HIV Prevention Interventions for Adolescents

Hosek, Sybil; Pettifor, Audrey

doi:10.1007/s11904-019-00431-y

Cited by 80 publications

(71 citation statements)

References 76 publications

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“…These young people need skills-based programs offered through in- or out-of-school settings to help them avoid the risks of HIV, STI, and unintended pregnancies. The literature suggests that implementation of school-based lessons may not be enough; programs may need to also include access to HIV counseling and testing services in a youth-friendly manner, address gender norms and intimate partner violence, and address structural drivers that affect sexual and reproductive health behaviors and outcomes [ 16 , 36 , 37 ]. As part of this study, we attempted to partner with local-level HIV implementation partners to incorporate HIV counseling and testing services in study schools as a follow-up activity to the dried blood spot data collection.…”

Section: Discussionmentioning

confidence: 99%

Impact evaluation of scripted lesson plans for HIV-related content in a life orientation curriculum: results from two provinces in South Africa

et al. 2020

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Background Young people under age 25 years are a key population at risk of unintended pregnancies, HIV and other sexually transmitted infections. School-based programming, focusing on youth under 17 years is strategic given that many in this age group are in school or are required to be in school and spend a considerable amount of their time at school. Prior evaluations of school-based HIV prevention programs for young people often employed weak study designs or lacked biomarkers (e.g., HIV or STI testing) to inform outcomes. Methods This study used longitudinal data collected in 2016 from a cohort of grade-8 girls from Mpumalanga and KwaZulu-Natal Provinces in South Africa. We followed them for 2 years to examine the impact of the South African Department of Basic Education’s revised scripted lesson plans for the HIV and sexual content of a “life orientation” curriculum on knowledge, attitudes, condom use behaviors, pregnancy incidence, and genital herpes incidence. Schools were randomized to intervention and control arms. Multivariable analyses were undertaken using hazard modeling for incidence-based outcomes (genital herpes and pregnancy) and generalized linear latent and mixed modeling for outcomes measured at each time period (knowledge, attitudes, and condom use). Results At end line, 105 schools were included from the two provinces (44 from Mpumalanga and 61 from KwaZulu-Natal). Fifty-five were intervention and fifty were control schools. A total of 2802 girls were surveyed at both time periods (1477 intervention and 1325 control). At baseline, participating girls were about 13.6 years; by end line, they were about 2 years older. Longitudinal data demonstrated few differences between intervention and control groups on knowledge, attitudes, condom use, genital herpes, and pregnancy experience. Monitoring data demonstrated that the program was not implemented as intended. Our results demonstrated 7% incidence of genital herpes in the two-year follow-up period indicating sexual risk-taking among our cohort. Conclusions We did not find significant effects of the revised life orientation curriculum on key outcomes; however, this may reflect poor implementation. Future HIV prevention programs for young people need to be implemented with fidelity to ensure they meet the crucial needs of the next generation. Trial Registration: This study has been registered at ClinicalTrials.gov. The trial registration number is: NCT04205721. The trial was retrospectively registered on December 18, 2019.

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Section: Discussionmentioning

confidence: 99%

Impact evaluation of scripted lesson plans for HIV-related content in a life orientation curriculum: results from two provinces in South Africa

et al. 2020

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“…This result is particularly important because of the high rate of new infections among this age group [ 24 ] and the broad opportunity for implementing HIV prevention strategies during this critical period in life. Addressing adolescents’ lack of HIV testing to improve treatment and prevention requires an increase in community-based approaches to testing, youth friendly services, integrating HIV testing with other health services, such as reproductive health services, and building differentiated service models amongst others [ 25 , 26 ]. Additionally, a plethora of evidence suggests that school-based sex education interventions is linked with a sound HIV knowledge which is put into practice among adolescents and youths [ 14 , 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Covariates and Spatial Interpolation of HIV Screening in Mozambique: Insight from the 2015 AIDS Indicator Survey

