Trends and correlates of HIV prevalence among adolescents in South Africa: evidence from the 2008, 2012 and 2017 South African National HIV Prevalence, Incidence and Behaviour surveys

Mabaso, Musawenkosi; Goitseone, Maseko; Sewpaul, Ronel; Naidoo, Inbarani; Jooste, Sean; Takatshana, Sinovuyo; Reddy, Tarylee; Zuma, Khangelani; Zungu, Nompumelelo

doi:10.1186/s12981-021-00422-3

Cited by 34 publications

(27 citation statements)

References 19 publications

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“…This is consistent with the literature that suggests that adolescents in South Africa are highly susceptible to HIV (see Fig. 3) (3,13,14). This risk of HIV was highest between 15 and 36 years old.…”

Section: Discussionsupporting

confidence: 93%

Cox proportional hazard-model application: Time to cervical cancer screening among women living with HIV in South Africa

Hollington

2023

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Background There is an increased risk of cervical cancer among women living with HIV. While studies have long examined the association between cervical cancer among women with HIV, no study has examined the time taken for women with HIV to undergo cervical cancer screening as well as the hazard thereof in South Africa. Methods The study used cross-sectional data from the 2016 South Africa Demographic and Health Survey. To allow for longitudinal analysis and to address the issue of right-censoring, the data was reformatted to a person-data file. The selection criteria were limited to women living with HIV (WLHIV) who had also responded to the question on cervical cancer screening. Descriptive statistics were employed to show the levels of HIV among women aged 15 and older in South Africa. Additionally, Kaplan‒Meier curves were employed to investigate the time to CCS by WLHIV in South Africa. Thereafter, an unadjusted Cox hazards regression model was employed to examine the hazard of undergoing CCS among WLHIV. Last, it employed an adjusted model to examine the hazard of CCS among WLHIV while adjusting for other factors. Results Nineteen percent (n = 1,159) of the women who participated in the study tested positive for HIV. Herein, it was found that the risk of CCS among WLHIV began at the age of approximately 19 years. Thereafter, the hazard of undergoing CCS among WLHIV began to decrease at 58 years. There was a significant association between CCS and WLHIV. Additionally, several covariates were found to be significantly associated with HIV. These were race, province, area of residence, marriage, educational attainment, employment, alcohol consumption, perceived health perception, and health insurance. Conclusion The hazard of CCS was lower among WLHIV compared to WLHIV who did not undergo CCS in South Africa. This puts HIV-positive women at risk of increased morbidity and mortality from potential cervical cancer and HIV comorbidity due to CCS deficits within this group, as they are susceptible to HPV and subsequent cervical cancer due to a compromised immune system. HIV-positive women need to routinely undergo CCS every 12 months from baseline for 3 years. Thereafter, they should undergo CCS once every 3 years to reduce their risk of developing the disease.

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Section: Discussionsupporting

confidence: 93%

Cox proportional hazard-model application: Time to cervical cancer screening among women living with HIV in South Africa

Hollington

2023

Preprint

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“…South Africa has approximately 360,000 adolescents ages 10 to 19 living with HIV, over a third of all adolescents living with HIV (ALHIV) in sub-Saharan Africa (SSA) [ 1 – 3 ]. KwaZulu-Natal province has the highest number of ALHIV in South Africa [ 3 – 5 ]. An estimated one in five adolescents living with HIV across the world was perinatally infected, and 79% of adolescents with perinatally-acquired HIV (APHIV) reside in SSA [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…An estimated one in five adolescents living with HIV across the world was perinatally infected, and 79% of adolescents with perinatally-acquired HIV (APHIV) reside in SSA [ 6 ]. Health policy has largely overlooked social health inequities among APHIV [ 5 ], who face unique risks related to their sexual and reproductive health (SRH) [ 7 ]. A 2021 scoping review identified gaps for APHIV pertaining to knowledge of SRH and access to SRH services, high rates of risky sexual practices, and low family planning uptake [ 8 ], leading to higher rates of unintended pregnancy than their HIV-negative counterparts [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…To bridge these gaps faced by all adolescents, but especially amongst adolescents who are coming of age while living with HIV, APHIV need holistic SRH education targeted to their unique health needs, including strategies to improve communication, decision-making skills, self-efficacy, and self-determination to begin to improve SRH knowledge and behavior [ 24 ]. In the realm of their sexual health, APHIV require integrated and engaging health, educational, and social services that promote holistic sexual wellness [ 5 , 12 ]. Researchers, healthcare providers, and APHIV alike have recommended the use of mobile health (mHealth) interventions, such as phone applications or text message programs, to connect adolescents with sexual health education and services, due to high smartphone coverage and technological familiarity amongst young people [ 13 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

