Efficacy of a Culturally Adapted Intervention for Youth Living with HIV in Uganda

Lightfoot, Marguerita; Kasirye, Rogers; Comulada, W. Scott; Rotheram‐Borus, Mary Jane

doi:10.1007/s11121-007-0074-5

Cited by 34 publications

(35 citation statements)

References 9 publications

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“…The located studies evaluate all the categories of social protection: four programmes evaluated cash-only social protection, seven care-only interventions, while eleven reviewed combinations of social protection: four cash-plus-care, iii three care-plus-capability, two cash-plus-capability, and one of three categories of social protection: cash-plus-care-plus-capability. Seven studies of care-only interventions included HIV-positive children and adolescents: two pre-post pilot studies (Bhana et al, 2014; Snyder et al, 2014), two mixed methods studies (Lightfoot, Kasirye, Comulada, & Rotheram-Borus, 2007; Webster Mavhu et al, 2013), and three qualitative studies (Parker et al, 2013; Senyonyi, Underwood, Suarez, Musisi, & Grande, 2012; Willis et al, 2015). …”

Section: Resultsmentioning

confidence: 99%

Resourcing resilience: social protection for HIV prevention amongst children and adolescents in Eastern and Southern Africa

Toska

Gittings

Hodes

et al. 2016

African Journal of AIDS Research

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Adolescents are the only age group with growing AIDS-related morbidity and mortality in Eastern and Southern Africa, making HIV prevention research among this population an urgent priority. Structural deprivations are key drivers of adolescent HIV infection in this region. Biomedical interventions must be combined with behavioural and social interventions to alleviate the socio-structural determinants of HIV infection. There is growing evidence that social protection has the potential to reduce the risk of HIV infection among children and adolescents. This research combined expert consultations with a rigorous review of academic and policy literature on the effectiveness of social protection for HIV prevention among children and adolescents, including prevention for those already HIV-positive. The study had three goals: (i) assess the evidence on the effectiveness of social protection for HIV prevention, (ii) consider key challenges to implementing social protection programmes that promote HIV prevention, and (iii) identify critical research gaps in social protection and HIV prevention, in Eastern and Southern Africa. Causal pathways of inequality, poverty, gender and HIV risk require flexible and responsive social protection mechanisms. Results confirmed that HIV-inclusive child- and adolescent-sensitive social protection has the potential to interrupt risk pathways to HIV infection and foster resilience. In particular, empirical evidence (literature and expert feedback) detailed the effectiveness of combination social protection particularly cash/in-kind components combined with ‘care’ and ‘capability’ among children and adolescents. Social protection programmes should be dynamic and flexible, and take into account age, gender, HIV-related stigma, and context, including cultural norms, which offer opportunities to improve programmatic coverage, reach, and uptake. Effective HIV prevention also requires integrated social protection policies, developed through strong national government ownership and leadership. Future research should explore which combinations of social protection work for sub-groups of children and adolescents, particularly those living with HIV.

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Section: Resultsmentioning

confidence: 99%

Resourcing resilience: social protection for HIV prevention amongst children and adolescents in Eastern and Southern Africa

Toska

Gittings

Hodes

et al. 2016

African Journal of AIDS Research

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“…All four experimental design studies reported within-group change for at least one sexual behaviour over time, with three randomising participants to a control and an intervention group [41,42,78]. …”

Section: Resultsmentioning

confidence: 99%

“…Three of the included intervention studies were individual-level randomised controlled trials [41,42,78] (Table 5), with one pre- and post-test experimental design study [40]. All interventions measured at least one high-risk sexual practice, with all measuring condom use or unprotected sex, three measuring number of sexual partners, and one measuring transactional sex.…”