Agbadi

Nutor²,

Darkwah

et al. 2020

IJERPH

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We examined the factors associated with human immunodeficiency virus (HIV) screening and developed a HIV screening prevalence surface map using spatial interpolation techniques to identify the geographical areas with the highest and lowest rates of HIV screening in Mozambique. We analyzed the cross-sectional 2015 Mozambique AIDS Indicator Surveys with an analytic sample of 12,995 participants. Analyses were conducted on SPSS-21, STATA-14, and R freeware 3.5.3. We adjusted for the sample design and population weights. Results indicated that 52.5% of Mozambicans had undergone HIV screening. Mozambicans with these characteristics have a higher probability of undergoing HIV screening: females, those with a primary education or higher, urban dwellers, residents of wealthy households, having at least one lifetime sexual partner, and dwelling in these provinces—Niassa, Tete, Manica, Sofala, Inhambane, Gaza, Maputo Provincia, and Maputo Cidade. The spatial map revealed that the national and regional estimates mask sub-regional level estimates. Generally, zones with the highest HIV screening prevalence are found in southern provinces while the lowest prevalence was found in the northern provinces. The map further revealed intraregional differences in HIV screening estimates. We recommend that HIV screening be expanded, with equitable screening resource allocations that target more nuanced areas within provinces which have a low HIV screening prevalence.

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“…As exemplified by the DREAMS programme , PrEP increasingly forms part of the expanding portfolio of interventions being made available to AGYW in sub‐Saharan Africa to prevent HIV acquisition . The DREAMS programme represents a breakthrough in HIV prevention in sub‐Saharan Africa, by laudably availing layers of quality and evidence‐informed interventions, covering biomedical, structural and behavioural initiatives.…”

Section: Discussionmentioning

confidence: 99%

Facilitating engagement with PrEP and other HIV prevention technologies through practice‐based combination prevention

Skovdal

2019

J Intern AIDS Soc

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Introduction Recent years have witnessed a rapid expansion of efficacious biomedical HIV prevention technologies. Promising as they may be, they are largely delivered through standard, clinic‐based models, often in isolation from structural and behavioural interventions. This contributes to varied, and often poor, uptake and adherence. There is a critical need to develop analytical tools that can advance our understandings and responses to the combination of interventions that affect engagement with HIV prevention technologies. This commentary makes a call for practice‐based combination HIV prevention analysis and action, and presents a tool to facilitate this challenging but crucial endeavour. Discussion Models and frameworks for combination HIV prevention already exist, but the process of identifying precisely what multi‐level factors that need to be considered as part of a combination of HIV interventions for particular populations and settings is unclear. Drawing on contemporary social practice theory, this paper develops a “table of questioning” to help interrogate the chain and combination of multi‐level factors that shape engagement with HIV prevention technologies. The tool also supports an examination of other shared social practices, which at different levels, and in different ways, affect engagement with HIV prevention technologies. It facilitates an analysis of the range of factors and social practices that need to be synchronized in order to establish engagement with HIV prevention technologies as a possible and desirable thing to do. Such analysis can help uncover local hitherto un‐identified issues and provide a platform for novel synergistic approaches for action that are not otherwise obvious. The tool is discussed in relation to PrEP among adolescent girls and young women in sub‐Saharan Africa. Conclusions By treating engagement with HIV prevention technologies as a social practice and site of analysis and public health action, HIV prevention service planners and evaluators can identify and respond to the combination of factors and social practices that interact to form the context that supports or prohibits engagement with HIV prevention technologies for particular populations.

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HIV Prevention Interventions for Adolescents

Cited by 80 publications

References 76 publications

Impact evaluation of scripted lesson plans for HIV-related content in a life orientation curriculum: results from two provinces in South Africa

Impact evaluation of scripted lesson plans for HIV-related content in a life orientation curriculum: results from two provinces in South Africa

Covariates and Spatial Interpolation of HIV Screening in Mozambique: Insight from the 2015 AIDS Indicator Survey

Facilitating engagement with PrEP and other HIV prevention technologies through practice‐based combination prevention

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