Intergenerational Interventions for People Living with HIV and Their Families: A Systematic Review

Han, Hae Ra; Floyd, Olivia; Kim, Kyounghae; Cudjoe, Joycelyn; Warren, Nicole; Seal, Stella; Sharps, Phyllis

doi:10.1007/s10461-018-2223-1

Cited by 10 publications

(10 citation statements)

References 48 publications

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“…Existing quantitative (23,(43)(44)(45)(46) and qualitative (47-49) studies on adolescent SRH needs in SSA, such as this one, demonstrate the gaps in young people's access to information and resources related to SRH, and provide the basis for the argument that sexuality education must be provided to younger adolescents. Importantly, these findings confirm research from the past decade, highlighting the magnitude of work that remains to be done to more effectively address the SRH needs of ALHIV (42,(50)(51)(52). Recent interventions highlight the importance of family engagement (29, 51, 53), peer-based approaches including peer support groups (8,52), and newer ways of engaging youth, such as mHealth (30,43,49,54).…”

Section: Discussionsupporting

confidence: 77%

“We Should Be Taught Self-Respect, Self-Confidence and Self-Love”: Youth Perspectives of Adult Influences on Their Sexuality and Relationships Among South African Adolescents Living With HIV

Bergam

Kuo

Atujuna

et al. 2022

Front. Reprod. Health

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IntroductionOf the 1.75 million adolescents aged 10–19 years living with HIV globally, 84% reside in sub-Saharan Africa. This problem is most acute in South Africa, where there are 720,000 adolescents living with HIV (ALHIV). ALHIV navigate the same challenges as other adolescents—such as puberty and first relationships—as well as challenges specific to their HIV-status—including stigma, disclosure, and concerns about HIV transmission. This dual burden calls for tailored sexual and reproductive health (SRH) programs. Here, we qualitatively explore the reflections of South African ALHIV on SRH education, communication, and discussion provided by adults in schools, clinics, and the home related to their unique SRH needs.MethodsThis paper reports on qualitative data from a mixed-methods study to inform interventions that meet the SRH needs of ALHIV. In-depth interviews (N = 20) were conducted with ALHIV recruited from two clinics in Cape Town, South Africa. Nine males and 11 females aged 16–19 participated in semi-structured in-depth interviews to discuss their sexual health as ALHIV. The interview guide explored 1) perceived SRH needs; 2) healthy living with HIV; 3) future goals; 4) intimate relationships; 5) psychosocial challenges; and 6) preferred interventions. Data were thematically applied to an iteratively-developed codebook and analyzed by the cross-cultural research team using NVivo 12.ResultsThese qualitative data reveal the pressing needs among ALHIV for open communication and accurate information about sexuality and HIV, given the risk to themselves and their partners as they enter intimate relationships. Three themes emerged from the data: 1) Intergenerational pressures coming from caregivers, clinicians, and teachers often stigmatize the sexual heath behaviors of ALHIV; 2) When present, open intergenerational communication can provide ALHIV with crucial information, resources, and social support that supports healthy decisions, and 3) ALHIV offer specific ideas about how adults can support their decision-making in the transition to adulthood.ConclusionsFindings highlight adolescents' recommendations for programs involving open communication, stigma-reduction around sexuality, and support from both peer and adult mentors. This study lays the foundation for strategies to improve intergenerational communication about sexual health to promote positive approaches to sexuality for ALHIV.

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Section: Discussionsupporting

confidence: 77%

“We Should Be Taught Self-Respect, Self-Confidence and Self-Love”: Youth Perspectives of Adult Influences on Their Sexuality and Relationships Among South African Adolescents Living With HIV

Bergam

Kuo

Atujuna

et al. 2022

Front. Reprod. Health

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“…The Cochrane Collaboration and the U.S. Institute of Medicine have endorsed that review teams must have content and methodological expertise (Bigendako & Syriani, 2018;Gøtzsche & Ioannidis, 2012;Institute of Medicine, 2011). A major strength of this study is that our contributors have undergone training in systematic review methodology and have published prior reviews (Cajita, Cajita, & Han, 2016;Han, Floyd, et al, 2018;. Additionally, most of the authors are clinicians with expertise in health promotion among populations with poor health literacy.…”

