World Health Organization Guidance on Ethical Considerations in Planning and Reviewing Research Studies on Sexual and Reproductive Health in Adolescents

Singh, Jerome Amir; Siddiqi, M. Farooq; Parameshwar, Pooja S.; Chandra-Mouli, Venkatraman

doi:10.1016/j.jadohealth.2019.01.008

Cited by 64 publications

(41 citation statements)

References 5 publications

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“…Verbal consent was obtained from the head teachers of the six schools that participated in the study. Since this study involved minors, researchers upheld the value that children must be treated differently from adults as they are vulnerable and lack capacity to participate in research autonomously especially in studies that focus on their sexual and reproductive health [30]. Written consent was obtained from the adolescent female participants' parents/guardians.…”

Section: Supplementary Informationmentioning

confidence: 99%

“…The researchers assured participants that they were free to respond to questions in any way they felt like as no response was considered wrong, and that their responses would not be used against them in any way. This was done to mitigate the power imbalances between researchers and participants and to create a child-friendly atmosphere that facilitated freedom of expression for the participants [29,30]. Researchers maintained anonymity and confidentiality of participants throughout the study.…”

Section: Supplementary Informationmentioning

confidence: 99%

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Economic support, education and sexual decision making among female adolescents in Zambia: a qualitative study

Milimo¹,

Zulu

Svanemyr

et al. 2021

BMC Public Health

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Background The importance of educating female adolescents has been recognized as critical to the development of any country. However, in low income countries like Zambia they often drop out of school due to poverty, early pregnancy and early marriages. Some studies indicate that economic support such as Social Cash Transfers (SCTs) can mitigate the effects of poverty on female adolescents by improving their school participation and helping postpone pregnancy and marriage. This study aimed to explore the role of economic support in influencing education and sexual decision making among female adolescents in a randomised controlled trial in Zambia. Methods The study adopted a qualitative approach. It utilized purposive and convenient sampling. Data were collected from 6 schools using 18 in-depth interviews (IDIs) and 4 focus group discussions (FGDs) comprising 48 school-going female adolescents in grade 8 aged 14 to 17. All participants received economic support in form of SCTs and payment of school fees as part of the Research Initiative to Support the Empowerment of Girls (RISE), a Cluster Randomised Controlled Trial. Data were analyzed using thematic analysis. Results Findings suggested several benefits of the economic support for the female adolescents such as economic independence and empowerment; increased assertiveness and autonomy; reduced desire for sexual relationships with boys in exchange for cash and gifts; increased motivation for school; enhanced parental and community support for female adolescents’ education and; reduced school dropouts. However, they also experienced jealousy from those who did not benefit from the economic support. Conclusion Economic support played a significant role in influencing both educational and sexual decision making among female adolescents. Trial registration ISRCTN Registry: ISRCTN12727868, (4 March 2016).

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Section: Supplementary Informationmentioning

confidence: 99%

Section: Supplementary Informationmentioning

confidence: 99%

Economic support, education and sexual decision making among female adolescents in Zambia: a qualitative study

Milimo¹,

Zulu

Svanemyr

et al. 2021

BMC Public Health

View full text Add to dashboard Cite

show abstract

“…Structural barriers related to ethical and legal challenges, it should be noted, often stand in the way of rigorous research with adolescents, especially on sensitive topics such as sexual and reproductive health [20]. Given this, the lack of evidence on HIV PN services among AGYW is not surprising.…”

Section: Is Hiv Index Testing and Partner Notification Safe For Agyw?mentioning

confidence: 99%

Is HIV index testing and partner notification safe for adolescent girls and young women in low‐ and middle‐income countries?

