scholarly journals Gender and Power Dynamics of Social Relationships Shape Willingness to Participate in Biomedical HIV Prevention Research Among South African Adolescents and Young Adults

2021 ◽  
Vol 3 ◽  
Author(s):  
Kalysha Closson ◽  
Laura Lee ◽  
Janan J. Dietrich ◽  
Mags E. Beksinska ◽  
Stefanie Hornschuh ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
South African ◽  
Young Women ◽  
Ecological Model ◽  
Perceived Barriers ◽  
Barriers And Facilitators ◽  
Power Dynamics ◽  
Prevention Research ◽  
Willingness To Participate ◽  
Biomedical Hiv Prevention

Background: Understanding young women and men's perceived barriers and facilitators to participation in biomedical HIV prevention research is important for designing youth friendly services (YFS) and acceptable technologies, which are necessary for preventing high sustained HIV incidence in South Africa. This study explores the multileveled barriers and facilitators to young men and women's willingness to participate in hypothetical biomedical HIV prevention research.Methods: Eight age- (16–18 and 19–24 years) and gender-stratified focus group discussions (FGDs) were conducted using semi-structured interview guides to explore young South African women and men's willingness, perceived barriers, and facilitators to participating in biomedical HIV prevention research. FGD transcripts were uploaded to NVivo and coded collaboratively with youth study team members. Thematic analysis using Bronfenbrenner's ecological model (individual, inter-personal, community, and societal) was used to guide a deductive coding procedure, which was documented and compared by gender.Results: Thirty-one participants from Durban and 34 from Soweto participated in FGDs. Individual facilitators for participation were discussed more by young men and included financial incentives and altruism. Concerns about side-effects of biomedical products were a common barrier. Interpersonal relationships with peers, intimate partners and caregivers influenced young people's willingness to participate in HIV prevention research, more so among young women. For young women, gendered power dynamics and distrust of intimate partners and parents influenced both communication regarding participation and willingness to participate in research that is often stigmatized, due to societal norms around women's sexuality. On a societal level, participants expressed distrust in medical and research institutions, however a sense of community that was developed with the study staff of this project, was a motivator to participate in future studies.Discussion: At each level of the ecological model, we found participants expressed gendered barriers and facilitators for participation. Gender norms as well as distrust of partners, parents, and health care professionals were key barriers that cut across all levels. At each level participants discussed facilitators that were youth-engaged, underscoring the need to implement YFS, establish trust and address gender inequities within future biomedical HIV prevention studies wishing to engage and retain South African youth.

scholarly journals Why MSM in Rural South African Communities Should be an HIV Prevention Research Priority

2012 ◽  
Vol 17 (S1) ◽  
pp. 70-76 ◽  
Author(s):  
John Imrie ◽  
Graeme Hoddinott ◽  
Sebastian Fuller ◽  
Stephen Oliver ◽  
Marie-Louise Newell
Keyword(s):  
Hiv Prevention ◽  
South African ◽  
Prevention Research ◽  
Rural South ◽  
Research Priority

Homo adhaerens: Risk and adherence in biomedical HIV prevention research

2020 ◽  
Vol 50 (6) ◽  
pp. 860-880
Author(s):  
Clay Davis
Keyword(s):  
Clinical Trials ◽  
Hiv Prevention ◽  
The United States ◽  
Magic Bullet ◽  
Prevention Research ◽  
Prophylactic Regimen ◽  
Hiv Therapy ◽  
Making Sense ◽  
Biomedical Hiv Prevention ◽  
Exposure Prophylaxis

After the turn of the millennium, HIV clinical researchers pivoted from developing and testing new antiretrovirals (ARVs) for treatment, to reconfiguring the same molecules for pre-exposure prophylaxis (PrEP). In 2012, Truvada became the first HIV therapy to also be approved by the FDA for PrEP, regarded as a magic bullet that promised to end the epidemic. However, six years after its approval, it continues to be inaccessible to those who are most vulnerable. In this article, I critically analyze HIV PrEP clinical trials, dissecting the novel techniques researchers use to demonstrate efficacy. I argue that in making sense of the interplay between adherence to a prophylactic regimen and risk for HIV, biomedical HIV prevention research has revealed a new subject of biopolitics, Homo adhaerens. In the early 2000s, clinical researchers operating in the Global South identified Homo adhaerens as the ideal subject, one who embodies both high-risk behavior and diligent adherence to a daily oral regimen. I trace the construction of Homo adhaerens to the United States, where I listen closely to activists engaged with the ongoing DISCOVER trial of PrEP. Activists either aspire for Homo adhaerens as a standard, making the liberal argument that expanding access could make PrEP successful, or they rebuke the framework of clinical research that produces narrow understandings of adherence, efficacy, and universality. Ultimately, I argue that by failing to grapple with the social realities that underlie poor adherence, PrEP clinical trials produce knowledge that is not useful for those who are most vulnerable.

scholarly journals Parents’ Perspectives About Adolescent Boys’ Involvement in Biomedical HIV Prevention Research

2017 ◽  
Vol 47 (7) ◽  
pp. 1923-1935 ◽  
Author(s):  
Brian Mustanski ◽  
Kathryn Macapagal ◽  
Matthew Thomann ◽  
Brian A. Feinstein ◽  
Michael E. Newcomb ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Prevention Research ◽  
Adolescent Boys ◽  
Biomedical Hiv Prevention

scholarly journals Performing Drug Safety Research During Pregnancy and Lactation: Biomedical HIV Prevention Research as a Template

