Application of Core Processes for Understanding Multiple Concurrent Sexual Partnerships Among Adolescents in Uganda.

Introduction: Adolescents in Uganda, as in other sub-Saharan countries, engage in sex with multiple concurrent partners, thus placing them at risk for HIV and unplanned pregnancies, but it is not clear why. This study explored why adolescents in Uganda engage in multiple concurrent sexual partnerships (MCSP). Methods: This study used a Core Processes methodology. We used the processes of brainstorming, and identification of evidence and theoretical support, in various phases/steps of intervention planning, to provide possible explanations for adolescent MCSP. Results: Adolescents were found to have limited knowledge of the risks associated with MCSP and perceived a low risk for HIV. Peer influence to engage in MCSP exacerbated the problem among adolescents. Poor communication with sexual partners and parents and societal indifference to multiple sexual partnerships increased permissive attitudes toward infidelity. The unclear adolescent sexual and reproductive health policies hampered access to services, and transactional sexual relationships with older (polygamous) sexual partners increased the HIV risk. Adolescents were found to be more concerned about unplanned pregnancies than HIV risk. Discussion: From the empirical evidence, adolescent health programs in Uganda should incorporate comprehensive sexual health education on HIV and teenage pregnancy risk-reduction strategies. Programs should strengthen parental and community support through enhanced collaborative training on communication with and for adolescents. Forming strategic partnerships with various stakeholders for concerted efforts to address the MCSP problem among adolescents is critical.

Understanding the Psychosocial Correlates of the Intention to Use Condoms among Young Men in KwaZulu-Natal, South Africa.

South Africa leads the world with the number of people infected with HIV. Even with all attempts that have been made to curb HIV, it is still evident that new infections are on the rise. Condom use remains one of the best tools against this challenge yet a small number of sexually active men use them. This study investigates the psychosocial correlates of the intention to use condoms among young men in KwaZulu-Natal province. Using the Theory of Planned Behaviour as a framework, hierarchical linear regression models were used to determine the unique contribution of the study measures in explaining the overall variance of intention to consistently use condoms. Subjective norms and perceived behavioural control towards consistent condom use explained 46% of the variance in the intention to use a condom, suggesting that health behaviour interventions should focus on targeting the normative beliefs as well as control beliefs of the target population. Furthermore, subjective norms and intentions towards reducing alcohol and marijuana use explained an additional 7% to the final model in intentions to condom use, implying that substance use and condom usage may influence each other. No significant contributions were found for beliefs underlying cultural aspects of responsible manhood.

"Can it be that god does not remember me": a qualitative study on the psychological distress, suffering, and coping of Dominican women with chronic filarial lymphedema and elephantiasis of the leg.

The psychological states of Dominican women with chronic lymphedema and elephantiasis of the leg and the coping strategies they used to ameliorate the negative psychological effects of this condition were explored using modified precepts of grounded theory method. Qualitative data were gathered through in-depth interviewing and focus group discussions held in the Dominican Republic. Thematic results found that compounding their physical disfigurement, functional limitations, and social losses were feelings of depression, embarrassment, social isolation, and despair. Adaptive problem solving and emotion-focused coping strategies that emerged during analysis also are discussed. It is recommended that management of psychological distress should be a significant component of lymphedema management programs in developing countries.