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 South Africa: Providers should encourage sexually active youth to use condoms

2001 ◽  
Author(s):  
Keyword(s):  
South Africa ◽  
Young People ◽  
Reproductive Health ◽  
Condom Use ◽  
Service Providers ◽  
Sexual Practices ◽  
Sexually Active ◽  
Kwazulu Natal ◽  
Youth Centers ◽  
Hiv Aids

To assess the effectiveness of youth centers in reaching adolescents with reproductive health information, life skills, and services, the Reproductive Health Research Unit in KwaZulu Natal and the Population Council conducted an assessment of 12 youth centers and their affiliated peer education programs. The centers were run by the KwaZulu Natal Department of Health, the loveLife program, and the Youth and Adolescent Reproductive Health Program. Researchers also examined young people’s use of condoms as protection against pregnancy and HIV/AIDS. Data sources for this study, conducted in 2000, were an inventory of youth center services, interviews with center staff and clients, service statistics, and community surveys of 1,399 young people aged 12–24 and their parents. As noted in this brief, the study found that many sexually active young people in South Africa are knowledgeable about the sexual transmission of HIV/AIDS but do not use condoms consistently. Service providers can do more to promote condom use among youth by placing condom dispensers in private places and counseling youth on correct condom use and safer sexual practices.

Antiretroviral Therapy Based Hiv Prevention Targeting Young Female-Sex Workers: A Mixed Method Approach to Understand the Implementation of Prep in a Rural Area of Kwazulu-Natal, South Africa

2020 ◽  
Author(s):  
Natsayi Chimbindi ◽  
Nondumiso Mthiyane ◽  
Thembelihle Zuma ◽  
Kathy Baisley ◽  
Deenan Pillay ◽  
...  
Keyword(s):  
South Africa ◽  
Young People ◽  
Hiv Prevention ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Community Members ◽  
Long Distance ◽  
Female Sex ◽  
Kwazulu Natal ◽  
Prep Awareness

Abstract Introduction: Pre-exposure prophylaxis (PrEP) has the potential to alter the HIV epidemic in South Africa. Between 2016 and 2018 PrEP was rolled-out for 18-24 year-old female-sex workers (FSW) in a rural KwaZulu-Natal subdistrict with very high HIV incidence among adolescent girls and young women (AGYW). Using a ‘framework of access’ model, we describe PrEP access, awareness and uptake for AGYW, including community members’ attitudes towards PrEP for young people.Methods: We enrolled a cohort of 2184 AGYW aged 13-22 living within the subdistrict and quantitatively measured their eligibility, awareness and uptake of PrEP and other HIV prevention interventions in 2017 and 2018. We supplemented this insight with in depth exploration by conducting 19 group discussions with young people and community members, nine stakeholder key informant interviews, 58 in-depth interviews with 15-24 year-olds and 33 with implementing partners, and participatory observations. All interviews were recorded, transcribed and analysed using thematic analysis.Results: PrEP awareness increased from 2% to 9% from 2017 to 2018. Among 965 AGYW sexually-active by 2018, 13.4% (95%CI: 11.4-15.7%) reported transactional sex and 10.6% (95%CI: 8.8-12.7%) sex for money. Of these latter 194 PrEP-eligible AGYW, 21 were aware of PrEP, but none had ever used it. Wider community members were generally unaware of PrEP but imagined it would benefit young people, HIV-serodiscordant couples and those in long-distance relationships. Youth saw PrEP as a positive alternative to condoms since it “will be in their system” and not get in the way of sex. Teachers and healthcare providers were more apprehensive: worrying that PrEP would lower personal responsibility for sexual health.Conclusions: Although PrEP awareness increased and it was generally acceptable, uptake was low even among eligible AGYW, i.e., who reported FSW activity. Condom use remained undesirable suggesting a need to include PrEP in offers of alternative HIV prevention technologies to comdoms. The targeted nature of public-sector PrEP for FSW may have limited the reach, and the future broader roll-out, of PrEP in this setting. Inclusive approaches to PrEP provision integrated with wider sexual healthmay help improve demand and access to PrEP.

scholarly journals HIV-Related Knowledge, Attitudes, and Behaviors among Grade 10 Girls and Boys in Mpumalanga and KwaZulu-Natal: Cross-Sectional Results

2020 ◽  
Vol 14 (1) ◽  
pp. 75-83 ◽  
Author(s):  
Ilene S. Speizer ◽  
Khou Xiong ◽  
Mahua Mandal ◽  
Ndinda Makina-Zimalirana ◽  
Aiko Hattori ◽  
...  
Keyword(s):  
South Africa ◽  
High Risk ◽  
Young People ◽  
Hiv Prevalence ◽  
Trial Registration ◽  
Cross Sectional ◽  
Attitudes And Behaviors ◽  
Kwazulu Natal ◽  
And Behaviors ◽  
And Control

Background: Young people in KwaZulu-Natal and Mpumalanga South Africa are at high risk of HIV and other sexually transmitted infections. Therefore, awareness programs are needed to reach these young people and change their knowledge, attitudes, and behaviors. Objective: The objective of this study is to use cross-sectional data from grade 10 female and male learners in randomly assigned intervention and control schools to examine their knowledge, attitudes, and sexual behaviors. Methods: Participants, who were in grade 10 in the 2018 school year and attending schools, were randomly assigned to the intervention and control arms for implementation of the Department of Basic Education’s adapted life orientation curriculum that included scripted lesson plans. The study took place in two high HIV prevalence provinces in South Africa. Participants completed self-administered tablet-based surveys and female participants provided a dried blood spot for HIV testing. Results: Results demonstrate that two-fifths to one-half of male learners reported being sexually experienced and a quarter (KwaZulu-Natal) to a third (Mpumalanga) of the female learners reported the same. A greater percentage of learners in Mpumalanga reported consistent condom use than learners in KwaZulu-Natal. HIV prevalence among female grade 10 learners in both provinces was about 6-7%. No notable differences were observed between intervention and control school learners on the knowledge, attitudes, and behavior outcomes. Conclusion: The findings demonstrate the importance of developing HIV prevention programs for young people in high HIV prevalence provinces since these young people remain at high risk for HIV and other negative outcomes. 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.

