Boys in Vhembe District felt neglected and isolated in adolescent sexual and reproductive health services, which they perceived as centred around girls, forcing them to rely on peers for distorted sexual health information.
Key Findings
Results
Boys felt isolated and excluded from adolescent sexual and reproductive health services, which they perceived as primarily designed for girls.
The study was conducted in Vhembe District, Limpopo Province, South Africa.
One of the main themes identified was 'We are on our own,' reflecting boys' sense of abandonment by formal health structures.
Another main theme was 'Programmes are centred around a girl-child,' indicating boys perceived systematic exclusion from reproductive health programming.
Boys felt neglected across multiple settings including schools, non-governmental organisations, and youth-friendly services.
Results
Boys relied on peers rather than formal sources for sexual and reproductive health information, receiving distorted information about practices such as masturbation and withdrawal.
Boys had to rely on friends to teach them methods of preventing pregnancy that can be used by boys, such as masturbation and 'pulling out.'
A main theme was identified as 'Distorted information on Boko (masturbation),' where 'Boko' refers to masturbation in the local context.
The belief that 'boys don't get pregnant' was identified as a theme contributing to boys being excluded from pregnancy prevention education.
Peer-sourced information was the primary channel for sexual health knowledge among the boys studied.
Results
Discussing sex education with parents and teachers was perceived as taboo among boys in the study.
A main theme identified was 'Discussion about sex with elders is taboo.'
Boys felt that engaging parents and teachers in conversations about sexual education was culturally or socially prohibited.
This taboo contributed to boys' reliance on peers for sexual health information rather than trusted adults or professionals.
The taboo surrounding intergenerational sex discussion compounded boys' sense of isolation in managing their sexuality.
Methods
The study used a cooperative inquiry design with the Lekgotla discussion method for data collection and thematic analysis via NVIVO software.
A cooperative inquiry design was employed as the study's methodological framework.
Data were collected using the Lekgotla discussion method, a culturally grounded group discussion approach.
Data were analysed using NVIVO software version 14.
Five steps of thematic analysis were followed during data analysis, yielding four main themes.
Conclusions
The authors recommend that the Department of Health Services establish boy-friendly services to assist boys in managing their sexuality.
The recommendation specifically targets the Department of Health Services as the responsible implementing body.
The proposed intervention is the creation of 'boy-friendly services' analogous to existing girl- or youth-focused services.
The identified gap is in helping boys manage their sexuality within a supported and accurate information environment.
The recommendation follows from findings that current youth-friendly services do not adequately address boys' sexual and reproductive health needs.
What This Means
This research suggests that adolescent boys in the Vhembe District of Limpopo, South Africa, feel left out of sexual and reproductive health programs and services. While programs exist for young people at schools and health clinics, the boys in this study felt these were largely designed for girls, leaving boys without reliable sources of information about their own sexual health. As a result, boys turned to their friends for guidance, receiving inaccurate or distorted information about topics like masturbation and withdrawal as pregnancy prevention methods.
The study also found that cultural norms made it very difficult for boys to discuss sex with adults such as parents or teachers, which the boys themselves described as taboo. This combination — being excluded from formal programs and unable to talk to adults — left boys feeling entirely on their own when navigating questions about their sexuality and reproductive health.
This research suggests there is a significant gap in how adolescent sexual health services are designed and delivered, with boys' needs largely overlooked. The authors call on health authorities to develop boy-friendly services that specifically address male adolescents' sexual and reproductive health needs. This matters because lack of accurate information can contribute to risky sexual behaviors, unintended pregnancies, and poor health outcomes for both boys and their partners.
Mulaudzi F, Seretlo R, Usie M, Sepeng N. (2025). "We are on our own": The neglected voices of the boy-child in adolescent sexual and reproductive health in Vhembe District, Limpopo, South Africa.. African journal of reproductive health. https://doi.org/10.29063/ajrh2025/v29i3.5