For many young South Africans, getting tested for HIV or accessing contraception isn’t just a quick clinic visit - it’s a gauntlet of judgment, privacy fears, and unsolicited lectures from healthcare staff.
Tired of being treated as passive recipients, youth activists across the country are calling for a complete overhaul of sexual healthcare, demanding judgment-free care and a real seat at the decision-making table.
Ngaatendwe Murombedzi, regional advocacy and policy manager at the AIDS Healthcare Foundation, says young people should have a greater role in shaping the services intended for them.
“Young people are increasingly taking up space. A ‘nothing for us without us’ approach positions youth not as passive recipients, but as informed co-creators. Health and education are two pillars South Africa must invest in,” she says.
Making healthcare more accessible
Young people say that improving access is not only about having healthcare facilities available, but also about how those services are delivered.
For 17-year-old Palesa Tsotetsi from Ratanda, creating spaces where young people can discuss sexual health without fear of judgement is important.
“Sexual health should not be treated as shameful,” she says. “We need safe spaces where young people can speak openly without fear.”
In the Eastern Cape, Silindokuhle Soshankane says the relationship between young people and healthcare workers also needs attention.
“Young people want to be heard without being judged. We need clinics where healthcare workers treat us with respect.”
Youth-friendly services, confidential testing and treatment, peer-led programmes and community-based services are among the approaches being advocated to make healthcare more accessible.
Digital platforms are another potential avenue for reaching young people, particularly with information about HIV prevention, testing and treatment.
The problem with misinformation
Access to reliable information is another concern.
Young people are exposed to health information through social media, websites, friends and other informal sources, but the quality of that information varies considerably.
For 23-year-old Neliswa Maneli, education remains an important part of the response.
“Nothing beats the power of education, but it must reach young people where they are,” she says.
This includes providing evidence-based information through digital platforms, where many young people already seek answers to questions about sexual and reproductive health.
Comprehensive sexuality education is also part of the discussion.
Rather than focusing only on abstinence, advocates argue that young people need practical information about HIV, contraception, relationships, consent and other aspects of sexual and reproductive health.
The aim is to give young people information they can use when making decisions about their health.
Health and everyday dignity
For young people, health issues can also overlap with other practical challenges.
Menstrual health is one, but while condoms and other HIV-prevention measures may be available through public health programmes, access to menstrual products remains a concern for some young women.
“Going on your period is not a choice,” Tsotetsi says.
The issue illustrates the broader range of health-related needs young people have to manage alongside education, family responsibilities and financial pressures.
The wider youth population
The discussion around youth health takes place against the backdrop of Africa’s growing young population.
The African Union's Agenda 2063 identifies the development of Africa's human capital as part of its long-term vision for the continent. The 50-year framework includes goals around education, health, employment and economic development.
South Africa's response to HIV therefore sits within a wider set of issues affecting young people, including education, employment, gender-based violence and access to healthcare.
Young people make up a significant part of the country’s population, making their access to education and healthcare an important consideration in planning for the future workforce.
Murombedzi says youth participation should extend beyond consultation.
“A ‘nothing for us without us’ approach positions youth not as passive recipients, but as informed co-creators,” she says.
Listening to young people
The young people speaking about these issues have identified several areas where they would like to see change. Healthcare services where they can speak openly, greater confidentiality, respectful treatment by healthcare workers and access to reliable information.
Their experiences also differ according to where they live and the services available in their communities.
Together, these concerns highlight the practical issues young people encounter when trying to access information and healthcare.
Improving youth health services will require attention to the availability of services, the way they are delivered and the information provided alongside them.
Young people want access to healthcare without judgement, reliable information and a greater role in decisions that affect their health.
Willem.vdputte@nationalmg.co.za