A Mixed-Method Evaluation of the Association Between Attitudes Toward Gender-Based Violence and Sexual Behaviors Among Adolescents and Young Adults in Rustenburg, South Africa

In South Africa, gender-based violence (GBV) is a public health crisis contributing to the transmission of HIV and requiring urgent intervention. Using mixed methods, this study evaluated the relationship between adolescents' attitudes toward GBV and their sexual behaviors. Adolescent girls and young women (AGYW) and adolescent boys and young men (ABYM) completed a questionnaire assessing socio-demographic characteristics, sexual risk behavior, and attitudes regarding GBV. Two focus group discussions (FGDs) were conducted to explore perceptions of GBV. Among 178 participants, 80 (44.9%) had permissive attitudes toward GBV. Being AGYW and in a relationship were associated with permissive GBV attitudes. FGDs revealed that participants perceive GBV as occurring both in society and communities, as well as within interpersonal relationships at home. This violence is perpetuated by enduring patriarchal beliefs, male authority, and economic inequalities. Effective prevention of GBV requires integrated, multi-level strategies addressing patriarchal norms, economic inequalities through contextually tailored interventions at home and throughout society.