DREAMS Intervention Uptake and Its Association with HIV Related Outcomes Among Adolescent Girls and Young Women in South Africa: Findings from a Cross Sectional Household Study

2021 ◽  
Author(s):  
Kaymarlin Govender ◽  
Sean Beckett ◽  
Tarylee Reddy ◽  
Richard Cowden ◽  
Cherie Cawood ◽  
...  
Keyword(s):  
South Africa ◽  
Adolescent Girls ◽  
Young Women ◽  
Cross Sectional ◽  
Intervention Uptake

scholarly journals Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa

2020 ◽  
Author(s):  
Anthony Idowu Ajayi ◽  
Henrietta Chinelo Ezegbe
Keyword(s):  
South Africa ◽  
Sexual Violence ◽  
Unintended Pregnancy ◽  
Adolescent Girls ◽  
Young Women ◽  
Teenage Pregnancy ◽  
Multivariable Analysis ◽  
Limited Attention ◽  
Cross Sectional ◽  
Unintended Pregnancies

Abstract Background Unintended pregnancy has dire consequences on the health and socio-economic wellbeing of adolescent girls and young women (AGYW) (aged 15-24 years). While most studies tend to focus on lack of access to contraceptive information and services, and poverty as the main contributing factor to early-unintended pregnancies, the influence of sexual violence has received limited attention. Understanding the link between sexual violence and unintended pregnancy is critical towards developing a multifaceted intervention to reduce unintended pregnancies among AGYW in South Africa, a country with high teenage pregnancy rates. MethodsDrawing from cross-sectional data obtained among AGYW in a South African university between June and November 2018, we estimated the magnitude of unintended pregnancy among AGYW and also examined the effect of sexual violence on unintended pregnancy. A final sample of 451 girls aged 17-24 years, selected using stratified sampling, were included in the analysis. We used adjusted and unadjusted logistic regression analysis to examine the effect of sexual violence on unintended pregnancy. ResultsThe analysis shows that 41.9% of all respondents had experienced an unintended pregnancy, and 25.9% of those unintended pregnancies ended in abortions. Unintended pregnancy was higher among survivors of sexual violence (54.4%) compared to those who never experienced sexual abuse (34.3%). In the multivariable analysis, sexual violence was consistently and robustly associated with increased odds of having an unintended pregnancy (AOR:1.70; 95% CI: 1.08-2.68).ConclusionAddressing unintended pregnancies among AGYW in South Africa requires interventions that not only increase access to contraceptive information and services but also reduce sexual violence and cater for survivors.

scholarly journals Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anthony Idowu Ajayi ◽  
Henrietta Chinelo Ezegbe
Keyword(s):  
South Africa ◽  
Sexual Violence ◽  
Unintended Pregnancy ◽  
Adolescent Girls ◽  
Young Women ◽  
Teenage Pregnancy ◽  
Multivariable Analysis ◽  
Limited Attention ◽  
Cross Sectional ◽  
Unintended Pregnancies

Abstract Background Unintended pregnancy has dire consequences on the health and socioeconomic wellbeing of adolescent girls and young women (AGYW) (aged 15–24 years). While most studies tend to focus on lack of access to contraceptive information and services, and poverty as the main contributing factor to early-unintended pregnancies, the influence of sexual violence has received limited attention. Understanding the link between sexual violence and unintended pregnancy is critical towards developing a multifaceted intervention to reduce unintended pregnancies among AGYW in South Africa, a country with high teenage pregnancy rate. Thus, we estimated the magnitude of unintended pregnancy among AGYW and also examined the effect of sexual violence on unintended pregnancy. Methods Our study adopted a cross-sectional design, and data were obtained from AGYW in a South African university between June and November 2018. A final sample of 451 girls aged 17–24 years, selected using stratified sampling, were included in the analysis. We used adjusted and unadjusted logistic regression analysis to examine the effect of sexual violence on unintended pregnancy. Results The analysis shows that 41.9% of all respondents had experienced an unintended pregnancy, and 26.3% of those unintended pregnancies ended in abortions. Unintended pregnancy was higher among survivors of sexual violence (54.4%) compared to those who never experienced sexual abuse (34.3%). In the multivariable analysis, sexual violence was consistently and robustly associated with increased odds of having an unintended pregnancy (AOR:1.70; 95% CI: 1.08–2.68). Conclusion Our study found a huge magnitude of unintended pregnancy among AGYW. Sexual violence is an important predictor of unintended pregnancy in this age cohort. Thus, addressing unintended pregnancies among AGYW in South Africa requires interventions that not only increase access to contraceptive information and services but also reduce sexual violence and cater for survivors.