Ambivalence, silence and gender differences in church leaders’ HIV-prevention messages to young people in KwaZulu-Natal, South Africa

2010 ◽  
Vol 12 (1) ◽  
pp. 103-114 ◽  
Author(s):  
Elisabet Eriksson ◽  
Gunilla Lindmark ◽  
Pia Axemo ◽  
Beverley Haddad ◽  
Beth Maina Ahlberg
Keyword(s):  
South Africa ◽  
Gender Differences ◽  
Young People ◽  
Hiv Prevention ◽  
Church Leaders ◽  
Prevention Messages ◽  
Kwazulu Natal ◽  
And Gender

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 “I enjoy sex more without condoms": revisiting barriers and facilitators of consistent condom use among adolescents and young adults in South Africa

2021 ◽  
Author(s):  
Anthony Ajayi ◽  
Olumuyiwa Omonaiye ◽  
Charlotte Nwogwugwu
Keyword(s):  
South Africa ◽  
Young People ◽  
Condom Use ◽  
Financial Support ◽  
Consistent Condom ◽  
Sexually Active ◽  
Partner Communication ◽  
Consistent Condom Use ◽  
Inconsistent Condom ◽  
Inconsistent Condom Use

Abstract Background Previous studies have examined consistent condom use correlates in South Africa, focusing on sociodemographic factors, HIV risk perceptions, relationship conflict, multiple sexual partners, and masculinity. However, the effect of family financial support, HIV testing, partner communication and self-efficacy for HIV prevention is less studied. We drew from a cross-sectional survey to address this gap and highlight the key barriers and facilitators of consistent condom use among young people. Methods We analysed data obtained from 631 unmarried sexually active male and females students selected using stratified sampling from a university in Eastern Cape Province of South Africa. Consistent condom use was defined as regular use of condoms in all sexual encounters in the past year. We used an open-ended question to probe the reasons for inconsistent condom use. Adjusted and unadjusted regression analysis were fitted to examine factors associated with consistent condom use. Results The prevalence of consistent condom use was 39.3% (CI: 35.5%-43.2%), with no significant gender and age differences. After adjusting for relevant covariates, living with foster parents (AOR; 1.80 95% CI; 1.09-2.97), adequate family financial support (AOR; 2.49 95% CI; 1.71-3.62), partner knew status (AOR; 1.91 95% CI; 1.09-3.37) and feeling confident in one's ability to prevent HIV (AOR; 1.77 95% CI; 1.09-2.86) were associated with increased odds of consistent condom use. However, self-report of low condom self-efficacy (AOR; 0.58 95% CI; 0.40-0.85) and alcohol use (AOR; 0.83 95% CI; 0.58-1.19) were associated with lower odds of consistent condom use. Young people who inconsistently used condoms reiterated that sex is often unplanned and condoms are not always available. The desire for maximum pleasure, partner's objection, trust, and use of hormonal contraceptives were further reasons others inconsistently use condoms. Conclusions Inconsistent condom use remains a challenge among unmarried sexually active young people in South Africa. Education of young people on the need for partner communication about HIV, HIV testing uptake, and condom use should happen more rigorously in school and through the media to improve their consistent use of condoms.

‘If You Cannot Control Yourself’

2014 ◽  
Author(s):  
Anaïs Bertrand-Dansereau
Keyword(s):  
Public Health ◽  
Young People ◽  
Hiv Prevention ◽  
Condom Use ◽  
Southern Africa ◽  
Sexuality Education ◽  
Health Messages ◽  
Aids Patients ◽  
Faith Based ◽  
Public Health Messages

In Malawi, as elsewhere in southern Africa, faith-based organisations (FBOs) have been integrated in the official response to HIV/AIDS. This new role, and the funding that accompanies it, has professionalised their traditional care activities around AIDS patients, widows and orphans, and it has also put them in charge of HIV prevention. As HIV preventers, they are asked to bridge epistemic differences between conflicting notions of sexuality and morality by reconciling public health messages, Christian teachings and local cosmologies. This becomes challenging when it comes to the question of sexuality education, specifically the promotion of abstinence, and condom use. Many FBO leaders’ response to this challenge is nuanced and defies stereotypes, as they try to balance their concern for young people, the demands of donors and the moral imperatives of their faith.

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 Correction: The Impact of Gender Norms on Condom Use among HIV-Positive Adults in KwaZulu-Natal, South Africa

PLoS ONE ◽  
2015 ◽  
Vol 10 (6) ◽  
pp. e0129637 ◽  
Author(s):  
Kristin Fladseth ◽  
Mitzy Gafos ◽  
Marie Louise Newell ◽  
Nuala McGrath
Keyword(s):  
South Africa ◽  
Condom Use ◽  
Gender Norms ◽  
Hiv Positive ◽  
Kwazulu Natal ◽  
Hiv Positive Adults ◽  
The Impact
Sign in / Sign up

Export Citation Format

Share Document