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Background: Young people in South Africa are susceptible to HIV infection. They are vulnerable to peer pressure to have sex, but little is known about how peer pressure operates. Aim: The aim of the study was to understand how negative peer pressure increases high risk sexual behaviour among young adolescents in Cape Town, South Africa. Methods: Qualitative research methods were used. Eight focus groups were conducted with young people between the ages of 13 and 14 years. Results: Peer pressure among both boys and girls undermines healthy social norms and HIV prevention messages to abstain, be faithful, use a condom and delay sexual debut. Conclusions: HIV prevention projects need to engage with peer pressure with the aim of changing harmful social norms into healthy norms. Increased communication with adults about sex is one way to decrease the impact of negative peer pressure. Peer education is a further mechanism by which trained peers can role model healthy social norms and challenge a peer culture that promotes high risk sexual behaviour. Successful HIV prevention interventions need to engage with the disconnect between educational messages and social messages and to exploit the gaps between awareness, decision making, norms, intentions and actions as spaces for positive interventions.

I am not ``umqwayito'': A qualitative study of peer pressure and sexual risk behaviour among young adolescents in Cape Town, South Africa