scholarly journals Prevalence and correlates of sexual violence among adolescent girls and young women: findings from a cross-sectional study in a South African university

2020 ◽  
Author(s):  
Anthony Idowu Ajayi ◽  
Elmon Mudefi ◽  
Eyitayo Omolara Owolabi
Keyword(s):  
South Africa ◽  
Sexual Violence ◽  
Family Support ◽  
Adolescent Girls ◽  
Young Women ◽  
Financial Support ◽  
Epidemiological Data ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Factors Associated

Abstract Background: There is a window of opportunity to address the menace of sexual violence in South Africa, given the formation of the ministerial task team commissioned by the president in 2019 following the brutal rape and murder of a female university student in Cape Town. Epidemiological data on the prevalence and factors associated with sexual violence is critical to understanding the magnitude of the problem and designing interventions towards reversing the trend of sexual violence in the country. Drawing from cross-sectional data from a South Africa university, we examined the prevalence and correlates of sexual violence among adolescent girls and young women (AGYW). Methods: We analysed data of 451 AGYW selected using stratified sampling. Sexual violence was defined as any sexual acts, and attempt to obtain a sexual act without consent. We used adjusted and unadjusted logistic regression models to examine the factors associated with exposure to sexual violence while controlling for relevant covariates. Results: The lifetime and past year prevalence of sexual violence was 37.9% and 25.3%, respectively. A higher prevalence of sexual violence was reported by heavy episodic drinkers of alcohol (lifetime 48.4% and past year 34.0%), those who received insufficient financial support (lifetime 58.0% and past year 35.8%) compared to non-users of alcohol and those who received adequate financial support. AGYW who reported heavy episodic use of alcohol were twice more likely to report experiencing sexual violence compared to non-users. However, individuals who received adequate family support were 76% and 65% less likely to report lifetime and past year experience of sexual violence compared to those who received inadequate family support. Also, AGYW who rated themselves as very religious were 80% and 75% less likely to report lifetime and past year experience of sexual violence compared to those who were not religious.Conclusion: Our study shows that sexual violence affects a large proportion of girls, requiring intervention that not only focuses on increasing social support for survivors, facilitating reporting, and ensuring justice is served, but also target alcohol use reduction and poverty alleviation.

scholarly journals Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa

2020 ◽  
Author(s):  
Anthony Idowu Ajayi ◽  
Henrietta Chinelo Ezegbe
Keyword(s):  
South Africa ◽  
Sexual Violence ◽  
Unintended Pregnancy ◽  
Adolescent Girls ◽  
Young Women ◽  
Teenage Pregnancy ◽  
Multivariable Analysis ◽  
Limited Attention ◽  
Cross Sectional ◽  
Unintended Pregnancies

Abstract Background Unintended pregnancy has dire consequences on the health and socioeconomic wellbeing of adolescent girls and young women (AGYW) (aged 15-24 years). While most studies tend to focus on lack of access to contraceptive information and services, and poverty as the main contributing factor to early-unintended pregnancies, the influence of sexual violence has received limited attention. Understanding the link between sexual violence and unintended pregnancy is critical towards developing a multifaceted intervention to reduce unintended pregnancies among AGYW in South Africa, a country with high teenage pregnancy rates. Thus, we estimated the magnitude of unintended pregnancy among AGYW and also examined the effect of sexual violence on unintended pregnancy. Methods Our study adopted a cross-sectional design, and data were obtained from AGYW in a South African university between June and November 2018. A final sample of 451 girls aged 17-24 years, selected using stratified sampling, were included in the analysis. We used adjusted and unadjusted logistic regression analysis to examine the effect of sexual violence on unintended pregnancy. Results The analysis shows that 41.9% of all respondents had experienced an unintended pregnancy, and 25.9% of those unintended pregnancies ended in abortions. Unintended pregnancy was higher among survivors of sexual violence (54.4%) compared to those who never experienced sexual abuse (34.3%). In the multivariable analysis, sexual violence was consistently and robustly associated with increased odds of having an unintended pregnancy (AOR:1.70; 95% CI: 1.08-2.68). Conclusion Our study found a huge magnitude of unintended pregnancy among AGYW. Sexual violence is an important predictor of unintended pregnancy in this age cohort. Thus, addressing unintended pregnancies among AGYW in South Africa requires interventions that not only increase access to contraceptive information and services but also reduce sexual violence and cater for survivors.

