Safety-related moderators of a parent-based HIV prevention intervention in South Africa.

Abstract

Our study examined factors influencing the effectiveness of a parent-based HIV prevention intervention implemented in Cape Town, South Africa. Caregiver-youth dyads (N = 99) were randomized into intervention or control conditions and assessed longitudinally. The intervention improved a parenting skill associated with youth sexual risk, parent–child communication about sex and HIV. Analyses revealed that over time, intervention participants (female caregivers) who experienced recent intimate partner violence (IPV) or unsafe neighborhoods discussed fewer sex topics with their adolescent children than caregivers in safer neighborhoods or who did not report IPV. Participants with low or moderate decision-making power in their intimate relationships discussed more topics over time only if they received the intervention. The effectiveness of our intervention was challenged by female caregivers’ experience with IPV and unsafe neighborhoods, highlighting the importance of safety-related contextual factors when implementing behavioral interventions for women and young people in high-risk environments. Moderation effects did not occur for youth-reported communication outcomes. Implications for cross-cultural adaptations of parent-based HIV prevention interventions are discussed.

Gender and Power Dynamics of Social Relationships Shape Willingness to Participate in Biomedical HIV Prevention Research Among South African Adolescents and Young Adults

“…Conversations that occurred among women in this study highlighted that navigating behavioral control and monitoring by parents and caregivers was one important barrier to research participation as well as accessing health care generally. The gender differences in parental perceptions and barriers to participation were contrary to a previous study conducted in Tanzania indicating that men were much more likely to decline participation in HIV vaccine trials due to parental concern for young men's health (33,(35)(36)(37). Parental control and monitoring has been previously discussed as a common occurrence for young women growing up in sub-Saharan Africa, and an important determinant of sexual behavior among adolescents and young adults in sub-Saharan Africa (33,38,39).…”

“…Misconceptions about trials procedures or effects influenced both young men and women's decision to participate as well as their decisions to discuss their participation with others. Similar to previous research highlighting the reasons for declining to participate in an HIV vaccine trial (33,(35)(36)(37), participants discussed how perceptions of the trials in the community, including the belief that an HIV vaccine could give a participant HIV or false-positive HIV status, would be influential in their decision to participate (49,50). Thus, it is critical for young people to trust confidentiality processes and are provided with trusted, reliable, adequate and clear information about HIV vaccines and other biomedical modalities as well as both the benefits and potential side-effects from trial treatments.…”

“…Youth had to weigh the benefits, access to youthfriendly services and information against fears of potential sideeffects. Even after enrollment, previous studies have found that participants may drop-out due to fears about side effects (33,(35)(36)(37). Over the 12 months of follow-up in our cohort study, 95% of participants were retained in AYAZAZI.…”

Los contenidos de la formación parental y sus implicaciones en el comportamiento de los adolescentes: elementos desde una revisión

“…Entre los aspectos comunicativos abordados, están la resolución conjunta de problemas (Irvine et al, 2015;Romero et al, 2017;Sieving et al, 2016), la resolución interactiva de conflictos (Amaya et al, 2016;Hidalgo et al, 2014;Hidalgo et al, 2016;Rodríguez;Cruz, 2016;Tsang;Low, 2016), y el diálogo (Destin;Svoboda, 2017;Mejía;Ulph;Calam, 2016;Ramirez et al, 2012;Tarantino et al, 2014;Thomas;Parthasarathy;Bhugra, 2013), una práctica abordada por 32 de los 52 estudios, siendo la más incluida al desagregar los tópicos de crianza.…”

Violence Victimization and Parenting among Black South African Mothers

“…However, this relation was only significant for youthreported (but not parent-reported) parent-child communication. Secondly, in an examination of moderators of a family-based HIV prevention intervention, women's experience of IPV undermined the efficacy of the intervention (Tarantino et al, 2014). Specifically, women reporting past-year IPV did not maintain long-term benefits in parent-child communication about sex-the primary target of the intervention-compared to women who had not experienced recent IPV (Tarantino et al, 2014).…”