Section: Resultsmentioning

confidence: 99%

Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa

et al. 2017

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BackgroundEvidence on sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa is urgently needed. This systematic review synthesizes the extant research on prevalence, factors associated with, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa.MethodsStudies were located through electronic databases, grey literature, reference harvesting, and contact with researchers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Quantitative studies that reported on HIV-positive participants (10–24 year olds), included data on at least one of eight outcomes (early sexual debut, inconsistent condom use, older partner, transactional sex, multiple sexual partners, sex while intoxicated, sexually transmitted infections, and pregnancy), and were conducted in sub-Saharan Africa were included. Two authors piloted all processes, screened studies, extracted data independently, and resolved any discrepancies. Due to variance in reported rates and factors associated with sexual risk-taking, meta-analyses were not conducted.Results610 potentially relevant titles/abstracts resulted in the full text review of 251 records. Forty-two records (n = 35 studies) reported one or multiple sexual practices for 13,536 HIV-positive adolescents/youth from 13 sub-Saharan African countries. Seventeen cross-sectional studies reported on individual, relationship, family, structural, and HIV-related factors associated with sexual risk-taking. However, the majority of the findings were inconsistent across studies, and most studies scored <50% in the quality checklist. Living with a partner, living alone, gender-based violence, food insecurity, and employment were correlated with increased sexual risk-taking, while knowledge of own HIV-positive status and accessing HIV support groups were associated with reduced sexual risk-taking. Of the four intervention studies (three RCTs), three evaluated group-based interventions, and one evaluated an individual-focused combination intervention. Three of the interventions were effective at reducing sexual risk-taking, with one reporting no difference between the intervention and control groups.ConclusionSexual risk-taking among HIV-positive adolescents and youth is high, with inconclusive evidence on potential determinants. Few known studies test secondary HIV-prevention interventions for HIV-positive youth. Effective and feasible low-cost interventions to reduce risk are urgently needed for this group.

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“…Latino and African American), the relative efficacy of the intervention for different racial ethnic groups should be explored in addition to assessing the intervention with a larger sample of individuals from different cultures. Consideration of cross-cultural efficacy of HIV-prevention and risk-and stigma-reduction interventions is paramount not only for adaptation to other populations in the United States, but in a global context (Lightfoot, Kasirye, Comulada, & Rotheram-Borus, 2007). Improved capacity to measure and understand HIV-related stigma (USAID, 2006a(USAID, , 2006b) will need to be employed at a population level over time to understand the efficacy of efforts to reduce this and underlying stigmatizing attitudes (e.g.…”

Section: Discussionmentioning

confidence: 99%

Preventing human immunodeficiency virus (HIV) and other sexually transmitted infections and reducing HIV-stigmatizing attitudes in high-risk youth: Evaluation of a comprehensive community-based and peer-facilitated curriculum

Zuniga

Blanco

Sanchez³

et al. 2009

Vulnerable Children and Youth Studies

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2009) Preventing human immunodeficiency virus (HIV) and other sexually transmitted infections and reducing HIV-stigmatizing attitudes in high-risk youth: Evaluation of a comprehensive community-based and peer-facilitated curriculum, Vulnerable Children and Youth Comprehensive prevention programs for youth are needed to reduce transmission of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) and address HIV-stigmatizing attitudes effectively. We evaluated a behavioral riskreduction curriculum with high-risk youth in the United States. Participants in the fivesession course were recruited through a community-based agency in San Diego, California. Participants completed a demographic survey and pre-/post-test. Descriptive statistics and paired t-tests are provided for the 286 youth with complete pre-/posttests. Participants were 37% Latino, 21% non-Latino white, 17% African American, 25% > one ethnicity/other and mean age 16 years. Pre-/post-self-reports indicated significantly (p≤0.05) increased HIV/STI knowledge; ability to refuse sex without a condom; intention to use a condom with new partner; and decreased stigmatization of HIV-positive people. Significant improvements in knowledge and intention to practice safer sex were noted and HIV-related stigma was significantly decreased, indicating the curriculum's potential with ethnically diverse youth in other regions and global contexts.

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Efficacy of a Culturally Adapted Intervention for Youth Living with HIV in Uganda

Cited by 34 publications

References 9 publications

Resourcing resilience: social protection for HIV prevention amongst children and adolescents in Eastern and Southern Africa

Resourcing resilience: social protection for HIV prevention amongst children and adolescents in Eastern and Southern Africa

Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa

Preventing human immunodeficiency virus (HIV) and other sexually transmitted infections and reducing HIV-stigmatizing attitudes in high-risk youth: Evaluation of a comprehensive community-based and peer-facilitated curriculum

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