scholarly journals Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa

2020 ◽  
Author(s):  
Anthony Idowu Ajayi ◽  
Henrietta Chinelo Ezegbe
Keyword(s):  
South Africa ◽  
Sexual Violence ◽  
Unintended Pregnancy ◽  
Adolescent Girls ◽  
Young Women ◽  
Teenage Pregnancy ◽  
Multivariable Analysis ◽  
Limited Attention ◽  
Cross Sectional ◽  
Unintended Pregnancies

Abstract Background Unintended pregnancy has dire consequences on the health and socioeconomic wellbeing of adolescent girls and young women (AGYW) (aged 15-24 years). While most studies tend to focus on lack of access to contraceptive information and services, and poverty as the main contributing factor to early-unintended pregnancies, the influence of sexual violence has received limited attention. Understanding the link between sexual violence and unintended pregnancy is critical towards developing a multifaceted intervention to reduce unintended pregnancies among AGYW in South Africa, a country with high teenage pregnancy rates. Thus, we estimated the magnitude of unintended pregnancy among AGYW and also examined the effect of sexual violence on unintended pregnancy.Methods Our study adopted a cross-sectional design, and data were obtained from AGYW in a South African university between June and November 2018. A final sample of 451 girls aged 17-24 years, selected using stratified sampling, were included in the analysis. We used adjusted and unadjusted logistic regression analysis to examine the effect of sexual violence on unintended pregnancy. Results The analysis shows that 41.9% of all respondents had experienced an unintended pregnancy, and 26.3% of those unintended pregnancies ended in abortions. Unintended pregnancy was higher among survivors of sexual violence (54.4%) compared to those who never experienced sexual abuse (34.3%). In the multivariable analysis, sexual violence was consistently and robustly associated with increased odds of having an unintended pregnancy (AOR:1.70; 95% CI: 1.08-2.68).Conclusion Our study found a huge magnitude of unintended pregnancy among AGYW. Sexual violence is an important predictor of unintended pregnancy in this age cohort. Thus, addressing unintended pregnancies among AGYW in South Africa requires interventions that not only increase access to contraceptive information and services but also reduce sexual violence and cater for survivors.

scholarly journals Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa

2020 ◽  
Author(s):  
Anthony Idowu Ajayi ◽  
Henrietta Chinelo Ezegbe
Keyword(s):  
South Africa ◽  
Sexual Violence ◽  
Unintended Pregnancy ◽  
Adolescent Girls ◽  
Young Women ◽  
Teenage Pregnancy ◽  
Multivariable Analysis ◽  
Limited Attention ◽  
Cross Sectional ◽  
Unintended Pregnancies

Abstract Background Unintended pregnancy has dire consequences on the health and socioeconomic wellbeing of adolescent girls and young women (AGYW) (aged 15-24 years). While most studies tend to focus on lack of access to contraceptive information and services, and poverty as the main contributing factor to early-unintended pregnancies, the influence of sexual violence has received limited attention. Understanding the link between sexual violence and unintended pregnancy is critical towards developing a multifaceted intervention to reduce unintended pregnancies among AGYW in South Africa, a country with high teenage pregnancy rates. Thus, we estimated the magnitude of unintended pregnancy among AGYW and also examined the effect of sexual violence on unintended pregnancy.MethodsOur study adopted a cross-sectional design, and data were obtained from AGYW in a South African university between June and November 2018. A final sample of 451 girls aged 17-24 years, selected using stratified sampling, were included in the analysis. We used adjusted and unadjusted logistic regression analysis to examine the effect of sexual violence on unintended pregnancy. ResultsThe analysis shows that 41.9% of all respondents had experienced an unintended pregnancy, and 25.9% of those unintended pregnancies ended in abortions. Unintended pregnancy was higher among survivors of sexual violence (54.4%) compared to those who never experienced sexual abuse (34.3%). In the multivariable analysis, sexual violence was consistently and robustly associated with increased odds of having an unintended pregnancy (AOR:1.70; 95% CI: 1.08-2.68).ConclusionOur study found a huge magnitude of unintended pregnancy among AGYW. Sexual violence is an important predictor of unintended pregnancy in this age cohort. Thus, addressing unintended pregnancies among AGYW in South Africa requires interventions that not only increase access to contraceptive information and services but also reduce sexual violence and cater for survivors.

