scholarly journals Awareness and uptake of layered HIV prevention programming for young women: analysis of population-based surveys in three DREAMS settings in Kenya and South Africa

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Annabelle Gourlay ◽  
Isolde Birdthistle ◽  
Nondumiso Thandiwe Mthiyane ◽  
Benedict O. Orindi ◽  
Sheru Muuo ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Prevention ◽  
Young Women ◽  
Population Based ◽  
Age Group ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Younger Women ◽  
School Based ◽  
Kwazulu Natal

Abstract Background The DREAMS Partnership is an ambitious effort to deliver combinations of biomedical, behavioural and structural interventions to reduce HIV incidence among adolescent girls and young women (AGYW). To inform multi-sectoral programming at scale, across diverse settings in Kenya and South Africa, we identified who the programme is reaching, with which interventions and in what combinations. Methods Randomly-selected cohorts of 606 AGYW aged 10–14 years and 1081 aged 15–22 years in Nairobi and 2184 AGYW aged 13–22 years in uMkhanyakude, KwaZulu-Natal, were enrolled in 2017, after ~ 1 year of DREAMS implementation. In Gem, western Kenya, population-wide cross-sectional survey data were collected during roll-out in 2016 (n = 1365 AGYW 15–22 years). We summarised awareness and invitation to participate in DREAMS, uptake of interventions categorised by the DREAMS core package, and uptake of a subset of ‘primary’ interventions. We stratified by age-group and setting, and compared across AGYW characteristics. Results Awareness of DREAMS was higher among younger women (Nairobi: 89%v78%, aged 15-17v18–22 years; uMkhanyakude: 56%v31%, aged 13-17v18–22; and Gem: 28%v25%, aged 15-17v18–22, respectively). HIV testing was the most accessed intervention in Nairobi and Gem (77% and 85%, respectively), and school-based HIV prevention in uMkhanyakude (60%). Among those invited, participation in social asset building was > 50%; > 60% accessed ≥2 core package categories, but few accessed all primary interventions intended for their age-group. Parenting programmes and community mobilisation, including those intended for male partners, were accessed infrequently. In Nairobi and uMkhanyakude, AGYW were more likely to be invited to participate and accessed more categories if they were: aged < 18 years, in school and experienced socio-economic vulnerabilities. Those who had had sex, or a pregnancy, were less likely to be invited to participate but accessed more categories. Conclusions In representative population-based samples, awareness and uptake of DREAMS were high after 1 year of implementation. Evidence of ‘layering’ (receiving multiple interventions from the DREAMS core package), particularly among more socio-economically vulnerable AGYW, indicate that intervention packages can be implemented at scale, for intended recipients, in real-world contexts. Challenges remain for higher coverage and greater ‘layering’, including among older, out-of-school AGYW, and community-based programmes for families and men.

scholarly journals Coital frequency and condom use in age-disparate partnerships involving women aged 15 to 24: evidence from a cross-sectional study in KwaZulu-Natal, South Africa

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024362 ◽  
Author(s):  
Gavin George ◽  
Brendan Maughan-Brown ◽  
Sean Beckett ◽  
Meredith Evans ◽  
Cherie Cawood ◽  
...  
Keyword(s):  
South Africa ◽  
Condom Use ◽  
Young Women ◽  
Hiv Risk ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Coital Frequency ◽  
Cross Sectional ◽  
Kwazulu Natal

ObjectiveThis study examines the role of age-disparate partnerships on young women’s HIV risk by investigating coital frequency and condom use within age-disparate partnerships involving women aged 15 to 24.DesignA community-based, cross-sectional study was conducted.SettingParticipants were randomly selected using a two-stage random sampling method in uMgungundlovu district, KwaZulu-Natal, South Africa, between June 2014 and June 2015.ParticipantsA total of 1306 15–24-year-old women in an ongoing heterosexual partnership were included in the analysis. Participants had to be a resident in the area for 12 months, and able to provide informed consent and speak one of the local languages (Zulu or English).Primary and secondary outcome measuresSexual frequency was assessed by asking participants how many times they had sex with each partner in the past 12 months. The degree of condomless sex within partnerships was assessed in the survey by asking participants how often they used a condom with their partners.ResultsAge-disparate partnerships were associated with a higher order category (once, 2–5, 6–10, 11–20, >20) of coital frequency (adjusted OR (aOR) 1.32, p<0.05, 95% CI 1.02 to 1.71) and with sex on more than 10 occasions (aOR 1.48, p<0.01, 95% CI 1.12 to 1.96) compared with age-similar partnerships. Age-disparate partnerships were also more likely to involve sex on more than 10 occasions with inconsistent condom use (aOR 1.43, p<0.05, 95% CI 1.04 to 1.96) in the previous 12 months.ConclusionThe finding that increased sexual activity is positively associated with age-disparate partnerships adds to the evidence that age-disparate partnerships pose greater HIV risk for young women. Our study results indicate that interventions to reduce risky sexual behaviour within age-disparate partnerships remain relevant to reducing the high HIV incidence rates among adolescent girls and young women.

