Predictors of HIV, HIV Risk Perception, and HIV Worry Among Adolescent Girls and Young Women in Lilongwe, Malawi

Price, Joan T.; Rosenberg, Nora E.; Vansia, Dhrutika; Phanga, Twambilile; Bhushan, Nivedita L.; Maseko, Bertha; Brar, Savvy K.; Hosseinipour, Mina C.; Tang, Jennifer H.; Bekker, Linda‐Gail; Pettifor, Audrey

doi:10.1097/qai.0000000000001567

Cited by 79 publications

(107 citation statements)

References 46 publications

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“…Among the general population in Nigeria, the HIV stigma level has declined [13], however this is yet to be determined among young adolescents aged 10-14. Similarly on risk perceptions, some studies in Africa [14][15][16] have found perceived low and inaccurate reporting of HIV risks among adolescents. It is therefore beneficial to accurately understand why young adolescents perceive themselves to be at low risk in order to address misconceptions associated with their beliefs.…”

Section: Introductionmentioning

confidence: 99%

HIV comprehensive knowledge and prevalence among young adolescents in Nigeria: evidence from Akwa Ibom AIDS indicator survey, 2017

Badru¹,

Mwaisaka

Khamofu³

et al. 2020

BMC Public Health

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Background: Despite the recent increase in HIV infections among adolescents, little is known about their HIV knowledge and perceptions. This study, therefore, sought to examine the factors associated with comprehensive HIV knowledge, stigma, and HIV risk perceptions among young adolescents aged 10-14 years in Akwa Ibom State, Nigeria. Additionally, consenting parents and assenting young adolescents were tested for HIV. Methods: We used cross-sectional data from the 2017 Akwa Ibom AIDS Indicator Survey to analyze comprehensive HIV knowledge, stigma, and HIV risk perceptions among young adolescents. Demographic characteristics of young adolescents were summarized using descriptive statistics. Chi-square test (or Fisher's exact test in cases of small subgroup sample sizes) was used to elicit associations between demographics and study outcomes. Separate multivariable logistic regression models were then conducted to determine associations with the study outcomes. Sampling weights were calculated in order to adjust for the sample design. P-values less than 0.05 were considered to be significant. Results: A total of 1818 young adolescents were interviewed. The survey highlighted significant low levels of comprehensive HIV knowledge (9.4%) among young adolescents. Adolescent-parent discussions [AOR = 2.19, 95% C.I (1.10-4.38), p = 0.03], schools as sources of HIV information [AOR = 8.06, 95% C.I (1.70-38.33), p < 0.001], and sexual activeness [AOR = 2.55, 95% C.I (1.16-5.60), p = 0.02] were associated with comprehensive HIV knowledge. Majority (93%) of young adolescents perceived themselves not to be at risk of HIV. Overall, 81.5% of young adolescents reported stigmatizing tendencies towards people living with HIV. HIV prevalence among young adolescents was 0.6%. Conclusions: Results indicate low comprehensive HIV knowledge among young adolescents. Our findings suggest that there is a need for increased attention towards young adolescents particularly in the provision of comprehensive, functional sexuality education, including HIV at the family-and school-levels. Consequently, age appropriate interventions are needed to address the epidemiological risks of young adolescents that are influenced by a myriad of social issues.

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Section: Introductionmentioning

confidence: 99%

HIV comprehensive knowledge and prevalence among young adolescents in Nigeria: evidence from Akwa Ibom AIDS indicator survey, 2017

Badru¹,

Mwaisaka

Khamofu³

et al. 2020

BMC Public Health

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“…at a more advanced stage of the disease, interfering with its prognosis and progression of comorbidities. (19) The study found a higher prevalence of high clinical risk among cases with detectable viral load, LT-CD4+ between 200-500 cells/mm 3 , two or more opportunistic diseases at diagnosis, two or more clinical manifestations or a chronic disease.…”

