scholarly journals The Association of Recurrent and Multiple Types of Abuse with Adverse Mental Health, Substance Use, and Sexual Health Outcomes among Out-of-School Adolescent Girls and Young Women in Cape Town, South Africa

2021 ◽  
Vol 18 (21) ◽  
pp. 11403
Author(s):  
Bronwyn Myers ◽  
Felicia A. Browne ◽  
Tara Carney ◽  
Tracy Kline ◽  
Courtney Peasant Bonner ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Substance Use ◽  
Adolescent Girls ◽  
Young Women ◽  
Cape Town ◽  
Cluster Randomized Trial ◽  
Sexual Risks ◽  
Polydrug Use ◽  
Increased Risk

Although physical and sexual abuse exposure is a well-established risk for poor health, the dimensions of abuse associated with health among socially vulnerable adolescent girls and young women (AGYW) remain underexamined. This article describes associations between combinations of abuse type and timing with mental health, substance use, and sexual risk outcomes among a sample of 499 AGYW (aged 16 to 19) who had left school early and were recruited for a cluster randomized trial in Cape Town, South Africa. Approximately one-third (33.5%; 95% CI: 28.7, 38.6) of participants reported lifetime abuse. Exposure to more than one type of abuse was associated with increased risk of depression (β = 3.92; 95% CI: 2.25, 5.59) and anxiety (β = 3.70; 95% CI: 2.11, 5.28), and greater odds of polydrug use (OR = 2.10; 95% CI: 1.02, 4.34) and substance-impaired sex (OR = 2.17; 95% CI: 1.31, 3.86). Exposure to multiple types of abuse during childhood/early adolescence and again in late adolescence was associated with increased risk of depression (β = 4.65; 95% CI: 3.15, 6.14), anxiety (β = 4.35; 95% CI: 2.70, 6.02), and polydrug use (OR = 2.37; 95% CI: 1.03, 5.73). Findings underscore the need for trauma-informed interventions that reduce mental health, substance use, and sexual risks among AGYW who have experienced multiple forms of abuse and recurrent abuse.

scholarly journals Substance use and depressive and anxiety symptoms among out-of-school adolescent girls and young women in Cape Town, South Africa

2020 ◽  
Vol 111 (1) ◽  
pp. 40
Author(s):  
C P Bonner ◽  
T Carney ◽  
F A Browne ◽  
J W Ndirangu ◽  
B N Howard ◽  
...  
Keyword(s):  
South Africa ◽  
Substance Use ◽  
Adolescent Girls ◽  
Young Women ◽  
Cape Town ◽  
Anxiety Symptoms ◽  
Out Of School

scholarly journals Perceived need for substance use treatment among young women from disadvantaged communities in Cape Town, South Africa

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Bronwyn Myers ◽  
Tracy L Kline ◽  
Irene A Doherty ◽  
Tara Carney ◽  
Wendee M Wechsberg
Keyword(s):  
South Africa ◽  
Substance Use ◽  
Young Women ◽  
Cape Town ◽  
Substance Use Treatment ◽  
Disadvantaged Communities ◽  
Perceived Need

scholarly journals A community-based mobile clinic model delivering PrEP for HIV prevention to adolescent girls and young women in Cape Town, South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elzette Rousseau ◽  
Linda-Gail Bekker ◽  
Robin F. Julies ◽  
Connie Celum ◽  
Jennifer Morton ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Prevention ◽  
Adolescent Girls ◽  
Young Women ◽  
Scale Up ◽  
Cape Town ◽  
Sub Saharan Africa ◽  
Health Clinic ◽  
Community Based ◽  
Depth Interviews

