Background: South Africa has the highest burden of adolescents with perinatally-acquired HIV (APHIV) in the world. APHIV in South Africa have limited access to sexual and reproductive health (SRH) education and services specific to their HIV status. When lacking comprehensive SRH education, APHIV are prone to sexual risk behaviors that can lead to unintended pregnancy, sexually transmitted infections, and HIV transmission. The use of mHealth interventions has been shown to deliver information, foster social support, and improve decision-making skills. In this study, we evaluate how an mHealth intervention influences sexual health knowledge and behaviors in APHIV. Methods: We purposively enrolled adolescents from the intervention arm of a randomized clinical trial assessing a multi-module, moderated WhatsApp-based intervention—Interactive Transition Support for Adolescents Living with HIV (InTSHA)—within a government supported clinic in KwaMashu, an urban township of KwaZulu-Natal, South Africa. We conducted in-depth interviews based on World Health Organization guidelines for asking adolescents about SRH. We thematically analyzed data through an iterative, team-based coding approach combining deductive and inductive elements to contextualize SRH attitudes, knowledge, and behaviors before and after receiving the InTSHA intervention.Results: Of the 21 participants, 13 (61.9%) were female and the mean age was 16.6 years. Most participants reported first learning about SRH as young teenagers in school through non-targeted and negative ways, seeking clarification through peers and the internet rather than clinicians or caregivers. Participants reported that InTSHA provided a holistic and destigmatizing perspective on relationships, gender, and sexuality specific to growing up with HIV in South Africa. They praised the ability to give and receive information from peers in a moderated setting through the mHealth intervention, building their confidence, decision-making skills, and communication with partners and caregivers throughout their everyday lives. Despite reporting some technological challenges, adolescents agreed that InTSHA was convenient, confidential, and user-friendly.Conclusions: South African APHIV receive incomplete and conflicting sexual education from peers, caregivers, teachers, and technology that can be supplemented by mHealth curricula targeted for the unique needs of APHIV. Future, scaled-up mHealth interventions can destigmatize SRH by expanding access to sexual education and peer support, supplementing adolescents’ existing SRH education.
Background: Severe acute malnutrition (SAM) results in alterations of host defence mechanisms, which leads to increased susceptibility to infections. This study describes culture-confirmed bacterial infections in a cohort of HIV-negative severely malnourished children and compares it with a previously described cohort of HIV-positive children.Methods: A retrospective chart review was conducted of all HIV-negative children with SAM admitted to King Edward Hospital, Durban between January 1, 2015 and December 31, 2015. All positive bacterial cultures obtained within 2 days of admission (admission infections) and during 2 to 30 days of admissions (hospital acquired infections) were documented. A cohort of HIV-positive children with SAM was prospectively recruited between July 2012 and February 2015 at the same facility for the MATCH study.Results: A total of 101 patients were eligible for the study, 53% were HIV unexposed; 73% of the total 250 cultures obtained were during admission. Escherichia coli (E. coli) contributed 26% of all positive cultures on admission. Significant differences were noted in laboratory variables between HIV-negative vs. HIV-positive children admitted with SAM. Extended-spectrum betalactamase (ESBL) producers in HIV-positive patients constituted 40% of all Gram-negative isolates vs. 24% in HIV-negative patients.Conclusion: Gram-negative organisms remain an area of concern in both HIV-positive and HIV-negative patients with SAM with resistant organisms more prevalent in HIV-positive patients. Prevention of mother-to-child transmission of HIV reduces prevalence and incidence of HIV, which has been shown to contribute to the burden of bacterial infections in malnourished children.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.