A Systematic Review of Randomized Controlled Trials of School Based Interventions on Sexual Risk Behaviors and Sexually Transmitted Infections Among Young Adolescents in Sub-Saharan Africa

Shangase, Nosipho; Kharsany, Ayesha B. M.; Ntombela, Nonzwakazi P; Pettifor, Audrey; McKinnon, Lyle R.

doi:10.1007/s10461-021-03242-8

Cited by 16 publications

(21 citation statements)

References 97 publications

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“…In this study, we first assessed changes in the prevalence of HSV-2, asthma and co-morbidities of both in the United States from 1999–2016. Similar to the results of previous studies, the prevalence of HSV-2 infection showed a decreasing trend over time, which is closely related to past public health efforts ( 24 – 26 ). For asthma, smoking, environmental pollution and climate change may be potential reasons for the continued increase in asthma prevalence ( 8 ).…”

Section: Discussionsupporting

confidence: 88%

The association between Herpes simplex virus type 2 and asthma: A cross-sectional study from National Health and Nutrition Examination Survey 1999–2016

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BackgroundThe association between Herpes simplex virus type 2 (HSV-2) infection, a common infectious disease that increases the incidence of multisystem diseases, and asthma was less well studied. The aim of this study was to investigate the association between HSV-2 infection and the prevalence of asthma.Materials and methodsWe used data from National Health and Nutrition Examination Survey (NHANES) 1999–2016 for analysis. The study population included was limited to those aged 20–45 years and contained complete information on HSV-2 infection and asthma. We calculated the prevalence of HSV-2, asthma, and HSV-2 combined with asthma separately. The association between HSV-2 infection and asthma was analyzed using multiple logistic regression. We also performed stratified analyses to reduce bias and to find sensitive cohorts.ResultsThe prevalence of HSV-2 infection was decreasing with change in time period (P for trend < 0.01), but the prevalence of asthma was increasing (P for trend < 0.01). The prevalence of HSV-2 infection was higher in those with asthma than in non-asthma participants. A positive association was found between HSV-2 infection and asthma [odds ratio (OR) = 1.15, 95% CI: 1.04–1.27]. Subgroup analysis showed that this positive association was more pronounced in participants who were male, White, 30 years ≤ age ≤ 40 years, body mass index (BMI) ≤ 28 kg/m2, 1.39 ≤ ratio of family income to poverty (PIR) < 3.49 and smokers.ConclusionThere was a positive association between HSV-2 infection and asthma, and participants who were male, White race, 30 years ≤ age < 40 years, BMI ≥ 28 kg/m2, 1.39 ≤ PIR < 3.49, and smokers should receive more attention.

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Section: Discussionsupporting

confidence: 88%

The association between Herpes simplex virus type 2 and asthma: A cross-sectional study from National Health and Nutrition Examination Survey 1999–2016

et al. 2022

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“…A descriptive summary of the ten (10) cases is provided in Table I, including each case's country's socio-epidemiological context along with the intervention(s) conducted in the country. The cases focused on improving the implementation of a range of clinical innovations (the evidence-based tool for which efficacy has already been firmly established).…”

Section: Descriptivementioning

confidence: 99%

Using the Implementation Research Logic Model as a Lens to View Experiences of Implementing HIV Prevention and Care Interventions with Adolescent Sexual Minority Men—A Global Perspective

et al. 2022

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Adolescents and sexual minority men (SMM) are high priority groups in the United Nations’ 2021 − 2016 goals for HIV prevention and viral load suppression. Interventions aimed at optimizing HIV prevention, testing and viral load suppression for adolescents must also attend to the intersectional realities influencing key sub-populations of SMM. Consequently, there is not a robust evidence-base to guide researchers and program partners on optimal approaches to implementing interventions with adolescent SMM. Using a multiple case study design, we integrated the Implementation Research Logic Model with components of the Consolidated Framework for Implementation Research and applied it as a framework for a comparative description of ten HIV related interventions implemented across five countries (Ghana, Kenya, Nigeria, Tanzania and United States). Using self-reported qualitative survey data of project principal investigators, we identified 17 of the most influential implementation determinants as well as a range of 17 strategies that were used in 90 instances to support intervention implementation. We highlight lessons learned in the implementation research process and provide recommendations for researchers considering future HIV implementation science studies with adolescent SMM.