Abstract Background Daily doses of pre-exposure prophylaxis (PrEP) can reduce the risk of acquiring HIV by more than 95 %. In sub-Saharan Africa, adolescent girls and young women (AGYW) are at disproportionately high risk of acquiring HIV, accounting for 25 % of new infections. There are limited data available on implementation approaches to effectively reach and deliver PrEP to AGYW in high HIV burden communities. Methods We explored the feasibility and acceptability of providing PrEP to AGYW (aged 16–25 years) via a community-based mobile health clinic (CMHC) known as the Tutu Teen Truck (TTT) in Cape Town, South Africa. The TTT integrated PrEP delivery into its provision of comprehensive sexual and reproductive health services (SRHS). We analyzed data from community meetings and in-depth interviews with 30 AGYW PrEP users to understand the benefits and challenges of PrEP delivery in this context. Results A total of 585 young women started PrEP at the TTT between July 2017 – October 2019. During in-depth interviews a subset of 30 AGYW described the CMHC intervention for PrEP delivery as acceptable and accessible. The TTT provided services at times and in neighborhood locations where AGYW organically congregate, thus facilitating service access and generating peer demand for PrEP uptake. The community-based nature of the CMHC, in addition to its adolescent friendly health providers, fostered a trusting provider-community-client relationship and strengthened AGYW HIV prevention self-efficacy. The integration of PrEP and SRHS service delivery was highly valued by AGYW. While the TTT’s integration in the community facilitated acceptability of the PrEP delivery model, challenges faced by the broader community (community riots, violence and severe weather conditions) also at times interrupted PrEP delivery. Conclusions PrEP delivery from a CMHC is feasible and acceptable to young women in South Africa. However, to effectively scale-up PrEP it will be necessary to develop diverse PrEP delivery locations and modalities to meet AGYW HIV prevention needs.

scholarly journals Food Insufficiency, Substance Use, and Sexual Risks for HIV/AIDS in Informal Drinking Establishments, Cape Town, South Africa

2012 ◽  
Vol 89 (6) ◽  
pp. 939-951 ◽  
Author(s):  
Seth C. Kalichman ◽  
Melissa Watt ◽  
Kathleen Sikkema ◽  
Donald Skinner ◽  
Desiree Pieterse
Keyword(s):  
South Africa ◽  
Substance Use ◽  
Cape Town ◽  
Food Insufficiency ◽  
Sexual Risks ◽  
Hiv Aids

scholarly journals Common mental disorders and HIV status in the context of DREAMS among adolescent girls and young women in rural KwaZulu-Natal, South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nondumiso Mthiyane ◽  
Guy Harling ◽  
Natsayi Chimbindi ◽  
Kathy Baisley ◽  
Janet Seeley ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Hiv Prevention ◽  
Mental Disorders ◽  
Adolescent Girls ◽  
Young Women ◽  
Common Mental Disorders ◽  
Hiv Status ◽  
Kwazulu Natal ◽  
Hiv Acquisition

Abstract Background HIV affects many adolescent girls and young women (AGYW) in South Africa. Given the bi-directional HIV and mental health relationship, mental health services may help prevent and treat HIV in this population. We therefore examined the association between common mental disorders (CMD) and HIV-related behaviours and service utilisation, in the context of implementation of the combination DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) HIV prevention programme in rural uMkhanyakude district, KwaZulu-Natal. DREAMS involved delivering a package of multiple interventions in a single area to address multiple sources of HIV risk for AGYW. Methods We analysed baseline data from an age-stratified, representative cohort of 13–22 year-old AGYW. We measured DREAMS uptake as a count of the number of individual-level or community-based interventions each participant received in the last 12 months. CMD was measured using the validated Shona Symptom Questionnaire, with a cut off score ≥ 9 indicating probable CMD. HIV status was ascertained through home-based serotesting. We used logistic regression to estimate the association between CMD and HIV status adjusting for socio-demographics and behaviours. Results Probable CMD prevalence among the 2184 respondents was 22.2%, increasing steadily from 10.1% among 13 year-old girls to 33.1% among 22 year-old women. AGYW were more likely to report probable CMD if they tested positive for HIV (odds ratio vs. test negative: 1.88, 95% confidence interval: 1.40–2.53). After adjusting for socio-demographics and behaviours, there was evidence that probable CMD was more prevalent among respondents who reported using multiple healthcare-related DREAMS interventions. Conclusion We found high prevalence of probable CMD among AGYW in rural South Africa, but it was only associated with HIV serostatus when not controlling for HIV acquisition risk factors. Our findings highlight that improving mental health service access for AGYW at high risk for HIV acquisition might protect them. Interventions already reaching AGYW with CMD, such as DREAMS, can be used to deliver mental health services to reduce both CMD and HIV risks. There is a need to integrate mental health education into existing HIV prevention programmes in school and communities.

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.

Sign in / Sign up

Export Citation Format

Share Document