Implementation Science for the Prevention and Treatment of HIV among Adolescents and Young Adults in Sub-Saharan Africa: A Scoping Review

Vorkoper, Susan; Tahlil, Kadija M; Sam-Agudu, Nadia A.; Tucker, Joseph D.; Livinski, Alicia A.; Fernando, Frances; Sturke, Rachel

doi:10.1007/s10461-022-03770-x

Cited by 8 publications

(5 citation statements)

References 67 publications

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“…The results and analysis are extremely useful for identifying, selecting and developing highly relevant implementation strategies to minimize barriers and enhance facilitators across multiple social-ecological levels. In addressing the determinants (barriers and facilitators) of successful implementation, implementation strategies facilitate desired implementation outcomes, which, for AY-targeted LA ART, would include Acceptability among AY and other key stakeholders, Uptake among AY, Adoption by healthcare systems and providers, Feasibility, Fidelity, Costs, and Sustainment/Sustainability [45, 46].…”

Section: Discussionmentioning

confidence: 99%

Barriers and Facilitators to Equitable Implementation of Long-Acting ART for Adolescents and Youth with HIV in Low- and Middle-Income Settings

Sam-Agudu,

Adirieje,

Agwu

et al. 2023

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Recent approvals of long-acting (LA) antiretroviral treatment (ART) support an innovative alternative to daily oral pills that can improve adherence and treatment outcomes among adolescents and youth (AY) with HIV. We solicited stakeholder feedback on the implementation of LA ART for AY in low-and middle-income countries (LMICs) through a consensus-building forum at the 2022 International Workshop on HIV and Adolescence.We used the nominal group technique to generate, record, discuss, vote on, and rank perceived barriers and facilitators to implementing LA ART for AY. All in-person attendees were invited to participate and were assigned to six groups, each representing an intentional mix of AY, clinicians, researchers, program implementers and policymakers. We collected self-reported de-identified demographics and group rankings of barriers and facilitators. Responses were coded and categorized using the social-ecological model’s five levels of influence.137 Workshop delegates (67.9% male, 27.7% female; 0.7% non-binary and 46.7% less than 35 years old) participated in the group discussions. A large proportion of participants (51.9%) reported working in public health/program implementation. Most participants (88.4%) were from and/or worked in the African region. We identified 55 barriers and 48 facilitators of LA ART implementation and ranked them in social-ecological model categories of public policy, community, institutional/organizational, interpersonal, and individual levels. The highest number of ranked barriers was at the institutional/organizational level. The themes of “equitable access” and “choices of ART” were cross-cutting across individual and interpersonal levels. Other cross-cutting themes were “cost of LA ART” and “need for funding and sustainability of LA ART programs”. Proposed facilitators addressed identified barriers at each social-ecological level of influence and emphasized peer engagement.Our nominal groups identified key barriers and proposed facilitators at five different social ecological levels, which can inform implementation science-guided design and equitable implementation of youth centered LA ART in LMICs and globally.

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Section: Discussionmentioning

confidence: 99%

Barriers and Facilitators to Equitable Implementation of Long-Acting ART for Adolescents and Youth with HIV in Low- and Middle-Income Settings

Sam-Agudu,

Adirieje,

Agwu

et al. 2023

Preprint

Self Cite

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Section: Discussionmentioning

confidence: 99%

‘A spade was called a spade...it was not called a garden tool...’: Youth and intervention implementers’ perceptions of a resilience-based HIV prevention intervention for reducing risky sexual behaviors among youth in South Africa