Section: Study Stregnthsmentioning

confidence: 99%

Empirically Tested Health Literacy Frameworks

Cudjoe¹,

Delva²,

Cajita³

et al. 2020

HLRP: Health Literacy Research and Practice

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Background: Health literacy is a significant determinant of health behaviors, but the pathways through which health literacy influences health behaviors are not completely clear nor consistent. The purpose of this systematic review is to critically appraise studies that have empirically tested the potential pathways linking health literacy to health behavior. Methods: We performed searches of the electronic databases PubMed, Embase, and CINAHL to identify studies that proposed a conceptual framework and empirically tested the proposed mechanism through which health literacy influences certain health behaviors. Twenty eligible studies were included for analysis. Key Results: The 20 studies addressed various health behaviors: chronic disease self-management (n = 8), medication adherence (n = 2), overall health status (n = 4), oral care (n = 1), cancer screening (n = 1), shared decision-making (n = 1), health information sharing (n = 1), physical activity and eating behaviors (n = 1), and emergency department visits (n = 1). Most studies were conducted in the United States (n = 13) and used a cross-sectional design (n = 15). The Short Test of Functional Health Literacy in Adults was commonly used to assess health literacy levels. Selection of variables and their operationalization were informed by a theoretical model in 12 studies. Age, gender, race/ethnicity, and insurance status were reported antecedents to health literacy. The most commonly tested mediators were self-efficacy (n = 8) and disease knowledge (n = 4). Fit indices reported in the studies ranged from acceptable to excellent. Discussion: Current evidence supports self-efficacy as a mediator between health literacy and health behavior. Further research is needed to identify how health literacy interplays with known psychosocial factors to inform people's use of preventive care services. Future studies should include more disadvantaged populations such as immigrants with high disease burden and those with low health literacy. Theory-based, empirically tested health literacy models can serve as the conceptual basis for developing effective health interventions to improve health behaviors and ultimately decrease the burden of disease in such vulnerable populations. [HLRP: Health Literacy Research and Practice. 2020;4(1):e21-e44.] Plain Language Summary: This review systemically compiles, and critically appraises 20 existing studies that test conceptual frameworks that propose potential pathways through which health literacy affects health behaviors. The findings from this review can help inform the development of health literacy-focused interventions to improve the health behaviors of populations with disease burdens.

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“…Long term consequences will also need to be monitored and longitudinal designs and rigorous developmentally-sensitive measurement is needed to inform the design of large-scale policies and programming for children, adolescents and youth ( 35 ). Importantly, a number of studies reported the need for intergenerational evidence, both on experiences and interventions on the mental health of children and their families ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

Addressing the Mental and Emotional Health Impacts of COVID-19 on Children and Adolescents: Lessons From HIV/AIDS

Banati

Idele²

2021

Front. Psychiatry

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The COVID-19 pandemic has led to lasting mental health and psychosocial consequences just as were experienced with the HIV epidemic. A rapid review of published systematic reviews on HIV/AIDS and mental health outcomes and responses among children and adolescents was used to identify lessons for the COVID-19 pandemic response. The review found that HIV/AIDS responses to promote mental health, prevent ill-health and treat mental health conditions included diverse interventions at the structural or national, community, household and individual levels. Some of these responses can be easily replicated, others require substantial adaptation, and some can inform development of new innovative offline and online responses to mitigate impact of COVID-19 on mental health of children and adolescents. Programs that mitigate economic impacts including child grants, income generating activities for caregivers, food distribution, health care vouchers, and other economic empowerment interventions can be replicated with minor adjustments. Helplines for vulnerable or abused children and shelters for victims of gender-based violence can be scaled up to respond to the COVID pandemic, with minimal adaptation to adhere to prevention of contagion. Mass media campaigns to combat stigma and discrimination were successfully employed in the HIV response, and similar interventions could be developed and applied in the COVID context. Some programs will need more substantial adjustments. In health facilities, mainstreaming child-sensitive mental health training of frontline workers and task sharing/shifting to community volunteers and social workers as was done for HIV with community health workers, could advance mental illness detection, particularly among abuse victims, but requires adaptation of protocols. At the community and household levels, expansion of parenting programs can help caregivers navigate negative mental health effects on children, however, these are not often operating at scale, nor well-linked to services. Programs requiring innovation include converting adolescent and youth safe physical spaces into virtual spaces particularly for at-risk girls and young women; organizing virtual community support groups, conversations, and developing online resources. Re-opening of schools and introduction of health and hygiene policies, provides another opportunity for innovation - to provide mental health and psychosocial support to all children as a standard package of care and practice.

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Intergenerational Interventions for People Living with HIV and Their Families: A Systematic Review

Cited by 10 publications

References 48 publications

“We Should Be Taught Self-Respect, Self-Confidence and Self-Love”: Youth Perspectives of Adult Influences on Their Sexuality and Relationships Among South African Adolescents Living With HIV

“We Should Be Taught Self-Respect, Self-Confidence and Self-Love”: Youth Perspectives of Adult Influences on Their Sexuality and Relationships Among South African Adolescents Living With HIV

Empirically Tested Health Literacy Frameworks

Addressing the Mental and Emotional Health Impacts of COVID-19 on Children and Adolescents: Lessons From HIV/AIDS

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