Section: Discussionmentioning

confidence: 74%

Prevalência do alto risco de complicações clínicas associadas ao óbito por Aids

et al. 2019

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Resumo Objetivo: Investigar a prevalência do alto risco entre casos de óbitos a partir da classificação de risco de complicações clínicas associadas a aids e sua relação com variáveis sociodemográficas e terapêuticas. Métodos: Estudo epidemiológico, retrospectivo, envolvendo 80 casos de óbito por aids ocorridos entre 2007 e 2015 em um Estado do Nordeste brasileiro. A estratificação do risco considerou indicadores de acompanhamento obtidos no diagnóstico da infecção, atribuindo-se valores de 1,2 para carga viral, e 1,2 e 3 aos indicadores de linfócitos T CD4+, quantidade de doenças oportunistas, manifestações clínicas e doenças crónicas, com escore variando entre 5 e 14. Quanto maior esse escore, maior o risco para complicações clínicas. Os dados foram analisados estimando a prevalência e razão de prevalência para o alto risco, seguido do método de Weight of Evidence e estatística D de Somers. Resultados: Dos 80 casos estudados, 51,2% foram alocados no estrato de alto risco. O registro de antecedentes psiquiátricos aumentou em 2 vezes a prevalência para o alto risco e a faixa etária apresentou forte relação com esse estrato. A contagem de linfócitos T-CD4+, doenças oportunistas e manifestações clínicas foram os indicadores que apresentaram maior força de associação com a estratificação de risco. Conclusão: O estudo mostrou a prevalência do alto risco para o desenvolvimento de complicações clínicas, maior força associativa nos indicadores LT-CD4+, doenças oportunistas e manifestações clínicas com escore de risco proposto. Estes resultados sugerem a necessidade de atenção especial dos serviços de atenção especializada aos indivíduos acompanhados em nível ambulatorial.

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“…Even if increasing risk perception leads to increased condom use, low levels of risk perception in the population would mean that only limited numbers of people would increase condom use after increasing risk perception, so effects on population-level HIV incidence would be limited. Risk perception has often been found to be low even among those engaging in behaviours associated with increased risk of HIV infection (33)(34)(35), which may indicate that the change in prevention behaviour attributable to changes in risk perception is limited. However, again, lack of longitudinal studies limits our understanding of the degree to which behaviour can be attributed to change in risk perception.…”

Section: Introductionmentioning

confidence: 99%

Relationships between changes in HIV risk perception and condom use in east Zimbabwe 2003-2013: Population-based longitudinal analyses

Schaefer

Thomas

Maswera

et al. 2020

Preprint

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Background: Perceiving a personal risk for HIV infection is considered important for engaging in HIV prevention behaviour and often targeted in HIV prevention interventions. However, there is limited evidence for assumed causal relationships between risk perception and prevention behaviour and the degree to which change in behaviour is attributable to change in risk perception is poorly understood. This study examines longitudinal relationships between changes in HIV risk perception and in condom use and the public health importance of changing risk perception. Methods: Data on sexually active, HIV-negative adults (15-54 years) were taken from four surveys of a general-population open-cohort study in Manicaland, Zimbabwe (2003-2013). Increasing condom use between surveys was modelled in generalised estimating equations dependent on change in risk perception between surveys. Accounting for changes in other socio-demographic and behavioural factors, regression models examined the bi-directional relationship between risk perception and condom use, testing whether increasing risk perception is associated with increasing condom use and whether increasing condom use is associated with decreasing risk perception. Population attributable fractions (PAFs) were estimated. Results: 1988 males and 3715 females participated in ≥2 surveys, contributing 8426 surveys pairs. Increasing risk perception between two surveys was associated with higher odds of increasing condom use (males: adjusted odds ratio [aOR]=1.39, 95% confidence interval [CI]=0.85-2.28, PAF=3.39%; females: aOR=1.41 [1.06-1.88], PAF=6.59%), adjusting for changes in other socio-demographic and behavioural factors. Those who decreased risk perception were also more likely to increase condom use (males: aOR=1.76 [1.12-2.78]; females: aOR=1.23 [0.93-1.62]) compared to those without change in risk perception. Conclusions: Results on associations between changing risk perception and increasing condom use support hypothesised effects of risk perception on condom use and effects of condom use on risk perception (down-adjusting risk perception after adopting condom use). However, low proportions of change in condom use were attributable to changing risk perception, underlining the range of factors influencing HIV prevention behaviour and the need for comprehensive approaches to HIV prevention.

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Predictors of HIV, HIV Risk Perception, and HIV Worry Among Adolescent Girls and Young Women in Lilongwe, Malawi

Abstract: Most AGYW perceive little risk of HIV acquisition, even those at highest risk. As a critical gap in the HIV prevention cascade, accurate risk perception is needed to tailor effective and sustained combination prevention strategies for this vulnerable population.

Cited by 79 publications

References 46 publications

HIV comprehensive knowledge and prevalence among young adolescents in Nigeria: evidence from Akwa Ibom AIDS indicator survey, 2017

HIV comprehensive knowledge and prevalence among young adolescents in Nigeria: evidence from Akwa Ibom AIDS indicator survey, 2017

Prevalência do alto risco de complicações clínicas associadas ao óbito por Aids

Relationships between changes in HIV risk perception and condom use in east Zimbabwe 2003-2013: Population-based longitudinal analyses

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