Involving parents from the start: formative evaluation for a large randomised controlled trial with Botswana junior secondary school students

While HIV prevention research conducted among adolescent populations may encounter parental resistance; the active engagement of parents from inception to trial completion may alleviate opposition. In preparation for implementing a large randomised controlled trial (RCT) examining the efficacy of a behavioural intervention targeting adolescent sexual risk behaviours; a formative evaluation was undertaken to assess parental reactions to the proposed trial. Six focus groups were conducted with parents of adolescents (aged 13-17) from rural; peri-urban and urban junior secondary schools in Botswana. Focus groups explored comprehension and acceptability among parents of the forthcoming trial including HSV-2 testing; the return of results to the adolescent (not the parent); trial information materials and the parental consent process. Parents welcomed the study and understood and accepted its moral and ethical considerations. Their reactions regarding return of HSV-2 results only to adolescents (not the parent) were mixed. Parents understood the consent process and most agreed to consent; while indicating their desire to remain informed and involved throughout the RCT. The focus group discussions (FGDs) provided valuable information and insights that helped strengthen the study. As a result of parents' feedback; counselling procedures were strengthened and direct linkages to local services and care were made. Informational materials were revised to increase clarity; and materials and procedures were developed to encourage and support parental involvement and parent-child dialogue. Ultimately; parental feedback led to a decision by the Government of Botswana to allow parents to access their child's HSV-2 test results

Correlates of Sexual Activity Versus Non-Activity of Incoming First-Year Students at a South African University

In order to contribute to the design of more effective programmes to curb the spread of HIV at tertiary institutions; this study compares the profile of students who are sexually active versus those who are not yet sexually active when entering university. The study was conducted among three cohorts of first-year university students at the University of the Western Cape from 2007 to 2009. A range of correlates of sexual activity versus non-activity were explored using logistic regression analysis. The predicted probabilities of the logit link function depict marked differences between genders and racial groups. Males were more likely than females to be sexually active when entering university and the Black racial group was more likely than other racial groups to be sexually active. Risk-taking behaviours such as smoking; alcohol and drug use were shown to increase the likelihood of being sexually active when entering university; as did indicators of depression and suicidal ideation. The results indicate that religion plays an important role in influencing sexual behaviour; highlighting the important potential role that religious organisations can play in addressing HIV risk at tertiary institutions

Racing risk, gendering responsibility: a qualitative study of how South African students talk about sexual risk and responsibility

Individuals' perceptions of risk have implications for whether and how they engage with protective strategies. This study investigated how sexual risk; specifically HIV and pregnancy and responsibility for these risks were constructed in discussions across five groups of youth in KwaZulu-Natal; South Africa. The qualitative study used focus groups and interviews with a sample of 28 tertiary level students and 7 peri-urban youth. The constructions of risk intersected with raced and gendered narratives around sexual risk and responsibility. These constructions were used by the participants to assign and displace responsibility for the risks of HIV and pregnancy; rendering some groups immune to these risks. This constitutes a form of stigmatisation and also has implications for participants' prevention practices

Social and Cultural Aspects of HIV and AIDS in West Africa: A Narrative Review of Qualitative Research

With the increasing focus on the role of social aspects of the HIV epidemic in sub-Saharan Africa; the need for an overview of existing research dealing with such issues has become more urgent. The objective of this article is to provide a thematic overview of existing qualitative research on HIV and AIDS in the West African region and to analyze the main research findings in order to identify possible gaps and recommend new research themes to inform future research-based interventions. The analysis is based on a total of 58 articles published from 2001 to 2009 in eng or French identified through a literature search in seven scientific; bibliographical databases. Searches included terms related to qualitative studies combined with various terms related to HIV/AIDS. The results of this narrative review show that there was a geographical concentration on Nigeria; Ghana; Burkina Faso and Co. e d'Ivoire and a strong urban bias; with most studies taking place in the capital cities of these countries. The majority of the studies focused on women or women and men; only four articles dealt exclusively with men; of which only two were on men who have sex with men. The main study groups were people living with HIV; young people or female sex workers. Sexual risk-taking and stigmatization were the themes that were most prominently explored in the articles we reviewed. We conclude that research needs to be strengthened in relation to the analysis of experiences with antiretroviral therapy and the non-optimal access to treatment in West Africa. Also; more research is needed on men and their exposure to HIV/AIDS; as well as on the role of concurrent partnership in the spread of HIV

Baseline Findings of an HIV Incidence Cohort Study to Prepare for Future HIV Prevention Clinical Trials in Kisumu; Kenya

Introduction: In an analysis of baseline findings of an HIV incidence cohort study; an assessment was made of HIV prevalence among persons presenting for enrollment and any differences in demographic characteristics between persons not enrolled compared to those enrolled. We also described and compared HIV risk behaviors in males and females enrolled in the study. Methodology: A computer-assisted survey was administered to collect baseline demographic and HIV risk data from 1;277 men and women aged 18-34 years. Testing for HIV and other sexually transmitted infections (STI) was conducted. Out of 1;277 persons prescreened for eligibility; 625 were enrolled. Results: HIV prevalence of all persons who completed screening was 14.8 (females: 21.1; males: 8.1). The odds of being enrolled in the study were higher for persons 18-24 years compared to those 30-34 years of age [adjusted odds ratio (AOR)=2.18; CI=1.13; 4.21] and males compared to females [AOR=2.07; CI=1.43; 2.99]. Among those enrolled in the study; the most prevalent HIV risk behaviors were unprotected sex (49); alcohol use (45); and transactional sex (30) in the last three months. Compared to females; a significantly greater proportion of males reported using any alcohol or recreational drug in the last three months; a history of oral sex; sex with partner other than a spouse or main partner; ever having a blood transfusion; ever being treated for an STI; and having knowledge of their last HIV test result. Conclusion: The Kisumu Field Station successfully recruited individuals with HIV risk characteristics for the HIV incidence cohort study

