Sexual Risk Behavior: a Multi-System Model of Risk and Protective Factors in South African Adolescents

Govender, Kaymarlin; Cowden, Richard G.; Asante, Kwaku Oppong; George, Gavin; Reardon, Candice

doi:10.1007/s11121-019-01015-3

Cited by 21 publications

(11 citation statements)

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“…Moreover, there are indications that HIV infection rates among youth will increase annually by 13% leading to approximately 3.5 million new infections by 2030 [ 2 , 3 ]. The socio-ecological model [ 4 , 5 ] suggests that young people are vulnerable to HIV due to numerous factors at different socio-ecological levels that affect risky sexual behaviors including low self-esteem, lack of parent–child communication, peer pressure, poverty [ 6 , 7 ], alcohol or drug abuse [ 8 ], limited HIV-related knowledge, gender-based violence [ 9 ], gender disparities and cultural factors [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth worldwide: a systematic review

et al. 2022

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Background Interventions aimed at reducing risky sexual behavior are considered an important strategy for averting Human Immunodeficiency Virus (HIV) infection among youth (15–24 years) who continue to be at risk of the disease. Enhancing intervention success requires a comprehensive understanding of the barriers and facilitators to interventions targeting youth. However, there is lack of a systematic review of both quantitative and qualitative studies to comprehensively identify and synthesize barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth worldwide. This review aimed to identify and synthesize barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth globally based on original peer-reviewed studies published in the last decade. Methods The Joanna Briggs Institute approach for mixed methods systematic reviews and Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used to guide this review. Nine electronic databases, Joint United Nations Programme on HIV/AIDS and World Health Organization websites, and reference lists of included studies and systematic reviews on barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth were searched for eligible articles. Studies that met the inclusion criteria underwent quality appraisal and data extraction. Findings were analyzed using thematic synthesis and underpinned by Nilsen, 2015’s Determinant Framework. Results Overall 13 studies comprising of eight qualitative studies, four quantitative studies and one mixed methods study were included in the review. Several barriers and facilitators across the five Determinant Framework domains were identified. Most of the barriers fell under the characteristics of the context domain (e.g., gender-biased norms). The next important group of barriers emerged within the characteristics of the end users domain (e.g., fear of relationship breakdown). In terms of facilitators, the majority fell under the characteristics of the strategy of facilitating implementation domain (e.g., implementation of intervention with fidelity) and characteristics of the end users domain (e.g., fear of pregnancy or sexually transmitted infections). The next common set of facilitators appeared within the characteristics of the context domain (e.g., family support). Conclusion This review identified several multi-level barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth. Multi-level and combination approaches are needed to address these factors and enhance intervention success.

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Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth worldwide: a systematic review

et al. 2022

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“…Open access rate in this population is anticipated to increase yearly by 13% leading to an estimation of 3.5 million new infections by 2030. 4 5 Youth are vulnerable to HIV because of a myriad of factors that influence risky sexual behaviours including low self-esteem, poverty, peer pressure, 6 alcohol or drug abuse, 7 cultural practices, gender-disparities, 8 9 limited HIV-related knowledge and gender-based violence. 10 According to the socio-ecological model, these factors affect youth at individual, interpersonal, community, institutional and structural levels.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Systematic review protocol of the effectiveness of HIV prevention interventions for reducing risky sexual behaviour among youth globally