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“…These findings remain deeply concerning as many of these young girls were still in school underscoring the need for expanding effective pregnancy and HIV prevention options to protect young girls from early pregnancy and HIV. The evaluation of the impact of school-based interventions on sexual risk behaviours and sexually transmitted infections among young adolescents found that for 14,426 secondary school learners who participated across nine RCTs in Zimbabwe, South Africa, Tanzania, Zambia, Liberia, Swaziland, and Uganda, declines were observed in the number of pregnancies and improvements in HIV/AIDS related knowledge, normative beliefs, knowledge and self-efficacy in condom use, positive attitudes to HIV testing, with a moderate decline in sexual debut and intimate partner violence but no long term effect on condom use, or curable STIs, HSV-2 and HIV infections [ 44 ]. With the high rate of attrition, it is possible that risk taking behaviours may increase among learners leaving school prematurely and enhancing risk for HIV acquisition, thus explaining the link between incomplete high school school and low knowledge of HIV status.…”

Section: Discussionmentioning

confidence: 99%

Viral suppression among pregnant adolescents and women living with HIV in rural KwaZulu-Natal, South Africa: a cross sectional study to assess progress towards UNAIDS indicators and Implications for HIV Epidemic Control

et al. 2022

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Background South Africa has made significant progress in scaling up antiretroviral therapy (ART) to achieve the aspirational goal of HIV epidemic control. The aim of this study was to determine the prevalence of HIV, assess progress towards each of the Joint United Nations Programme on HIV/AIDS (UNAIDS) indicators and determine factors associated with achieving viral suppression among pregnant adolescents and women living with HIV in rural KwaZulu-Natal, South Africa. Methods Pregnant adolescents and women, 12 years and older seeking antenatal care at six primary health care clinics were enrolled in a cross-sectional study. Following written informed consent, structured questionnaires were administered, and finger-prick blood samples were collected for HIV antibody testing and viral load measurement. Viral suppression was defined as HIV viral load of < 400 copies per mL. Results Between Dec 2016 and March 2017, among the 546 enrolled participants, data for 545 were analysed. The overall HIV prevalence was 40.2% [95% Confidence Interval (CI) 36.1–44.3]. Age-stratified prevalence increased from 22.1% (95% CI, 15.9–30.0) in the 14–19 year age group to 63.9% (95% CI, 55.1–71.9) among women ≥ 30 years (Χ2 trend P < 0.0001). Of the HIV positive participants, 84.5% (95% CI, 79.0–88.8) knew their HIV positive status, 98.3% (95% CI 95.1–99.4) who knew their status were on ART, and of those on ART, 95.9% (95% CI 91.8–98.0) were virally suppressed. Among all HIV-positives 90.8% (95% CI, 86.3–94.0) had achieved viral suppression, whilst those in the 14–19 year age group were least likely to be virally suppressed at 82.8% (95% CI 65.5–92.4) compared to those in the older age groups. Married women compared to those unmarried were more likely to have achieved viral suppression (PRR) of 1.11 (95% CI 1.05–1.18), P < 0.001. Conclusions The proportion of HIV positive pregnant women achieving viral suppression was encouraging though far short of the target towards achieving epidemic control. Importantly, adolescent pregnant women were less likely to know their HIV status and to achieve viral suppression, underscoring the public health implications of sustained risk of HIV transmission. Thus, greater effort and strong social support are essential to improve HIV knowledge of status and care continuum towards the goal to achieving HIV epidemic control. Plain language summary To “fast-track” the response to achieve HIV epidemic control and end the AIDS epidemic, the Joint United Nations Programme on HIV/AIDS (UNAIDS) set ambitious HIV testing and treatment targets for people living with HIV. Meeting these targets through scaling up testing for HIV, initiating and sustaining antiretroviral therapy (ART) to maintain viral suppression provides both therapeutic and preventive benefits with the potential to reduce HIV transmission. Viral suppression among pregnant adolescents and women living with HIV is crucial for the prevention of mother-to-child transmission of HIV including onward transmission to sexual partners. As a public health approach, in South Africa all pregnant women are offered routine HIV testing and immediate initiation of lifelong ART irrespective of CD4 cell count. It is, therefore, important to ascertain progress towards reaching the targets. The proportion of HIV positive pregnant adolescents and women achieving viral suppression was encouraging though far short of the target towards achieving epidemic control. Importantly, pregnant adolescents were less likely to know their HIV status and to achieve viral suppression, underscoring the public health implications of sustained risk of HIV transmission. Thus, greater effort and strong social support are essential to improve HIV knowledge of status and care continuum towards the goal to achieving HIV epidemic control.

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A Systematic Review of Randomized Controlled Trials of School Based Interventions on Sexual Risk Behaviors and Sexually Transmitted Infections Among Young Adolescents in Sub-Saharan Africa

Cited by 16 publications

References 97 publications

The association between Herpes simplex virus type 2 and asthma: A cross-sectional study from National Health and Nutrition Examination Survey 1999–2016

The association between Herpes simplex virus type 2 and asthma: A cross-sectional study from National Health and Nutrition Examination Survey 1999–2016

Using the Implementation Research Logic Model as a Lens to View Experiences of Implementing HIV Prevention and Care Interventions with Adolescent Sexual Minority Men—A Global Perspective

Viral suppression among pregnant adolescents and women living with HIV in rural KwaZulu-Natal, South Africa: a cross sectional study to assess progress towards UNAIDS indicators and Implications for HIV Epidemic Control

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