An evidence-based HIV prevention intervention was adapted for Botswana youth with qualitative interviews, input from an adolescent panel, and social validation. Qualitative interviews were conducted with 40 boys and girls ages 13-19. An adolescent panel then drafted scenarios reflecting social situations described in the interviews that posed risk for HIV. A social validation sample (N = 65) then indicated the prevalence and difficulty of each situation. Youth described informational needs, pressures to use alcohol and drugs, peer pressure for unprotected sex, and intergenerational sex initiations as risk-priming situations. From 17% to 57% of the social validation sample had personally experienced the situations drafted by the adolescent panel. There were no differences in the ratings of boys versus girls, but youth over age 16 more often reported that they had experienced these risky situations. The results were embedded into the intervention. Major changes to the intervention resulted from this three-phase process.HIV and AIDS disproportionately affect sub-Saharan Africa, an area that comprises less than 10% of the world's population, yet contains 68% of the world's adults and 90% of the world's children who are living with HIV/AIDS (UNAIDS, 2010). Botswana is one of the two countries in the world hardest hit by HIV and AIDS
Botswana remains one of the countries with high prevalence of HIV infection with a population prevalence rate of 17.6 in 2008. In 2009, the Ministry of Health launched male circumcision as an additional strategy to the already existing HIV preventive efforts. The purpose of this paper is to share what the participants of a survey to evaluate a short-term male circumcision communication strategy in seven health districts of Botswana reported as impediments for the program's uptake. Qualitative data were obtained from 32 key informants and 36 focus group discussions in 2011. Content analysis method was used to analyze data and to derive themes and subthemes. Although male circumcision was generally acceptable to communities in Botswana, the uptake of the program was slow, and participants attributed that to a number of challenges or impediments that were frustrating the initiative. The impediments were organized into sociocultural factors, knowledge/informational factors, and infrastructural and system factors.
Policy changes are needed to improve collaboration between adolescents, parents, teachers, and youth officers in order to address adolescent sexuality problems. Further research is needed to explore the ways in which to improve sexuality communication between these groups. The results of the study provide valuable information on the sexuality risks that expose adolescents to HIV, pregnancy, and sexually transmitted infections and the strategies for the prevention of these risks, thus informing targeted interventions for risk reduction for adolescents.
Women comprise the fastest growing group of persons with AIDS. They are often diagnosed later in the disease, when antiretroviral therapy (ART) is strongly indicated. Antiretroviral therapy has transformed the course of HIV/AIDS to a treatable, chronic illness. This article provides a profile of women with HIV/AIDS and describes ART. Selected research related to adherence and motivation is summarized. Psychosocial and economic concerns specific to women, ART, adherence, and motivation are presented. The article reviews challenges for risk reduction behaviors for HIV + women, such as sexual activity and substance abuse. The authors discuss the Keeping Health and Active with Risk reduction and Medication Adherence (KHARMA) Project, a research project in progress that was designed to promote adherence to both ART and risk reduction behaviors in HIV+ women. The study includes two groups: a motivational group intervention based on motivational interviewing and a health promotion program control group tailored to the needs of HIV+ women. A description of the tailored intervention and project update is included.
Introduction: This qualitative study triangulated data from adolescents, parents, and key informants in Gaborone, Botswana on adolescents' risks for HIV infection, STIs and pregnancy, the types of relationships they get into, and preventive measures they use to protect themselves against HIV infection. The goal of this qualitative research is to inform adaptation of an intervention originally developed, implemented, and evaluated in the US that was effective in reducing the risk of HIV infection and early pregnancy by delaying initiation of sexual relationships of abstinent adolescents and lowering sexual risk behaviours of adolescents who were already sexually active. The objectives of this study were to conduct in-depth interviews with youth, key informants and parents; determine the behavioural risks that young people face; Assess youth and parents' attitudes toward providing a risk reduction programme for adolescents and Use the data to adapt an evidence-based programme for Botswana. Methodology: In-depth qualitative interviews with 40 youth, 20 key informants and 40 parents elicited information on the risks and relationships that youth engaged in and their suggestions how their risky behaviours could be minimized or counteracted. Findings: Youth of both sexes engage in risky sexual behaviours that could predispose them to contracting HIV and STI infections or unplanned pregnancies. Risks were associated with use of alcohol and drugs: commonly marijuana, and engaging in unsafe sexual relations. Youth, key informants and parents showed a high level of acceptability for offering a primary prevention intervention program for adolescents. In addition, all groups of participants concurred on the importance of offering a separate program for parents to equip them with skills that can enable to them to guide their adolescents to safely transit into adulthood through education and family communication skills. Other risks confronting adolescents included sexual initiations from either older men or women (sugar daddy and mummy syndrome) in exchange for material and financial gains. Conclusion: Informants endorsed the need for primary prevention programs addressing adolescents and their families to reduce risk behaviours among Batswana youth to provide them with skills and minimise the risk of HIV infection among adolescents.
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