Abstinence from sexual intercourse is the ‘A’ in the ‘ABC’ of mainstream interventions to address HIV/AIDS in South Africa. These interventions have been informed by social cognitive mode ls of sexual behaviour that emphasise the individual while neglecting the social context, and emphasise what the individual knows about long- term biomedical consequences while ignoring more immediate psychosocial factors on individual decision-making. The paper draws upon critical health psychology to explore decision-making around sexual abstinence among adolescent girls in Ocean View, a poor, ‘coloured’ neighbourhood in Cape Town. These girls ‘deviate’ from the norm in that they have chosen sexual abstinence in a context characterised by high levels of adolescent promiscuity. Their sexual decision-making is found to be a means whereby the participants attempt to challenge and counter destructive sexual norms operating within their community. Abstinence might be seen as part of a broader strategy of making and taking opportunities to escape from the destructive cycles of life in Ocean View. These concerns are both instrumental (in that sex has real consequences) and symbolic (in that abstaining from sex represents a more general approach to independence, self-control and relationships with others). This form of reaction against prevailing norms appeared more likely if a girl has some sources of support, such as a stable and loving home environment. However, in deviating from the norm, the girls are often targets of resentment by their sexually active peers, and have to deal with social isolation and exclusion. Sexual health concerns do not figure in these girls’ accounts of their sexual decision -making. This paper finds that sexual decision-making is informed more by the psychosocial and material context than by cognitive factors; in this sense, HIV/AIDS interventions based upon educating adolescents about sexual health are unlikely to have a significant effect upon sexual decision-making and behaviour
