Content Summary

LESSON 1:

Key Concepts
Physical health refers to the well-being and proper functioning of the body, maintained through regular exercise,
a balanced diet, adequate rest, and the absence of illness or injury.

Sexual health involves your physical body, your self-image, the quality of your relationships with others and your
morals and values. All these factors influence our choices around our sexual behaviour.

According to the current working definition of the World Health Organisation (WHO), sexual health is: "A state
of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of
disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual
relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion,
discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons
must be respected, protected and fulfilled."

Abstinence means to refrain from sex completely. This is the safest option (100% guaranteed) of preventing
pregnancy or sexually transmitted infections (STIs). Practising abstinence can help you focus on other things in
your life that are important to you, like friends, school, sports, activities, having fun, and planning for your future
– that is your goals/dreams.

Contraception refers to using methods to prevent pregnancy. This could include a female going on a
contraceptive pill, using a condom or using a contraceptive injection or a male wearing a condom while having
sex.

To prevent contracting HIV, a person would need to wear a condom during sex or a person should be tested by
a medical professional before sexual intercourse. According to the WHO: By reducing rates of unintended
pregnancies, contraception also reduces the need for unsafe abortion and reduces HIV transmissions from
mothers to newborns. This can also benefit the education of girls and create opportunities for women to
participate more fully in society, including paid employment.

©2025 Teenactiv 1 www.teenactiv.co.za

Embracing change and making healthy choices
Grade 9 is a special year because, in many ways, you begin to resemble an adult more closely. Some of you have
increased in height quite a bit since last year. You know your bodies are changing and puberty is no longer
something scary that’s going to happen. Remember puberty starts between ages 10-12 and ends around the age
of 19.

This is a unique stage of human development and an important time for laying the foundations of good health. You
are a young adult now and some of you might find that you are experiencing feelings of attraction toward someone
else.

Remember that all choices have consequences. They could have a positive impact when making a healthy choice
or a negative impact when making an unhealthy choice, for instance, choosing to drink alcohol with friends can
lower your inhibitions, leading you to engage in physical activities with someone that you might not do when sober.
Then you’ll have to deal with the embarrassment and possible pregnancy from that choice.

You need to develop standards for yourself, by which you will live your life, that protect your physical, emotional
and sexual health. These standards are influenced by your physical health, self-image, quality of the relationships
you have with others and your values.

Maybe you have parents who openly discuss healthy sexual behaviour habits with you. This could include things
like having certain moral standards about your body that you would not compromise on. It could also mean that
you believe in abstinence which means not having sex until you are older and more mature. Some young adults
have not had the same privileges. Maybe they don’t have mothers and fathers and come from a community of
extreme poverty where they have made unhealthy sexual choices out of necessity to survive.

Risk factors leading to unhealthy sexual behaviour

Risk factors are the things that impact you to make poor choices about your sexual behaviour. These choices could
place you at risk and lead to unhealthy sexual behaviour.

Here are some common beliefs of teenagers:

• Believing that nothing bad will happen to you even if you take risks, such as having sex without
contraception and assuming that pregnancy won't occur.
• Feeling the need to do something to be accepted by your peers, like boys believing they must have sex
with a girl to be considered "cool."
• Believing you have no control or say over what happens to you, such as feeling so insecure that you can't
refuse unhealthy sexual attention.
• Living in poverty often feels like you have no choice, leading to survival-driven decisions.
• The use of drugs and alcohol inhibits your ability to make wise decisions.

©2025 Teenactiv 2 www.teenactiv.co.za

Examples of unhealthy sexual behaviour
• Having sex at a young age.
• Having unprotected sex (This is very unwise! Do not have unprotected sex!)
• Having unprotected sex with more than one person.
• Having a high-risk partner (one who has multiple sex partners or other risk factors).

Consequence of unhealthy sexual behaviour

• Teenage pregnancy
• Sexually transmitted infections (STIs)
• HIV and AIDS
• Low self-esteem
• Emotional scars

Teenage Pregnancy
You might be tired of hearing about teenage pregnancy and believe that it could never happen to you or one of
your friends. The sad reality is that statistics show us that it happens to so many young girls who honestly believed
they would never fall pregnant as a teenager.