et al. 2022

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IntroductionHuman immunodeficiency virus (HIV) prevention interventions focused at reducing risky sexual behaviours are an important strategy for preventing HIV infection among youth (15–24 years) who continue to be vulnerable to the disease. This systematic review aims to synthesise current global evidence on the effectiveness of HIV prevention interventions for reducing risky sexual behaviour among youth in the last decade.Methods and analysisMEDLINE/PubMed, EMBASE, PsychINFO, ProQuest Central, CINAHL and Web of Science databases, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform and reference lists of included studies and systematic reviews on effectiveness of HIV prevention interventions for reducing risky sexual behaviour among youth will be searched for articles published from August 2011 to August 2021. Eligible studies will be longitudinal studies including randomised controlled trials and quasi-experimental studies that examined the effectiveness of HIV prevention interventions among youth populations (15–24 years) with risky sexual behaviour as a primary or secondary outcome. Study selection and quality assessment will be undertaken independently by three reviewers and disagreements will be resolved through consensus. Data analysis will be undertaken using RevMan software V.5.3.3. A random effects meta-analysis will be conducted to report heterogeneous data where statistical pooling is achievable. We will use I2 statistics to test for heterogeneity. Where appropriate, a funnel plot will be generated to assess publication bias. Where statistical pooling is unachievable, the findings will be reported in a narrative form, together with tables and figures to assist in data presentation if required. Reporting of the systematic review will be informed by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Ethics and disseminationEthical approval is not required. Findings of the systematic review will be published in a peer-reviewed journal. The findings will be of interest to researchers, healthcare practitioners and policymakers.PROSPERO registration numberCRD42021271774.

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“…Several studies have demonstrated that sociodemographic variables (male and increasing age of adolescents) [16,[19][20][21][22][23] were risk factors associated with involving in early sexual debut and sexual activity. Other risk factors for sexual behaviour among adolescents were low socioeconomic status (SES) [24], and substance use [19,23,25,26].…”

Section: Introductionmentioning

confidence: 99%

Risk and protective factors associated with health risk behaviours among school learners in Western Cape, South Africa

2023

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Background Health risk behaviour is rife among school learners in the Western Cape province. This paper assesses risk and protective factors related to health risk behaviours among high school learners. Method: Longitudinal data were sourced from 2950, 2675 and 2230 at Time 0, Time 1 and Time 2 among grade 8 learners aged 13–18 years between 2012 and 2013. Health risk behaviours were assessed on alcohol consumption, smoking cannabis in the past six months, and ever having sexual intercourse. The sociodemographic variables examined were age, sex, residence, socioeconomic status (SES), family structure and population group. Contextual variables studied were the feeling of learners about the intervention program, participation in religious activities, paid casual work and school sports. Descriptive statistics, bivariate associations and binary logistic analyses predicting health risk behaviours were carried out using generalized linear mixed models after restructuring the data collected at different time points. Result Health risk behaviours increased consistently for alcohol consumption (25.7–42.7%), smoking cannabis (10.4–22.1%) and (22.3–36.0%) engaging in sexual intercourse. Increasing age emerged as a risk factor for all the health risk behaviours: alcohol consumption [OR:1.3 (1.2–1.4), p < 0.001]; smoking cannabis [OR:1.3 (1.2–1.4), p < 0.001] and had sex [OR:1.5 (1.4–1.7), p < 0.001]. Participation in paid casual work also predicted health risk behaviour: alcohol use [OR:1.5 (1.2–1.8), p < 0.001]; smoking cannabis [OR:1.3 (1.0-1.7), p < 0.05] and sex [OR:1.4 (1.1–1.7), p < 0.01]. High SES and feelings about the EPEP programme enhanced alcohol consumption and smoking cannabis. Smoking cannabis was augmented by residing in an urban area. Participation in school sports was associated with increased alcohol consumption and engaging in sexual intercourse. Participation in religious activities was protected against alcohol consumption [OR:0.7 (0.53–0.83), p < 0.001]; and sex [OR: 0.5 (0.4–0.7), p < 0.001]. Being a female and belonging to a coloured population group diminished engaging in sexual intercourse, and the family structure of both parents attenuated involvement in smoking cannabis. Conclusion The findings of the study on risks and protective factors on health risk behaviours mirror those of school-based programmes in developing countries. Learners who participated in paid work and school sports are at risk of adverse health outcomes. Furthermore, participation in religious practices and family structure roles in attenuating health risk behaviours should be integrated and considered in the school-based intervention programme.

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Sexual Risk Behavior: a Multi-System Model of Risk and Protective Factors in South African Adolescents

Cited by 21 publications

References 50 publications

Barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth worldwide: a systematic review

Barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth worldwide: a systematic review

Systematic review protocol of the effectiveness of HIV prevention interventions for reducing risky sexual behaviour among youth globally

Risk and protective factors associated with health risk behaviours among school learners in Western Cape, South Africa

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