Mbengo

Adama

Towell-Barnard

et al. 2022

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Background: Youth (15-24 years) in South Africa remain at high risk of HIV infection despite interventional efforts to control the disease. Programs directed at promoting resilience or protective factors in youth have been recommended as a multifaceted approach to mitigate risky sexual behaviors associated with HIV infection among youth. However, limited research exists on how relevant stakeholders, such as youth and intervention implementers perceive resilience-based HIV prevention interventions targeting youth. Views of all relevant stakeholders, including youth and intervention implementers is important to guide future research, intervention design and implementation. This study explored youth and intervention implementers’ perceptions of a resilience-based HIV prevention intervention (You Only Live Once) aimed at reducing risky sexual behaviors among youth in South Africa. Methods: Semi-structured interviews were conducted with 10 youth who participated in the intervention and four intervention implementers at a not-for-profit organization in Maluti-a-Phofung Local Municipality, South Africa. Data were analyzed using thematic analysis. Results: Three main themes emerged from the data: (1) Acceptability and impact of the intervention – the intervention was perceived as important and helpful in fostering positive behavior change among youth and enhancing their sexual health and social skills knowledge; self-confidence; and relationships with parents and peers. (2) Factors influencing intervention implementation – participants reported several multi-level factors which impeded or promoted the implementation of the intervention. (3) Recommendations to improve intervention implementation – participants made suggestions on how intervention implementation could be enhanced. Conclusion: These findings suggest that resilience-based HIV prevention interventions are acceptable to young people in South Africa and have potential to mitigate their vulnerability to HIV. Findings also suggest that several multi-level factors influence implementation of resilience-based HIV prevention interventions for young people. The study contributes to knowledge on the acceptability, impact and barriers and facilitators to implementation of resilience-based HIV prevention interventions targeting youth in South Africa and similar contexts. Approaches to improve future interventions should remove barriers and strengthen facilitators at intervention, intervention recipient, intervention implementer, implementing organization and external context levels to promote successful implementation.

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“…Increasing the accessibility of the intervention to youth by extending its delivery to social media platforms, communities, schools, clinics and churches was one of the recommendations made. Research shows that use of social media has increased signi cantly among young people in Sub-Saharan Africa [57,58]. This highlights the importance of incorporating social media in the design, implementation and evaluation of interventions targeting youth to increase the accessibility of the intervention to the youth.…”

Section: Discussionmentioning

confidence: 99%

'A spade was called a spade...it was not called a gardening tool...': Youth and intervention implementers' perceptions of a resilience-based HIV prevention intervention for reducing risky sexual behaviors among youth in South Africa

Mbengo

Adama

Towell-Barnard

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: Youth (15-24 years) in South Africa remain at high risk of HIV infection despite interventional efforts to control the disease. Programs directed at promoting resilience or protective factors in youth have been recommended as a multifaceted approach to mitigate risky sexual behaviors associated with HIV infection among youth. However, limited research exists on how relevant stakeholders, such as youth and intervention implementers perceive resilience-based HIV prevention interventions targeting youth. This study explored youth and intervention implementers’ perceptions of a resilience-based HIV prevention intervention (You Only Live Once) aimed at reducing risky sexual behaviors among youth in South Africa. Methods: Semi-structured interviews were conducted with 10 youth who participated in the intervention and four intervention implementers at a not-for-profit organization in Maluti-a-Phofung Local Municipality, South Africa. Data were analyzed using thematic analysis. Results: Three main themes emerged from the data: (1) Acceptability and impact of the intervention– the intervention was perceived as important and helpful in fostering positive behavior change among youth and enhancing their sexual health and social skills knowledge; self-confidence; and relationships with parents and peers. (2) Factors influencing intervention implementation – participants reported several multi-level factors which impeded or promoted the implementation of the intervention. (3) Recommendations to improve intervention implementation – participants made suggestions on how intervention implementation could be enhanced. Conclusion: These findings suggest that resilience-based HIV prevention interventions are acceptable to young people in South Africa and have potential to mitigate their vulnerability to HIV. Implementation of resilience-based HIV prevention interventions targeting youth is linked to several multi-level factors that need to be considered for successful implementation.

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Implementation Science for the Prevention and Treatment of HIV among Adolescents and Young Adults in Sub-Saharan Africa: A Scoping Review

Cited by 8 publications

References 67 publications

Barriers and Facilitators to Equitable Implementation of Long-Acting ART for Adolescents and Youth with HIV in Low- and Middle-Income Settings

Barriers and Facilitators to Equitable Implementation of Long-Acting ART for Adolescents and Youth with HIV in Low- and Middle-Income Settings

‘A spade was called a spade...it was not called a garden tool...’: Youth and intervention implementers’ perceptions of a resilience-based HIV prevention intervention for reducing risky sexual behaviors among youth in South Africa

'A spade was called a spade...it was not called a gardening tool...': Youth and intervention implementers' perceptions of a resilience-based HIV prevention intervention for reducing risky sexual behaviors among youth in South Africa

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