scholarly journals Can traditional games be an option in increasing the physical activity of women following mastectomy?

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Małgorzata Bronikowska ◽  
Michał Bronikowski ◽  
Agata Glapa ◽  
Bartosz Prabucki
Keyword(s):  
Physical Activity ◽  
Older Women ◽  
Age Groups ◽  
Recovery Process ◽  
Age Group ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Younger Women ◽  
Younger Age ◽  
Ring Net

SummaryStudy aim: the purpose of the present study was to investigate the potential of traditional games as a method of increasing the physical activity (PA) of women following mastectomy. A cross-sectional survey during the 20th ONCO Games was conducted and the sample included data from women divided into two groups: up to 50 years old (n = 26) and over 50 years old (n = 86).Material and methods: PA was assessed using a questionnaire, and the number of steps taking during 30-minute periods was measured using pedometers during each of the games. Exertion was evaluated using Borg’s Scale.Results: there was no difference in levels of coherence between the age groups. The group of younger women were statistically more active (M = 3.34 days/week) than the older group (M = 2.77 days/week). All the games were evaluated to be of light intensity, with ringo perceived as being statistically more fatiguing in the over 50 age group. The highest number of steps was performed during the game of ring-net-ball (M = 1903 steps/30 min) in both age groups, with older women performing statistically more steps. Similar situations were observed in the cases of pétanque and speedminton. In ringo, the situation was reversed. The lowest number of steps was recorded in pétanque in the younger age group (M = 296 steps/30 min).Conclusion: this study indicates that in the rehabilitation and recovery process after mastectomy, traditional games could be a bridging link between exercising and sports as they provide not just activity but also a unique and valuable social context.

scholarly journals Impact evaluation of scripted lesson plans for HIV-related content in a life orientation curriculum: results from two provinces in South Africa

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ilene S. Speizer ◽  
Mahua Mandal ◽  
Khou Xiong ◽  
Ndinda Makina ◽  
Aiko Hattori ◽  
...  
Keyword(s):  
South Africa ◽  
Young People ◽  
Hiv Prevention ◽  
Longitudinal Data ◽  
Condom Use ◽  
Genital Herpes ◽  
Life Orientation ◽  
School Based ◽  
Kwazulu Natal ◽  
And Control

Abstract Background Young people under age 25 years are a key population at risk of unintended pregnancies, HIV and other sexually transmitted infections. School-based programming, focusing on youth under 17 years is strategic given that many in this age group are in school or are required to be in school and spend a considerable amount of their time at school. Prior evaluations of school-based HIV prevention programs for young people often employed weak study designs or lacked biomarkers (e.g., HIV or STI testing) to inform outcomes. Methods This study used longitudinal data collected in 2016 from a cohort of grade-8 girls from Mpumalanga and KwaZulu-Natal Provinces in South Africa. We followed them for 2 years to examine the impact of the South African Department of Basic Education’s revised scripted lesson plans for the HIV and sexual content of a “life orientation” curriculum on knowledge, attitudes, condom use behaviors, pregnancy incidence, and genital herpes incidence. Schools were randomized to intervention and control arms. Multivariable analyses were undertaken using hazard modeling for incidence-based outcomes (genital herpes and pregnancy) and generalized linear latent and mixed modeling for outcomes measured at each time period (knowledge, attitudes, and condom use). Results At end line, 105 schools were included from the two provinces (44 from Mpumalanga and 61 from KwaZulu-Natal). Fifty-five were intervention and fifty were control schools. A total of 2802 girls were surveyed at both time periods (1477 intervention and 1325 control). At baseline, participating girls were about 13.6 years; by end line, they were about 2 years older. Longitudinal data demonstrated few differences between intervention and control groups on knowledge, attitudes, condom use, genital herpes, and pregnancy experience. Monitoring data demonstrated that the program was not implemented as intended. Our results demonstrated 7% incidence of genital herpes in the two-year follow-up period indicating sexual risk-taking among our cohort. Conclusions We did not find significant effects of the revised life orientation curriculum on key outcomes; however, this may reflect poor implementation. Future HIV prevention programs for young people need to be implemented with fidelity to ensure they meet the crucial needs of the next generation. Trial Registration: This study has been registered at ClinicalTrials.gov. The trial registration number is: NCT04205721. The trial was retrospectively registered on December 18, 2019.

