Sexual Risk Reduction Interventions for HIV Prevention among South AfricanYouth: A Meta-Analytic Review

Scott-Sheldon, Lori A. J.; Walstrom, Paige; Harrison, Abigail; Kalichman, Seth C.; Carey, Michael P.

doi:10.2174/1570162x12666140129105726

Cited by 46 publications

(57 citation statements)

References 61 publications

(63 reference statements)

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“…However, they are not consistent with the findings of a meta-analysis of South African sexual risk reduction interventions among adolescents and youth, which found the interventions delayed sexual intercourse, increased condom use and reduced the number of sex partners [19]. The meta analysis suggested that features of interventions successful at delaying sexual intercourse and increasing condom use relative to the control condition were a focus on social norms, condom skills, gender inequalities and alcohol [19]. (All these factors were addressed in PREPARE).…”

Section: Discussionmentioning

confidence: 66%

“…For example, the PREPARE programme did not include interventions to ensure adolescents had safe, supportive homes, secure livelihoods, and social protection, factors important for adolescent sexual and reproductive health [1, 20]. However, these structural barriers to safe sexual behaviours apply to the other South African settings in which effective sexual risk reduction interventions have been demonstrated [19]. …”

Section: Discussionmentioning

confidence: 99%

“…Further evidence in support of this explanation comes from a meta-analysis of the effects of South African sexual risk reduction interventions. It found that interventions were successful in delaying sexual intercourse and increasing condom use among youth when they used more facilitators to deliver the intervention and participants received a higher “dose” [19]. The most efficient way to ensure young adolescents have adequate exposure to HIV risk reduction interventions is to embed such interventions in the school curriculum.…”

Section: Discussionmentioning

confidence: 99%

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Effects of PREPARE, a Multi-component, School-Based HIV and Intimate Partner Violence (IPV) Prevention Programme on Adolescent Sexual Risk Behaviour and IPV: Cluster Randomised Controlled Trial

et al. 2016

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Young South Africans, especially women, are at high risk of HIV. We evaluated the effects of PREPARE, a multi-component, school-based HIV prevention intervention to delay sexual debut, increase condom use and decrease intimate partner violence (IPV) among young adolescents. We conducted a cluster RCT among Grade eights in 42 high schools. The intervention comprised education sessions, a school health service and a school sexual violence prevention programme. Participants completed questionnaires at baseline, 6 and 12 months. Regression was undertaken to provide ORs or coefficients adjusted for clustering. Of 6244 sampled adolescents, 55.3 % participated. At 12 months there were no differences between intervention and control arms in sexual risk behaviours. Participants in the intervention arm were less likely to report IPV victimisation (35.1 vs. 40.9 %; OR 0.77, 95 % CI 0.61–0.99; t(40) = 2.14) suggesting the intervention shaped intimate partnerships into safer ones, potentially lowering the risk for HIV.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effects of PREPARE, a Multi-component, School-Based HIV and Intimate Partner Violence (IPV) Prevention Programme on Adolescent Sexual Risk Behaviour and IPV: Cluster Randomised Controlled Trial

et al. 2016

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“…Intervention programs with a focus on delaying sexual debut among adolescents, which have targeted both girls and boys, have had mixed findings in their effectiveness (Mathews et al, 2012; O’Leary et al, 2012; Tibbits, Smith, Caldwell, & Flisher, 2011). However, studies examining sex differences in delayed sexual debut after interventions found no statistically significant differences for men and women (O’Leary et al, 2012; Scott-Sheldon, Walstrom, Harrison, Kalichman, & Carey, 2013). The findings from the current study suggest that sexual health education programs geared toward delaying sexual debut among children and adolescents should consider addressing ACEs such as neglect, physical/psychological abuse, sexual abuse, witnessing parental violence and incarceration and/or mental illness of parents/guardians.…”

Section: Discussionmentioning

confidence: 99%

Sex and sexual orientation disparities in adverse childhood experiences and early age at sexual debut in the United States: Results from a nationally representative sample

