Association of Adolescent- and Parent-Reported Relationship Functioning with HIV Sexual Risk Among Adolescents in Botswana

Sun, Christina J.; Seloilwe, Esther; Magowe, Mabel; Dithole, Kefalotse; Lawrence, Janet S. St.

doi:10.1007/s10461-019-02429-4

Cited by 4 publications

(3 citation statements)

References 45 publications

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“…A study conducted in Botswana found that parents' inaccurate perception of their adolescent's sexual relationships was significantly associated with more risk-taking behaviours, emphasising the importance of parent-adolescent communication. 35 Our study only found a borderline significant association between self-management and consistent condom use; according to the IFSMT, higher levels of self-management is associated with better health behaviour. 7 Modelling in our study did not indicate a significant association between self-management and sexual behaviour.…”

Section: Discussioncontrasting

confidence: 77%

Adolescent human immunodeficiency virus self-management: Associations with treatment adherence, viral suppression, sexual risk behaviours and health-related quality of life

Crowley

Merwe

Kidd

et al. 2020

Southern African Journal of HIV Medicine

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BackgroundAdolescents living with HIV (ALHIV) represent a growing proportion of the global population of people living with HIV. In 2018, 1 600 000 adolescents [1 100 000; 2 300 000] between the ages of 10 and 19 years were living with HIV. That year, 190 000 were newly infected. 1 Sub-Saharan Africa (SSA) has the highest burden of HIV: 89% of the world's ALHIV reside in this region. Of South Africa's (SA) estimated 460 000 ALHIV, 52 000 new infections and 5 600 AIDS-related deaths were reported in 2018. 1 Adolescents living with HIV can be divided into two groups: perinatally infected adolescents who are diagnosed as infants or children; and behaviourally/horizontally infected adolescents who likely acquired HIV through sexual transmission. 2 One South African study reported 25.4% (n = 269) out of a sample of 1059 adolescents aged 10-19 years acquired HIV horizontally. 3 Perinatally infected adolescents are usually treatment-experienced and more likely to suffer from the chronic effects of HIV infection such as delayed growth and development. 4 Although the healthcare needs of perinatally and behaviourally infected adolescents may differ, shared healthcare concerns include medication non-adherence, risky sexual behaviour, psychosocial stressors and comorbid psychiatric illness. 2,5 Background: With the advent of access to antiretroviral treatment (ART), human immunodeficiency virus (HIV) has become a chronic disease and self-management is an important component of its care. Research to date has not explored associations between adolescent HIV self-management and treatment adherence, viral suppression, sexual risk behaviour and health-related quality of life (HRQoL).Objectives: To explore the associations between adolescent HIV self-management and treatment adherence, viral suppression, sexual risk behaviour and HRQoL. Methods:A quantitative cross-sectional study of 385 adolescents living with HIV (ALHIV) aged 13-18 years, who were recruited from 11 healthcare facilities between March and August 2017 in the Cape Metropole of the Western Cape, South Africa, provided the data that were examined in this self-completed questionnaire. Validated scales were used to measure key variables. The most recent viral load (VL) was obtained from the participants' clinic folder, taking into account that VL is done annually.Results: Adolescents who reported higher HIV self-management were more likely to be adherent to treatment (t = 4.435 [336], p < 0.01), virally suppressed (t = 2.376 [305], p = 0.02) and to practise consistent condom use (t = 1.947 [95], p = 0.54). Structural equation modelling (SEM) indicated a significant relationship between self-management and HRQoL (r = 0.43, p < 0.01), whilst non-adherent treatment taking behaviour, correlated with elevated VL log values. No significant correlation was found between self-management and sexual risk behaviour. Conclusion:Targeting adolescents' skills related to HIV self-management in the clinical setting may improve adolescents' treatment taking behaviour, viral suppression...