Sero-Epidemiology of Human Immunodeficiency Virus (HIV) in Plateau State; Nigeria

Introduction: Previous sentinel surveys of HIV in Nigeria studied pregnant women attending antenatal care; thereby omitting other important high-risk groups. We therefore investigated the prevalence of HIV/AIDS in low- and high-risk populations in the state of Plateau; Nigeria. Methodology: Blood samples were collected by venepuncture from 5;021 adults aged ?15 years between August and October 2008. At least one major town and one rural community were selected in each Local Government Area (LGA). Samples were initially screened with a rapid HIV testing kit; reactive samples were further tested using Stat Pak. Discordant samples were confirmed using Genie-II. Results: Of 5;021 subjects screened; 245 (4.88) were seropositive. Local Government prevalence ranged from 0.68 in Bassa to 16.07 in Jos North. On average; LGAs in the Southern Senatorial Zone had higher rates. Most (over 80) positive cases were younger than 40 years. Females had a significantly higher (6.85) prevalence than males (2.72). Age-specific prevalence was higher among females aged 25 to 29 years (2.09). Risk factors identified for acquisition of HIV infection were previous history of STDs (6; 16.28); men having sex with men (2; 11.76); having multiple sexual partners (97; 10.49); intravenous drug use (10; 7.58); sharing of sharp objects (20; 4.82); and history of blood transfusion (21; 3.65). Conclusion: The seemingly higher prevalence recorded in this survey could be attributed to the inclusion of high- and low-risk groups in the general population; unlike previous reports which studied only antenatal care attendees. This survey provides useful baseline information for further studies

A Study of Knowledge; Attitude; practice towards HIV/AIDS and Prevalence of HIV/AIDS among Tea Sellers women in Khartoum State (April 2004 - May 2005)

This was a descriptive community based study conducted to determine Tea seller's women risk behavior and factors towards AIDS in order to assist national planner to develop behavior change interventions. The study was carried out in Khartoum state during the period April 2004 - May 2005; 648 tea sellers women of age 15-49 were participated. It was found that they spend most of the day out of home; had high-risk sexual behavior. The majority of them are married; knowledge and behavior related to sexually transmitted disease and AIDS was generally satisfactory. Condom use was found to be not adequate; the tea sellers refer to pharmacies as a main source of obtaining condoms. The study showed a high level of misbelieves about mode of transmission of HIV / AIDS. Only little proportion of tea sellers has under gone voluntary testing for AIDS virus. The tea seller women are listening to radio and watching television; which make them potential sources for dissemination of information in the future. The tea sellers women when getting infected with ;sexually transmitted disease; used to seek treatment in governmental clinics and private pharmacies. The tea sellers women; like general population; are stigmatizing people living with AIDS. Although tea sellers women constitute a large proportion of the high risk population for HIV infection; no specific program to raise their awareness such as peer education; was designed for them

Alcohol and its association with sexual abstinence; condom use and risky behaviour among unmarried young people aged 18-24 years in uganda

The study establishes the level of association of alcohol consumption with sexual abstinence; condom use and risky behaviour among young unmarried people aged 18-24. The data were obtained from a multi-country study on Gender; Alcohol and Culture (GENACIS) in which Uganda participated. The dependent variables were age at first sex; number of partners in previous one and two years and condom use at last sex. Multivariate logistic regression was used to analyse correlation of alcohol on the three outcomes of interest. Alcohol consumption was not significantly associated with abstinence and condom use but it was associated with risky behaviour. Results on risky behaviour re-affirm dangers of alcohol consumption among young people. Policy and programmes should include control of alcohol consumption among young people

Parental factors and sexual risk-taking among young people in Côte d'Ivoire

Côte d'Ivoire is the country worst affected by the HIV epidemic inWest Africa, and young people in this country are a particularly vulnerable group. This study examined the relation between parental factors and sexual risk-taking among young people using logistic regression and survival analysis methods. Three parental factors (living in the same household as the father during childhood, perceived parental disapproval of early and premarital pregnancy, and parent-child communication about sexual abstinence) were positively associated with primary sexual abstinence (defined as yet to experience sexual debut), secondary sexual abstinence (defined as sexual abstinence subsequent to sexual debut) and reduced number of sex partners. The findings suggest that parental monitoring and control are important predictors of youth sexual behaviours and underscore the need to target parents and guardians in efforts to promote responsible sexual behaviours among adolescents. It is important to promote parent-child communication about sexual issues and empower parents and guardians to communicate effectively with their children and wards about sexual issues

Test-retest reliability of self-reported adolescent addictive and other risk behaviours in Tanzania; South Africa and Zimbabwe

The aim was to ascertain the test-retest reliability of a wide range of addictive and other adolescent risk behaviours using questionnaires in Swahili in Dar es Salaam; Xhosa in Cape Town; and Shona in Harare. The sample consisted of 119; 104 and 112 in the three sits respectively. Of the 43 variables for which Cohen's kappa was the appropriate measure; the reliability was poor for 0 (0.0); fair for 5 (11.6); moderate for 16 (37.2); substantial for 20 (46.58) and almost perfect for 2 (4.7). Of the 27 variables for which the observed agreement was the most appropriate measure; it was above 90for 22 (81.5) variables. All three versions of our questionnaire provide data that is of acceptable reliability