2016 ◽  
Vol 25 (7) ◽  
pp. 761-766 ◽  
Author(s):  
Richard H. Beigi ◽  
Lisa Noguchi ◽  
Gina Brown ◽  
Jeanna Piper ◽  
D. Heather Watts
Keyword(s):  
Hiv Prevention ◽  
Drug Safety ◽  
Prevention Research ◽  
Biomedical Hiv Prevention ◽  
Safety Research ◽  
Pregnancy And Lactation

scholarly journals Mental health outcomes of a pilot 2-arm randomized controlled trial of a HIV-prevention program for South African adolescent girls and young women and their female caregivers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Geri Donenberg ◽  
Katherine G. Merrill ◽  
Millicent Atujuna ◽  
Erin Emerson ◽  
Bethany Bray ◽  
...  
Keyword(s):  
Mental Health ◽  
Logistic Regression ◽  
Hiv Prevention ◽  
Reproductive Health ◽  
Health Outcomes ◽  
South African ◽  
Adolescent Girls ◽  
Young Women ◽  
Sexual And Reproductive Health

Abstract Background South African adolescent girls and young women (AGYW) report significant mental distress and sexual and reproductive health concerns. Mental health problems and trauma symptoms are consistently associated with sexual and reproductive health behavior. Despite their intersection, few interventions address them simultaneously or engage female caregivers (FC) as collaborators. This study presents findings from a pilot test of an empirically supported culturally adapted family-based HIV-prevention program, Informed Motivated Aware and Responsible Adolescents and Adults- South Africa (IMARA-SA), on AGYW anxiety, depression, and trauma. Methods Sixty 15–19-year-old AGYW (mean age = 17.1 years) and their FC from outside Cape Town were randomized to IMARA-SA or a health promotion control program. AGYW reported their anxiety using the GAD-7, depression using the PHQ-9, and trauma using the PC-PTSD-5 at baseline and follow-up (6–10 months post). Both interventions were delivered by Xhosa-speaking Black South African women in groups over 2 days for approximately 10 h. We examined intervention effects using zero-inflated negative binomial regression for anxiety, multinomial logistic regression for depression, and logistic regression for trauma. Results At baseline, groups did not differ in demographic characteristics but AGYW randomized to IMARA-SA had higher depression scores than controls (p = 0.04) and a greater proportion screened positive for PTSD (p = .07). Controlling for baseline mental health scores, AGYW who received IMARA-SA compared to controls had significantly fewer anxiety symptoms at follow-up (adjusted incidence rate ratio for count model = 0.54, 95% CI = 0.29–0.99, p = 0.05), were less likely to report at least one depressive symptom relative to no symptoms (relative risk ratio = 0.22, 95% CI = 0.05, 0.95, p = 0.04), and were less likely to report symptoms of PTSD relative to no symptoms, but this difference was not statistically significant. Conclusions Mental health is implicated in risky sexual behavior, and reducing emotional distress can mitigate exposure to poor sexual and reproductive health outcomes. This pilot study yielded promising findings for the mental health impact of IMARA-SA, justifying replication in a larger randomized trial. Trial registration ClinicalTrials.gov Number NCT04758390, accepted 17/02/2021.

Consumer Journeys of Adolescent Girls and Young Women in South Africa: Implications for Marketing HIV Prevention Products

2021 ◽  
pp. 152450042110309
Author(s):  
Michelle Dugas ◽  
Kenyon Crowley ◽  
Guodong (Gordon) Gao ◽  
Lorcan McHarry ◽  
Louise Kenmuir ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Prevention ◽  
South African ◽  
Health Beliefs ◽  
Adolescent Girls ◽  
Young Women ◽  
Low Income ◽  
Sexual Experience ◽  
Personal Hygiene ◽  
Consumer Journeys

Background: Female-initiated prevention products could reduce HIV infection rates in contexts with pronounced gender inequality like South Africa, but uptake and adherence remain low when available. Insights into the behavior of target consumers are needed to effectively promote these products; however, perceptions of stigma may discourage honest reporting. Focus of the Article: To address this need, we examined differences among the consumer journeys of six segments of South African adolescent girls and young women (AGYW), who vary on sexual health beliefs, sexual experience, and self-enhancement, when buying hygiene products. Research Question: We hypothesized that segments would differ in what motivated their purchases and in engagement with different touchpoints, reflecting a need for targeted outreach strategies. Methods: 1,500 low-income, Black South African AGYW (14–25 years of age) were surveyed face-to-face in their homes about their consumer journeys when purchasing deodorant and sanitary products, with the aim of extending the insights obtained to HIV prevention. Results: We found notable similarities across segments but also several important differences underscoring the potential for tailored marketing of HIV prevention products. Among some of the segments, differences were found in prepurchase mindsets and touchpoints, retail and brand drivers, and postpurchase feelings. Recommendations for Research or Practice: These findings highlight the need for tailored outreach among AGYW and may inform the design of effective, personalized marketing strategies that enhance the appeal of HIV prevention products. Limitations: To circumvent potential stigma associated with HIV, survey questions were anchored on personal hygiene products. While this may encourage greater honesty, findings may not fully generalize to HIV prevention products.

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