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Section: Discussioncontrasting

confidence: 77%

Adolescent human immunodeficiency virus self-management: Associations with treatment adherence, viral suppression, sexual risk behaviours and health-related quality of life

Crowley

Merwe

Kidd

et al. 2020

Southern African Journal of HIV Medicine

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“…Adolescent–parent relationship (APR), which includes open and truthful communication between adolescents and parents, a warm and affectionate relationship, parental support and guidance, and parental monitoring, remains a critical topic due to its role in adolescent development. Evidence suggests a desirable effect of APR on a wide range of outcomes such as better mental health (van Eijck et al, 2012), reduction in risky sexual behaviors (Sun et al, 2019), and healthy interpersonal relationships (Kaufman-Parks et al, 2018). Similarly, in Ghana, the quality of APR has been shown to be predictive of better mental health, psychosocial functioning, and school engagement among adolescents (Marbell & Grolnick, 2013; Marbell-Pierre et al, 2019).…”

mentioning

confidence: 99%

Direct and Indirect Associations of Food Insecurity, Adolescent–Parent Relationship, and Adolescent Future Orientation

Masa

Bates

Chowa

2020

Journal of Family Issues

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This cross-sectional study on Ghanaian adolescents examined the direct and indirect associations of food insecurity, parent–adolescent relationship, and adolescent future orientation. We used structural equation modeling to examine reliability and validity of our latent constructs and our hypothesized direct and indirect relationships. Results indicated adequate fit of our measurement and structural models with the data. Results also showed a significant direct and indirect effect of food insecurity. Food insecurity was directly associated with parental connection, orientation toward success, and uncertainty about the future. Food insecurity was also indirectly associated with orientation toward success and uncertainty about the future, via parental connection. Further, higher levels of parental connection were directly associated with higher levels of orientation toward success and with lower levels of uncertainty about the future. Understanding the direct and indirect effect of food insecurity is important for the design of appropriate interventions that promote holistic and positive adolescent development.

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“…Similar to other studies on the continent, youth also accused parents of failing to offer appropriate guidance, not only abandoning informational support to other sources like school teachers, but also offering inadequate material support to the young woman, leading her to seek support elsewhere [ 52 ]. A Botswana study also found parents’ misperceptions about their adolescent children’s relationships to be associated with higher risk activities on the part of the adolescents [ 53 ]. Although nothing guarantees that youth will listen to their parents, the accusation that they do not provide any guidance at all highlights the possibility that parents don’t have a ‘script’ of their own to provide their children.…”

Section: Discussionmentioning

confidence: 99%

Exploring HIV risk perception mechanisms among youth in a test-and-treat trial in Kenya and Uganda

Owino,

Johnson-Peretz,

Lee

et al. 2024

PLOS Glob Public Health

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Understanding risk perception and risk-taking among youth can inform targeted prevention efforts. Using a health beliefs model-informed framework, we analysed 8 semi-structured, gender-specific focus group discussions with 93 youth 15–24 years old (48% male, 52% female), drawn from the SEARCH trial in rural Kenya and Uganda in 2017–2018, coinciding with the widespread introduction of PrEP. Highly connected social networks and widespread uptake of antiretrovirals shaped youth HIV risk perception. Amid conflicting information about HIV prevention methods, youth felt exposed to multiple HIV risk factors like the high prevalence of HIV, belief that people with HIV(PWH) purposefully infect others, dislike of condoms, and doubts about PrEP efficacy. Young women also reported minimal sexual autonomy in the context of economic disadvantages, the ubiquity of intergenerational and transactional sex, and peer pressure from other women to have many boyfriends. Young men likewise reported vulnerability to intergenerational sex, but also adopted a sexual conquest mentality. Comprehensive sexuality education and economic empowerment, through credible and trusted sources, may moderate risk-taking. Messaging should leverage youth’s social networks to spread fact-based, gender- and age-appropriate information. PrEP should be offered alongside other reproductive health services to address both pregnancy concerns and reduce HIV risk.

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Association of Adolescent- and Parent-Reported Relationship Functioning with HIV Sexual Risk Among Adolescents in Botswana

Cited by 4 publications

References 45 publications

Adolescent human immunodeficiency virus self-management: Associations with treatment adherence, viral suppression, sexual risk behaviours and health-related quality of life

Adolescent human immunodeficiency virus self-management: Associations with treatment adherence, viral suppression, sexual risk behaviours and health-related quality of life

Direct and Indirect Associations of Food Insecurity, Adolescent–Parent Relationship, and Adolescent Future Orientation

Exploring HIV risk perception mechanisms among youth in a test-and-treat trial in Kenya and Uganda

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