respondents (15–40 years of age) increasing the number of exposures to different LoveLife interventions included use of television and radio messages, billboards, a free monthly magazine for youth, special school sports and community events, involvement of youth peer educators, and support for schools through classroom programmes and by linking clinic staff and peer educators. Cumulative exposure to LoveLife interventions resulted in more respondents believing that HIV could be prevented (p<0.005) and treated (p=0.007) and that people should test for HIV (p=0.03). Half of the respondents reported using a condom at last sex and cumulative exposure to LoveLife was associated with increased condom use (p<0.005). However, despite exposure to LoveLife, only 41.9% respondents had ever tested for HIV and cumulative exposure to LoveLife did not significantly influence respondents going to hospital for anti-retroviral treatment. The dose-response effect of cumulative LoveLife exposure appeared to have a positive influence on some beliefs and practices, but did not discriminate the extent of LoveLife exposure nor exposure to other HIV/AIDS interventions.