Policy considerations for scaling up access to HIV pre‐exposure prophylaxis for adolescent girls and young women: Examples from Kenya, South Africa, and Uganda

2021 ◽  
Author(s):  
Jeff Lane ◽  
Audrey Brezak ◽  
Pragna Patel ◽  
Andre R. Verani ◽  
Irene Benech ◽  
...  
Keyword(s):  
South Africa ◽  
Adolescent Girls ◽  
Young Women ◽  
Scaling Up ◽  
Exposure Prophylaxis

scholarly journals The Community PrEP Study: a randomized control trial leveraging community-based platforms to improve access and adherence to pre-exposure prophylaxis to prevent HIV among adolescent girls and young women in South Africa—study protocol

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Andrew Medina-Marino ◽  
Dana Bezuidenhout ◽  
Sybil Hosek ◽  
Ruanne V. Barnabas ◽  
Millicent Atujuna ◽  
...  
Keyword(s):  
South Africa ◽  
Adolescent Girls ◽  
Young Women ◽  
Randomized Control Trial ◽  
Community Based ◽  
Adherence Support ◽  
Randomized Control ◽  
Exposure Prophylaxis ◽  
Effective Use ◽  
Improve Access

Abstract Background HIV incidence among South African adolescent girls and young women (AGYW) remains high, but could be reduced by highly effective pre-exposure prophylaxis (PrEP). Unfortunately, AGYW report significant barriers to clinic-based sexual and reproductive health services. Even when AGYW access PrEP as an HIV prevention method, poor prevention-effective use was a serious barrier to achieving its optimal HIV prevention benefits. Determining the acceptability and feasibility of community-based platforms to increase AGYW’s access to PrEP, and evaluating behavioural interventions to improve prevention-effective use of PrEP are needed. Methods We propose a mixed-methods study among AGYW aged 16–25 years in Eastern Cape Province, South Africa. In the first component, a cross-sectional study will assess the acceptability and feasibility of leveraging community-based HIV counselling and testing (CBCT) platforms to refer HIV-negative, at-risk AGYW to non-clinic-based, same-day PrEP initiation services. In the second component, we will enrol 480 AGYW initiating PrEP via our CBCT platforms into a three-armed (1:1:1) randomized control trial (RCT) that will evaluate the effectiveness of adherence support interventions to improve the prevention-effective use of PrEP. Adherence will be measured over 24 months via tenofovir-diphosphate blood concentration levels. Qualitative investigations will explore participant, staff, and community experiences associated with community-based PrEP services, adherence support activities, study implementation, and community awareness. Costs and scalability of service platforms and interventions will be evaluated. Discussion This will be the first study to assess the acceptability and feasibility of leveraging CBCT platforms to identify and refer at-risk AGYW to community-based, same-day PrEP initiation services. It will also provide quantitative and qualitative results to inform adherence support activities and services that promote the prevention-effective use of PrEP among AGYW. By applying principles of implementation science, behavioural science, and health economics research, we aim to inform strategies to improve access to and prevention-effective use of PrEP by AGYW. Trial registration ClinicalTrials.govNCT03977181. Registered on 6 June 2019—retrospectively registered.

Associations of Father and Adult Male Presence with First Pregnancy and HIV Infection: Longitudinal Evidence from Adolescent Girls and Young Women in Rural South Africa (HPTN  068)

2021 ◽  
Author(s):  
Lisa M. Albert ◽  
Jess Edwards ◽  
Brian Pence ◽  
Ilene S. Speizer ◽  
Susan Hillis ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Infection ◽  
Adolescent Girls ◽  
Young Women ◽  
Adult Male ◽  
Rural South ◽  
Rural South Africa
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