et al. 2020

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Introduction While HIV index testing and partner notification (PN) services have the potential to reach adolescent girls and young women (AGYW) aged 15 to 24 and their sexual partners in need of HIV testing services, the potential social harms have not yet been studied. This commentary highlights the risks of this approach, including intimate partner violence (IPV), stigma and discrimination, and outlines an urgent research agenda to fully understand the potential harms of PN for AGYW, calling for the development of mitigation strategies. Discussion A substantial evidence base exists demonstrating the feasibility, acceptability and effectiveness of index testing and partner notification for adults aged 18 years and older in low‐ and middle‐income countries (LMICs), particularly for men, and for adults who are married/cohabiting and referring a current sexual partner. AGYW who are most vulnerable to HIV infection in LMICs do not reflect these demographics. Instead, they are often in age‐disparate partnerships, have limited negotiating power within relationships, experience high rates of violence and face economic challenges that necessitate transactional sex. PN services may be particularly difficult for adolescent girls under 18 who face restrictions on their decision making and are at increased risk of rape. Adolescent girls may also face coercion to notify partners due to unequal power dynamics in the provider–adolescent client relationship, as well as judgemental attitudes towards adolescent sexual activity among providers. Conclusions As index testing and PN with AGYW is already being rolled out in some LMICs, research is urgently needed to assess its feasibility and acceptability. Implementation science studies should assess the availability, accessibility, acceptability and quality of HIV PN services for AGYW. Qualitative studies and routine monitoring with age‐disaggregated data are critical to capture potential social harms, PN preferences and support needs for AGYW aged 15 to 17, 18 to 20 and 21 to 24. To mitigate potential harms, PN methods should prioritize confidentiality and avoidance of adverse outcomes. Healthcare providers should be trained to conduct routine enquiry for IPV and provide first‐line support. Support services for AGYW living with HIV and survivors of violence should be implemented alongside HIV PN.

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“…The recruitment and retention of adolescent couples is even more challenging given that these relationships can often be short-lived and also warrant special protection considerations. For example, research involving minors (individuals 17 years and under) requires consideration of parental consent, protection of minor's privacy regarding sexual activity and romantic relationship involvement, minors' capacity to consent to research participation, and adolescents' ability to consent to receipt of SRH services without parental permission [15][16][17]. SRH research that includes adolescent couples also warrants attention to local laws regarding age of sexual consent and mandated reporting of abuse [18,19].…”

Section: Introductionmentioning

confidence: 99%

Methodological strategies to engage young black and Latino heterosexual couples in sexual and reproductive health research

Lanier

Campo

Lavarin

et al. 2020

BMC Health Serv Res

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Background: Approaches that move beyond individuals and target couples may be an effective strategy for reducing sexual and reproductive health (SRH) disparities among adolescents and young adults (AYA). However, few researchers have attempted to recruit couples due to feasibility and methodological issues. This study aims to enhance implementation and methodological approaches to successfully engage heterosexual Black and Latino adolescent and young adult (AYA) couples in sexual reproductive health (SRH) research. Methods: We developed a four-step approach to systematically engage AYA couples in a qualitative study examining factors that influence uptake of combination HIV prevention methods: 1) understanding barriers and facilitators to engaging AYA couples, (2) identifying AYAs living in geographic areas of HIV vulnerability, (3) recruiting and screening AYA couples, and (4) scheduling and completion of the interview session. Results: Black and Latino youth aged 16 to 24 and their opposite sex romantic were recruited in the South Bronx, New York from September 2017-May 2018. Three hundred and seventy-two men and women completed screening procedures to determine eligibility for the index participant; 125 were eligible and enrolled into the study. Forty-nine nominated partners (NPs) participated in screening procedures and enrolled into the study. A total of 49 couples enrolled into the study; 23 couples completed study activities. Conclusions: Developing a systematic recruitment plan aided in successfully engaging Black and Latino heterosexual youth. Nevertheless, barriers to study enrollment remained including locating eligible IPs and screening of the NP. Targeting both young men and women was an effective recruitment strategy. Moreover, dyadic strategies that allow for simultaneous interaction with both couple members may be a beneficial strategy to couples' study enrollment and completion of study activities.

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World Health Organization Guidance on Ethical Considerations in Planning and Reviewing Research Studies on Sexual and Reproductive Health in Adolescents

Cited by 64 publications

References 5 publications

Economic support, education and sexual decision making among female adolescents in Zambia: a qualitative study

Economic support, education and sexual decision making among female adolescents in Zambia: a qualitative study

Is HIV index testing and partner notification safe for adolescent girls and young women in low‐ and middle‐income countries?

Methodological strategies to engage young black and Latino heterosexual couples in sexual and reproductive health research

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