“In this place we have found sisterhood”: perceptions of how participating in a peer-group club intervention benefited South African adolescent girls and young women

Duby, Zoe; Verwoerd, Wilmé; Appollis, Tracy McClinton; Jonas, Kim; Maruping, Kealeboga; Dietrich, Janan; LoVette, Ashleigh; Kuo, Caroline; Vanleeuw, Lieve; Mathews, Catherine

doi:10.1080/02673843.2021.1898423

Cited by 7 publications

(10 citation statements)

References 42 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: 78%

“…With the help of supportive adults who have helped to shape their self-image, some ALHIV felt confident in their ability to make healthy choices around relationships and sexual activity—whether through delaying sexual activity until ready for relationships, or through safer sex and relationship practices. The school and the clinic are crucial mechanisms for the encouragement of sex-positive, well informed, and healthy lifestyles, but often fall short ( 21 , 40 – 42 ). Systematic training for ALHIV-targeted sexuality education is required to tailor programs to their specific needs.…”

Section: Discussionmentioning

confidence: 99%

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“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: 78%

Section: Discussionmentioning

confidence: 99%

“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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“…Oruko et al [18] reported a number of secondary school girls in the same setting, spoke about parental absence or neglect, and our baseline FGDs also suggested some general lack of concern for daughters' welfare, nurturing feelings of low self-worth. Studies that incorporate skills, health education or empowerment have been highly effective in helping to address gender norms, and protect girls from SRH harms [5,58] The narratives emerging inductively from our discussions suggest girls from backgrounds such as rural Kenya would both welcome and benefit from such input.…”

Section: Discussionmentioning

confidence: 99%

“…Of particular concern is the high exposure to sexual and reproductive health (SRH) harms. In SSA these include HIV, (where adolescent girls have twice the rate of new infections compared to adolescent boys), sexually transmitted infections (STIs) and reproductive tract infections (RTIs), female genital mutilation, unsafe abortion and adolescent pregnancy [3][4][5]. Babies born to adolescents are more likely to be preterm, underweight and have a higher risk of dying in infancy [6].…”

Section: Introductionmentioning

confidence: 99%

‘You don’t have to sleep with a man to get how to survive’: Girl’s perceptions of an intervention study aimed at improving sexual and reproductive health and schooling outcomes

Mason

Zulaika²,

Eijk³

et al. 2022

PLOS Glob Public Health

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In sub-Saharan Africa, girls suffer from high rates of morbidity and mortality, enduring high exposure to sexual and reproductive health harms. Staying in school helps protect girls from such harms. Focus group discussions were conducted in a rural, impoverished area of Kenya with adolescent girls participating in a 4-arm cluster randomised controlled trial, evaluating menstrual cups, cash transfer, or combined cups plus cash transfer against controls. To explore girls’ perceptions of how trial interventions affected their SRH risks and schooling, semi-structured discussions were held at baseline, midline, and study end. Data was explored using thematic analysis. At baseline there were no discernible differences between the 4 intervention groups regarding their perceptions of relationships with boys/men, and difficulties attending or remaining in school. Midline and endline discussions found that narratives from those receiving cash transfer only, or alongside a cup were similar; girls noted fewer pregnancies and less school dropout, attributed to the cash transfer reducing the need for transactional sex. Lower absenteeism was reported by the cup only group, with perceived minimal effect on pregnancy and dropout. Girls in control and cup only groups described feeling valued through inclusion, benefitting from puberty and hygiene education. Although seemingly having little effect on reducing pregnancy or dropout, these inputs reportedly empowered girls, whilst cash transfer girls were emboldened to refuse male sexual advances. Girls noticed benefits from trial interventions, with a reduction in transactional sex and resulting pregnancy impacting on school dropout, or reduced menstrual related absenteeism. Education and study inclusion were perceived as important. Future programmes should consider alleviating material deprivation which prevents girls from attending or performing at school through schemes such as cash transfer, alongside hygiene and education packages. This will empower girls to refuse unwanted sex and understand risks, in addition to motivating academic achievement and school completion. Trial registration: ClinicalTrials.gov NCT03051789.

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“…The Sauti ya Vijana (The Voice of Youth) group‐based intervention to address youth mental health challenges in Tanzania proved to be successful in promoting resilience by increasing utilisation of new coping skills, improving relationships and self‐confidence, and reducing stigma in youth living with HIV [32]. A peer group intervention for adolescent girls and young women implemented in South Africa successfully promoted self‐esteem, well‐being and perceived social support, which play a protective role in the sexual and reproductive health of this population [29].…”

Section: Introductionmentioning

confidence: 99%

Adolescent Health Series: The status of adolescent mental health research, practice and policy in sub‐Saharan Africa: A narrative review

Sequeira

Singh

Fernandes

et al. 2022

Tropical Med Int Health

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Sub-Saharan Africa (SSA) has the fastest growing adolescent population in the world. In addition to developmental changes, adolescents in SSA face health and socioeconomic challenges that increase their vulnerability to mental illhealth. This paper is a narrative review of adolescent mental health (AMH) in SSA with a focus on past achievements, current developments, and future directions in the areas of research, practice and policy in the region. We describe the status of AMH in the region, critical factors that negatively impact AMH, and the ways in which research, practice and policy have responded to this need. Depression, anxiety and post-traumatic stress disorders are the most common mental health problems among adolescents in SSA. Intervention development has largely been focused on HIV/AIDS service delivery in school or community programs by non-specialist health workers. There is a severe shortage of specialised AMH services, poor integration of services into primary health care, lack of a coordinated intersectoral collaboration, and the absence of clear referral pathways. Policies for the promotion of AMH have been given less attention by policymakers, due to stigma attached to mental health problems, and an insufficient understanding of the link between mental health and social determinants, such as poverty. Given these gaps, traditional healers are the most accessible care available to help-seeking adolescents. Sustained AMH research with a focus on the socioeconomic benefits of implementing evidence-based, contextually adapted psychosocial interventions might prove useful in advocating for much needed policies to improve AMH in SSA.

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“In this place we have found sisterhood”: perceptions of how participating in a peer-group club intervention benefited South African adolescent girls and young women

Cited by 7 publications

References 42 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

‘You don’t have to sleep with a man to get how to survive’: Girl’s perceptions of an intervention study aimed at improving sexual and reproductive health and schooling outcomes

Adolescent Health Series: The status of adolescent mental health research, practice and policy in sub‐Saharan Africa: A narrative review

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