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“I am not shy anymore”: A qualitative study of the role of an interactive mHealth intervention on sexual health knowledge, attitudes, and behaviors of South African adolescents with perinatal HIV

et al. 2022

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Background South Africa has one of the highest burdens of adolescents with perinatally-acquired HIV (APHIV) in the world. APHIV in South Africa have limited access to sexual and reproductive health (SRH) education and services specific to their HIV status. When lacking comprehensive SRH education, APHIV are prone to sexual risk behaviors that can lead to unintended pregnancy, sexually transmitted infections, and HIV transmission. The use of mHealth interventions has been shown to deliver information, foster social support, and improve decision-making skills. In this study, we evaluate how an mHealth intervention influences sexual health knowledge and behaviors in APHIV. Methods We purposively enrolled adolescents from the intervention arm of a randomized clinical trial assessing a multi-module, moderated WhatsApp-based intervention—Interactive Transition Support for Adolescents Living with HIV (InTSHA)—within a government supported clinic in KwaMashu, an urban township of KwaZulu-Natal, South Africa. We conducted in-depth interviews based on World Health Organization guidelines for asking adolescents about SRH. We thematically analyzed data through an iterative, team-based coding approach combining deductive and inductive elements to contextualize SRH attitudes, knowledge, and behaviors before and after receiving the InTSHA intervention. Results Of the 21 participants, 13 (61.9%) were female and the mean age was 16.6 years. Most participants reported first learning about SRH as young teenagers in school through non-targeted and negative ways, seeking clarification through peers and the internet rather than clinicians or caregivers. Participants reported that InTSHA provided a holistic perspective on relationships, gender, and sexuality specific to growing up with HIV in South Africa. They praised the ability to give and receive information from peers in a moderated setting through the mHealth intervention, building their confidence, decision-making skills, and communication with partners and caregivers throughout their everyday lives. Despite reporting some technological challenges, adolescents agreed that InTSHA was convenient, confidential, and user-friendly. Conclusions South African APHIV receive incomplete and conflicting sexual education from peers, caregivers, teachers, and technology that can be supplemented by mHealth curricula targeted for the unique needs of APHIV. Future, scaled-up mHealth interventions can lower SRH stigma by expanding access to sexual education and peer support, supplementing adolescents’ existing SRH education.

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“…Adolescents aged 10-19 years 28 have unique challenges and are at increased risk of HIV infection compared to other groups. 29 Therefore, exploring their perspectives on how DSD models influence the utilization of services is critical. Their insights can help improve the availability and quality of HIV prevention and treatment programs for adolescents.…”

Section: Introductionmentioning

confidence: 99%

HIV Treatment and Care of Adolescents: Perspectives of Adolescents on Community-Based Models in Northern Uganda

Miyingo¹,

Mpayenda²,

Nyole³

et al. 2023

HIV

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Background: Differentiated service delivery models for people living with HIV continue to be scaled up to expand access to HIV services and treatment continuity. However, there is a gap in information on adolescents' perspectives on community-based models. We aimed to explore the perspectives of adolescents living with HIV on community-based models in northern Uganda. Materials and Methods: Between February and March 2022, we conducted a descriptive qualitative study at two health centres IV in Northern Uganda. Data was collected using an interview guide. The study had 25 purposively selected adolescents enrolled in community-based models for HIV care and treatment. The interviews were audio-recorded, transcribed verbatim, and translated. We analyzed data using a thematic approach. Results: A total of 25 in-depth interviews with HIV-positive adolescents were conducted. More than half (52.0%) of the participants were females, 84.0% were not married, and 44.0% had no formal education. The mean age of the respondents was 15.6 (±1.9) years. The major themes were: community-based models currently accessed by adolescents, benefits, and challenges of the models. Although there are other community-based models (community pharmacies, home ART deliveries) our exploration only discovered two models used by these adolescents to access care, namely, Community Drug Distribution Point (CDDP) and Community Client-Led ART Delivery Groups (CCLADs). The benefits included reduced transportation costs, convenient service access, ART adherence, peer support, a comfortable environment and less stress. However, our results indicate that these models had some challenges, including lack of confidentiality and privacy, perceived stigma, and a lack of face-to-face interaction. Conclusion: Our findings show that CDDP and CCLADs are the two CBMs used by adolescents in Lira District to access treatment and care. Adolescents benefited from these models through reduced transport costs, the convenience of accessing HIV care and treatment, and social support. The challenges associated with these models are lack of confidentiality and privacy, perceived stigma, and a lack of face-to-face interaction. The Ministry of Health should work with other implementing partners to strengthen the implementation of these models to improve HIV/AIDS service delivery for adolescents.

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Trends and correlates of HIV prevalence among adolescents in South Africa: evidence from the 2008, 2012 and 2017 South African National HIV Prevalence, Incidence and Behaviour surveys

Cited by 34 publications

References 19 publications

Cox proportional hazard-model application: Time to cervical cancer screening among women living with HIV in South Africa

Cox proportional hazard-model application: Time to cervical cancer screening among women living with HIV in South Africa

“I am not shy anymore”: A qualitative study of the role of an interactive mHealth intervention on sexual health knowledge, attitudes, and behaviors of South African adolescents with perinatal HIV

HIV Treatment and Care of Adolescents: Perspectives of Adolescents on Community-Based Models in Northern Uganda

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