scholarly journals Risk factors for undernutrition of young children in a rural area of South Africa

2003 ◽  
Vol 6 (7) ◽  
pp. 645-652 ◽  
Author(s):  
Mickey Chopra
Keyword(s):  
Risk Factors ◽  
South Africa ◽  
Health District ◽  
Full Potential ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Social ◽  
Kwazulu Natal ◽  
Z Scores ◽  
Height For Age

AbstractObjective:To identify the factors associated with childhood undernutrition.Design:Cross-sectional survey.Setting:Hlabisa health district in KwaZulu/Natal, South Africa.Subjects:Eight hundred and sixty-eight children aged 3–59 months.Methods:Questionnaire survey and anthropometric survey of 516 random house-holds with children in the health district. Multivariate analysis took into account the hierarchical relationships between the proposed risk factors. This conceptual model was built up during qualitative studies and with reference to international research in this area.Results:The mean Z-scores for weight-for-age and height-for-age were −0.52 (95% confidence interval (CI)−0.44 to −0.60) and −1.25 (95% CI −1.15 to −1.35), respectively. Of the children, 26.3% (95% CI 23.3–29.3%) were stunted, 12.0% (95% CI 9.8–4.2%) were underweight-for-age (UWFA) and only 1.3% were wasted. Migrant father, mother's education, literate mother, whether the house was made of traditional materials, the presence of a toilet, whether the last child was breast-fed, duration of breast-feeding and birth weight were found to be significantly related to UWFA, the latter with an odds ratio of more than eight.Conclusion:While there are individual health and feeding behaviours that need to be addressed, this study has also uncovered the maternal and socio-economic factors which present an array of constraints in the social environment shaping the infant feeding and caring practices employed by women. For the full potential of nutrition promotion activities to be realised, there is a need to address some of these ‘deeper’ constraints.

scholarly journals Shoulder injuries in competitive swimmers in KwaZulu-

2006 ◽  
Vol 18 (1) ◽  
pp. 10
Author(s):  
T Puckree ◽  
KJ Thomas
Keyword(s):  
South Africa ◽  
Shoulder Pain ◽  
Sports Medicine ◽  
Shoulder Injuries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Voluntary Consent ◽  
Kwazulu Natal ◽  
Competitive Swimmers

Objective. To determine the incidence of shoulder injuries in competitive swimmers in KwaZulu-Natal, a province in South Africa. Design. A cross-sectional survey was conducted. A random sample of 96 swimmers from a pool of 300 swimmers registered with first-division clubs affiliated to the KwaZulu-Natal Aquatics Association participated in the study by informed voluntary consent. Data were gathered using a validated questionnaire. Setting. Data were gathered at time trials, races and club meetings. Main measures. Variables monitored included the incidence of shoulder injuries, shoulder pain and proportion of overuse injury. Results. Seventy-one per cent of the swimmers had shoulder pain and 64% reported injury to the shoulder. Forty-six per cent of the swimmers with pain complained of anterior shoulder pain, while 65% of all injuries were due to overuse. The commonest diagnoses included tendonitis (35%), muscle imbalance (29%), impingement (19%) and other (17%). Sixty-nine per cent of the swimmers swam freestyle which was related to 70% of the injuries. Eighty-one per cent of the injured swimmers sought physiotherapy for the shoulder pain. Conclusion. The incidence of shoulder injuries in competitive swimmers is high. This study shows the need for more research into swimming injuries, and the conditioning and rehabilitation of athletes in South Africa. South African Journal of Sports Medicine Vol. 18 (1) 2006: pp. 10-12

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