Teenage pregnancy is a huge problem in South Africa. Statistics show a significant increase in teenage pregnancies
between 2015 and 2023. Young people are sexually active and not using contraceptives. Some women feel that
using the pill will make them fat or that it will stop them from falling pregnant as adults. This is a myth. Some men
think that women need to be responsible and prevent pregnancy. This is dangerous thinking, as STIs can still be
transmitted. It is disheartening to learn that many young girls in poverty exchange sex for money.

LESSON 2:

Key Concepts

Sexually Transmitted Infections (STIs): Infections that are transmitted through sexual contact from one
infected person to another, most commonly when a couple has sex without using a condom.

A norm is a standard that is acceptable to a group of people

Symptoms of STIs
Many of the STI’s have similar symptoms. STI symptoms include the following:
• An unusual discharge from the vagina, penis or anus.
• Pain when urinating.
• Lumps, skin growths or a rash around the genitals or anus.
• Unusual vaginal bleeding.
• Itchy genitals or anus.
©2025 Teenactiv 3 www.teenactiv.co.za
 • Blisters and sores around the genitals or anus.
• Warts around the genitals or anus.
• Warts in the mouth or throat (this is very rare).
• Hepatitis B: No clear symptoms.
• Genital Herpes: Small blisters on genitals (can be managed with medication).
• Syphilis: Genital sores. If left untreated, it can result in death.
• Gonorrhoea: Burning sensation when urinating (can be cured).

Some teenagers who believe they might have an STI might feel embarrassed, afraid, ashamed or even scared and
prefer to ignore the symptoms, thinking it will go away. Some might not realise how serious it is. If any of these
symptoms are present, a person should visit their doctor or clinic and be honest about their concerns so they can
do the necessary tests and receive proper medical intervention.

Low self-image as a result of unhealthy sexual behaviour

Unhealthy sexual behaviour can lead to negative emotions and self-perception issues. Engaging in such behaviour
might make you feel bad about yourself, lowering your self-image. You could experience disappointment, shame,
fear, and self-blame for making poor decisions. Low self-esteem can further impact your decision-making, leading
to dangerous and damaging actions, such as self-harm or severe depression.

Emotional Scars as a result of unhealthy sexual behaviour

Unhealthy sexual behaviour in teens can lead to emotional scars, which are mental or emotional pains carried for
a long time. Without seeking help from counsellors, this pain can last a lifetime. Some teenagers struggle with this
pain and find it difficult to return to normal life, pulling away from friends and partners, and often becoming
depressed.

Perhaps you’ve experienced something in your life that has left an emotional scar. It's important to reach out:
Contact a counsellor or seek advice from a trusted adult on how to address it. Ignoring an emotional scar is like
leaving a physical wound untreated, which can lead to an infection. Many adults struggle with depression or anxiety
due to past emotional trauma. It’s crucial to address these scars while you are still young so that you can move
forward in life more healthily and confidently.

HIV and AIDS as a result of unhealthy sexual behaviour

HIV and AIDS are still prevalent among teenagers. In the same way that an STI is transmitted, HIV infections are a
result of unprotected sex. If you become infected, your immune system weakens and you cannot be protected
from other infections or diseases. At this stage, you develop AIDS, which could result in death. Sadly, 80% of
adolescent deaths in Africa are as a result of AIDS.

©2025 Teenactiv 4 www.teenactiv.co.za

Factors that influence personal behaviour
Many of our choices around sexual behaviour are personal responses. Our personal behaviour is greatly influenced
by the people we spend time with. We know this influence could be negative or positive. You need to consider
these influences around you and as you grow up, make choices that line up with your own value system and vision
for your future. Many of us are fortunate to have people in our lives who love us and inspire us to be better people.

Family
When your parents enforce certain rules during your early teens for your health, such as not smoking because it
can lead to lung cancer, it often helps you avoid smoking altogether. This is an example of a positive influence.
However, a family could also have a negative influence. For example, a father who is an abusive alcoholic might
spend money on alcohol instead of providing food for the family. This creates a home environment with an absent
father who presents a negative image of what a father should be.

Community
Living in a community where many learners have absent parents and are on the streets instead of in school often
leads to an increase in crime and gang violence. The role of community members significantly impacts your role in
the community. In such environments, there is a rise in teen prostitution, drug and alcohol abuse, and a higher risk
of contracting STIs, HIV, and AIDS. These are examples of negative influences within a community. But a community
could also have a positive influence. In some communities, the neighbours rally around to support and challenge
learners to go to school and get an education because they believe that education changes the future. In this
community, it is the norm to treat elders with respect regardless of whether they are family or not.

