Respondents attended one of three partner schools in Langa, a low income community with the highest density of people in the region because it is the closest black township to Cape Town. All students in Grade 8 to Grade 11 who were 16 years of age (the legal age of consent in South Africa) or older were invited to voluntarily participate in the study.

Surveys were completed via paper and pencil in the absence of the teachers and school administrators. To assure anonymity, names were not collected on the survey instrument.

Respondents took an average of one hour to complete the survey. The survey was written in English, which is the official language of South Africa and the language of instruction in the high schools. There are multiple living languages in South Africa, however (Intersol Inc, 2010). The survey was first piloted among youth in the target age range to ensure readability and acceptability of sensitive questions.

All surveys were double entered by project staff to ensure accuracy. Missing data were imputed using the “impute” command in Stata, which estimates missing values using best set regression (StataCorp, 2009). Each respondent was required to have valid, non-missing data for at least 70% of the variables included in the analyses. Based on this criterion, 92 respondents were removed and 1,015 were retained.

As shown in Table 2, one in three youth (38%) somewhat or strongly agreed that they were tired of hearing about how to prevent HIV/AIDS and other STDs. Few expressed interest in learning: how to “refuse sex” (43%), how to use a condom (42%), and about birth control (32%). Even topics posited to be of interest to adolescents (e.g., how to develop a relationship) were endorsed by less than half of youth. Males tended to be more fatigued and less interested than females about HIV prevention programming.

Of the five access points queried, youth were most likely to indicate that they would be somewhat or very likely to access an HIV prevention program if it were delivered at school (85%, Table 3).

Sixty percent of youth who appraised their likelihood of getting HIV as above average chance said they were somewhat or very likely to access an HIV prevention program if it were online and 54% if it were via SMS. Similar rates of interest in Internet (60%) and SMS (53%) programming were noted among youth who agreed they were tired of HIV prevention messaging, and for youth who reported ever having vaginal or anal sex (67% and 55%, respectively). As shown in Table 4, among otherwise similar youth, those who were tired of hearing about HIV prevention were about 50% less likely to access a program if it were offered at school or online, with a similar trend noted for email. Youth who had had vaginal sex were 34% less likely to access it if it were offered online.

The generalizability of these data to greater South Africa, and youth who do not speak English fluently or are not enrolled in high school is unknown. Furthermore, it is possible that some youth did not answer honestly. Additionally, technology use was lower among the 92 respondents excluded from the analyses. Differences in findings may have been noted if these youth or those who were absent on the day of the survey had been included in the analytical sample.

In South Africa, like many countries, people who live in low income households are at higher risk for HIV (Government of the Republic of South Africa, 2011). The access to and interest in technology as a delivery mechanism for HIV prevention programming among low income students in the current study suggest this may be an under-utilized opportunity to reach this vulnerable population. Importantly, too, youth with characteristics that may further increase their risk for HIV (e.g., vaginal sex) are generally as likely to be interested in technology-based programming as their peers. The current data support a greater exploration of applications of technology in delivering HIV preventive behavior in South Africa.