During adolescence, youth usually begin to explore their sexuality [1–5]. Yet, in South Africa any sexual behaviour including kissing, petting, and penetrative intercourse between young adolescents (under 16 years of age), regardless of consent, is illegal (the Criminal Law [Sexual Offences and Related Matters] Amendment Act No. 32 or 2007; ). In the case of similar age adolescents, both partners are prosecutable under this law whereas in an age discordant couple, where one partner is two or more years older than the other, a statutory offense applies only charging the older partner with a crime. Such laws are incongruent with common sexual practice among South African adolescents [1, 2]. This law may negatively impact healthcare and education services for young adolescents by forcing a mandatory reporting and abstinence-only approach. Such an approach is not only in contravention of provisions in other South African legislation , but it may compromise comprehensive education and reproductive health services that promote and support a spectrum of healthy sexual decision-making.
Given the rapid and significant developmental changes during this period it is important to understand patterns of behaviour at different stages of adolescence. Young adolescents’ sexual behaviour is of particular concern given the myriad adverse correlates associated with early sexual debut, including having unprotected sex, having multiple sexual partners, STI and HIV infection [8–13], early pregnancy , and a host of risk behaviours and social and emotional difficulties  including alcohol use, delinquency, school problems, and (among girls) depressive symptoms [4, 16, 17]. In sub Saharan Africa, young adolescent girls have higher rates of HIV prevalence than adolescent boys [18–20]. A national household survey found that among youth between the ages of 15 and 24 years, 15.5% of young women and 4.8% of young men were HIV positive . In a recent school-based survey in KwaZulu Natal, South Africa, HIV prevalence among girls was 12.7% at School A and 7.0% at School B whereas for boys it was 1.4% at School A and 2.5% at School B . The sex differences in HIV prevalence and our understanding of adolescent sexuality and the influence of gender norms indicate that it is important to develop nuanced understandings of girls’ and boys’ behavioural patterns because this information must inform prevention interventions .
Much of the adolescent sexual behaviour prevalence data focuses on sexual intercourse, yet adolescent sexual exploration and expression may span a variety of behaviours such as hand holding, hugging, kissing, petting or masturbation, oral sex, vaginal sex, and anal sex [5, 22]. Studies in the US and the UK with young adolescents found that lower hierarchy sexual behaviours such as hand holding, hugging, and kissing were more prevalent (25-50% of the samples) than higher level behaviours such as intercourse (between 5% and 20% of the samples) [22, 23].
Previous study results indicate that a significant proportion of South African youth experience sexual debut between the ages of 14 and 17 years [2, 20, 24–26]. A Cape Town school-based study reported that 11.9% of 12-year old boys and 0.9% of 12-year old girls had experienced sexual intercourse with the proportions increasing to 45.9% of boys and 24.5% of girls by age 16 years . A school-based study with young teenagers (age 13 years) in South Africa and Tanzania who had not yet had sexual intercourse found that approximately one in five teens experienced sexual debut during the 15 months of the study . These studies indicate that a significant proportion of South African youth are sexually active before the legal age of consent.
Sexuality is expressed and experienced in various ways in different relationship contexts [5, 16, 27]. Although it is assumed that dating relationships are the primary venue for sexual exploration [28, 29], sexual exploration may also occur individually (e.g., masturbation), within non-dating relationships, or as casual encounters. Interviews with Grade 8 and 11 adolescents in Cape Town found that dating and sex are not entirely co-occurring .
All sexual activity between young teenagers is illegal and in some controversial cases teenagers have been charged within the terms of this legislation. Little is known about the prevalence of non-intercourse sexual behaviours among young South African adolescents nor the circumstances in which these teenagers experience sex such as the relationship with the sex partner, contraceptive use, consent, co-occurring substance use, and the frequency of sex which would provide insight into the levels of risky sexual contact. The aims of this paper are to describe (a) the kinds of sexual activity young (under age 16), urban South African adolescents are engaging in, including risky sexual behaviours; (b) the connections between dating and sexual activity in this age group; and (c) the factors associated with early penetrative sex. The implications of these data for risk prevention, especially in light of legal concerns, will be discussed.