Friends and Peers

One of the greatest influences during your teens is your peers and friends. Teenagers often place a high value on
these friendships, sometimes even more than relationships with adults. Friends and peers can positively impact
you by encouraging you to focus on schoolwork or promoting abstinence from sex until marriage. However, they
can also have a negative influence, leading to risky behaviours such as drug use, excessive drinking, and reckless
sexual behaviour.

LESSON 3:
Strategies to deal with unhealthy sexual behaviour
Abstinence
Abstinence means to refrain from sex completely. This is the safest option. There is no chance of contracting an STI
or getting pregnant if you are not having sex. When you decide to practice abstinence, you must communicate that
this value is important to you when entering into a relationship. A person who really cares about you and respects
you will NOT push your boundaries and try to change your mind.

You could also look for online groups that support your ideas. This approach allows you to focus on developing
healthier relationships without the potential baggage of emotional scars.
©2025 Teenactiv 5 www.teenactiv.co.za
Change in behaviour
Another approach to addressing negative sexual behaviour is to change your behaviour. This starts by not making
impulsive decisions based on emotions but rather sticking to your own values and moral code. This means making
choices to stay safe. If you choose not to abstain, then always using a condom when having sex is vital. Be faithful
to one partner. Females should use female contraception.

Remember it is not going to be easy to implement these changes and you might find some friends will try to change
your mind. Friends can also have a positive influence and help you make these changes. This would be a good time
to evaluate your friendships and see if their influence is toxic or helpful. Look for people in your community or join
a group where you can be supported in these new choices you have made.

It is also good to find other forms of enjoyment like playing sports with a team or joining a cultural society like a
choir. These changes will strengthen you and help develop healthy relationships that are not of a sexual nature.

Protective factors in dealing with sexual behaviour

Protective factors are elements within yourself, your family, or your community that support you in managing
life’s challenges. They include the following:
• Be assertive and confident: Believe in your potential for a positive future. Use your negotiation skills and
confidently say NO! Stick to your decisions and beliefs.
• Have open conversations about sexual behaviour and other important or sensitive topics within your
family.
• Seek friends who support your decisions and help you avoid risky sexual behaviour.
• Apply the skills you've learned at school to make wise choices and stand up for yourself against peer
pressure.
• Choose healthy role models by finding individuals in your school or community who exemplify the
qualities you aspire to and who can guide you towards becoming a person you’d be proud to be.
• If local resources like clinics are unavailable, use national helplines or websites for assistance with teen
pregnancy, HIV and AIDS counselling, gender-based violence and abuse.

Change comes when we reach out and partner with those who believe in us and want the best future for us.
You don’t have to do it alone!

The adverse consequences and implications of teenage pregnancy

Becoming a parent as a teenager is extremely challenging. Having a child as a teenager not only affects you as the
young parent but also your own family and that of the father/mother of the child. For a young girl, there are
physical dangers when going through labour at a young age. The pregnancy could damage her bone structure, she
could tear giving birth causing a lot of pain and she would need an operation.

©2025 Teenactiv 6 www.teenactiv.co.za

Both the young mother and father would be affected emotionally by this new burden. They may
suffer depression as they lose friends and respect from community members. They may feel depressed and might
turn to alcohol or drugs to escape their reality.

This young couple would be confronted with choices of abortion (the termination of the child) or adoption (placing
the child in another home). The outcome of these choices would have a lifelong impact on each of them in different
ways.

Many young mothers drop out of school to have the baby and struggle to return to school because of the burden
of responsibility of being a young mom.

Should a young mother choose to keep her child, there are physical challenges that the young baby will face:
• Often the baby is underweight when born due to a mother who did not eat nutritionally, trying to hide the
fact she was pregnant for so long.
• The baby could experience health problems and may even be sick.
• Additionally, as the child grows, they often experience further malnutrition and sometimes abuse as the
young couple/mother struggles to handle the pressures of parenting.

Sadly, many children of these young teens will grow up in poverty and possibly repeat the cycle of falling pregnant
in their teen years. This keeps these families in a constant cycle of poverty and lack of education.

©2025 Teenactiv 7 www.teenactiv.co.za