Brown

Masho

Perera

et al. 2015

Child Abuse & Neglect

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Adverse childhood experiences (ACEs) have been linked to early sexual debut, which has been found to be associated with multiple adverse health outcomes. Sexual minorities and men tend to have earlier sexual debut compared to heterosexual populations and women, respectively. However, studies examining the association between ACEs and early sexual debut among men and sexual minorities are lacking. The aim of this study was to examine the sex and sexual orientation disparities in the association between ACEs and age at sexual debut. Data were obtained from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic and linear regression model were used to obtain crude and adjusted estimates and 95% confidence intervals adjusting for age, race/ethnicity, income, education, insurance and marital status for the association between ACEs (neglect, physical/psychological abuse, sexual abuse, parental violence, and parental incarceration and psychopathology) and early sexual debut. Analyses were stratified by sex and sexual orientation. Larger effect estimates depicting the association between ACEs and sexual debut were seen for women compared to men, and among sexual minorities, particularly among men who have sex with men (MSM) and women who have sex with women (WSW), compared to heterosexuals. Sexual health education programs with a focus on delaying sexual debut among children and adolescents should also consider addressing ACEs, such as neglect, physical, psychological and sexual abuse, witnessing parental violence, and parental incarceration and psychopathology. Public health practitioners, researchers and sexual health education curriculum coordinators should consider these differences by sex and sexual orientation when designing these programs.

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“…According to a meta-analysis by Sheeran et al [23] of 121 condom use studies, knowledge and risk perception have only small correlations with condom use (weighted r < 0.10). More recent studies in sub-Saharan Africa corroborate this and were unable to find strong associations between risk perception and behaviour or intentions [21, 24–26]. These findings are unexpected, since theories such as the Health Belief Model and Protection-Motivation theory, assume that risk perception is directly associated with intentions or behaviour [9, 27].…”

Section: Introductionmentioning

confidence: 99%

Predicting Primary and Secondary Abstinence Among Adolescent Boys and Girls in the Western Cape, South Africa

et al. 2016

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Two of the most effective health behaviours with regard to HIV prevention are condom use and sexual abstinence. While determinants of condom use among sub-Saharan African adolescents have been studied extensively, factors related to abstinence have received far less attention. This study identified socio-cognitive determinants of primary and secondary abstinence intentions and of early sexual activity. This study also assessed whether these factors had a direct or indirect association with intentions to abstain from sex. A longitudinal design was used in which 1670 students (age 12–16) of non-private South African high schools filled in a questionnaire, with a follow-up after 6 months, concerning sexual abstinence, attitudes, social norms, self-efficacy, risk perception and knowledge. Logistic and linear regression analysis with latent factors was used to assess determinants of intentions and abstinence, and structural equation modelling was used to assess indirect effects. Results showed that among sexually inactive students, social norms predicted the intention to abstain from sex in the next 6 months. Among sexually active students, reporting less disadvantages of abstinence predicted the intention to abstain. Sexual activity at follow-up was predicted by attitudes and intention among sexually inactive girls, and by knowledge among sexually inactive boys. No predictors were found for sexually active adolescents. Structural equation modelling further showed that risk perception was indirectly related to intentions to abstain from sexual intercourse. We conclude that addressing socio-cognitive factors in order to motivate adolescents to delay sex is more likely to be successful before they experience sexual debut. In addition, this study shows that the effect of increasing risk perceptions, a strategy often applied by parents and HIV prevention programmes, is to a large extent mediated by more proximal cognitive factors such as attitude. Research is needed to identify factors that influence the execution of intentions to abstain from sex.

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Sexual Risk Reduction Interventions for HIV Prevention among South AfricanYouth: A Meta-Analytic Review

Cited by 46 publications

References 61 publications

Effects of PREPARE, a Multi-component, School-Based HIV and Intimate Partner Violence (IPV) Prevention Programme on Adolescent Sexual Risk Behaviour and IPV: Cluster Randomised Controlled Trial

Effects of PREPARE, a Multi-component, School-Based HIV and Intimate Partner Violence (IPV) Prevention Programme on Adolescent Sexual Risk Behaviour and IPV: Cluster Randomised Controlled Trial

Sex and sexual orientation disparities in adverse childhood experiences and early age at sexual debut in the United States: Results from a nationally representative sample

Predicting Primary and Secondary Abstinence Among Adolescent Boys and Girls in the Western Cape, South Africa

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