Background: Sexually transmitted infections (STIs) and HIV/AIDS are a major problem in South Africa. This, coupled with a high incidence of teenage pregnancy, alcohol and drug abuse, is of grave concern, especially its impact among the young (15–24 years) and in economically poor, rural populations. This study aimed to assess the youths' knowledge, attitudes and behaviours regarding STIs, teenage pregnancy, contraception and substance abuse.

Methodology: This is an interview-based, descriptive study. The sample design employed a stratified sample (using schools as strata) of young people aged 15 to 24 years in three schools in the Mhlakulo region, Eastern Cape province. From each school, a sample of learners from grades 10 to 12 was selected randomly. Questionnaires covering relevant parameters were used to interview the learners, after which the data were assimilated and analysed.

Results: A total of 150 learners were surveyed (86 females and 64 males). In total, 56% of them knew about STIs. About 88% of the participants learned about STIs from health care workers/nurses/doctors/clinics, the media, educators, the school and friends. Most preferred to communicate to friends (38.67%) and siblings (28%); only 15% communicated with parents. Among the sexually active, 54% reported the use of condoms; of these only 62% used them consistently. Of the participants, 7.33% had more than five sexual partners. Of the young women, 12.8% reported to have fallen pregnant with one-sixth of them wanting to become pregnant. Thirty per cent of those pregnant had to quit school, but did return subsequently. Common contraceptives used were condoms (54%) and pills (58%). Twenty-two per cent of the youths admitted to the use of recreational drugs at some time; most of these were related to alcohol (19.33%). A small fraction (1.33%) used dagga (cannabis).

Conclusion: There is lack of knowledge of STIs and their prevention and condom and contraceptive use among young people of this community. Sexual promiscuity and teenage pregnancy in the group is a cause for concern. Substance abuse is another important problem that requires urgent attention.