A scoping review of strategies for adolescents' sexual and reproductive health role modelling.

BACKGROUND:  Individuals strive to maintain their sexual and reproductive health (SRH) by being exposed to correct information, having access to contraceptives, and promoting safe sex practices. Adolescent SRH promotion efforts should consider the influence of role models. This review explored the availability and nature of strategies and programmes on adolescents' SRH role modelling and described them using a scoping review. METHODS:  Studies were retrieved from four databases and grey literature through a search of 223 studies. The databases included EBSCO-host, Medline, Sabinet, and Pubmed. Data extraction was guided by a data-extraction tool adapted from the JBI Manual for Evidence Synthesis. The characteristics of the selected studies were recorded in a Microsoft spreadsheet. Eleven studies published between 2014 and 2022 were included for the final review and analysed using thematic analysis. RESULTS:  Selected articles focused on adolescents' SRH; however, only two studies focused particularly on role modelling. Nonetheless, some aspects of the findings and recommendations presented could be extrapolated to adolescents' SRH role modelling. This includes adolescent-parent communication on SRH, community engagement, mentoring, positive role modelling, and information sharing through media campaigns. CONCLUSION:  There is a lack of literature on SRH role modelling because most studies did not focus on role modelling as an aspect of SRH. Therefore, research needs to be conducted on strategies and programmes focusing on SRH modelling.Contribution: The findings of this scoping review may encourage the development and implementation of strategies and programmes targeting adolescents' SRH throughout diverse communities to promote adolescent SRH.

Interventions for Type 2 Diabetes reduction among older people living with HIV in Harare.

BACKGROUND: Interventions for Type 2 Diabetes reduction among older people aged more than 50 years living with HIV (PLWH) are pertinent as they face excess risks amid a growing population of ageing PLWH. AIM: To describe interventions for Type 2 Diabetes reduction among older people living with HIV in Harare Urban DistrictSetting: The study was conducted in a low socio-economic setting from five primary health care clinics in Harare urban District. METHODS: A qualitative multi-method approach was applied using an exploratory descriptive design and an integrative review literature. The exploratory descriptive study collected data from two purposively selected samples; (1) older PLWH and (2) nurses. Whittemore and Knafl's framework was used for the integrative literature review with articles from 2013 to 2023 selected. Data source triangulation was applied using Braun and Clark's content analysis framework. Ethical approval was obtained (14056739_CREC_CHS_2022). RESULTS: 23 older PLWH with mean age, 62 years, 9 nurses with an average of 6 years' experience and 12 articles comprised the three data sources.  Key themes that emerged were that, screening should include; assessment from a younger age; assessment of HIV and ART-specific risks; diagnostic testing of Type 2 diabetes tests at ART initiation and routinely. Health education should provide information on adequate physical activity parameters and increased consumption of fruits and vegetables. Metformin may be considered as a pharmacological intervention where lifestyle interventions fail. CONCLUSION: The proposed interventions suggest measures to reduce Type 2 Diabetes and mitigate excess risks faced by older PLWH.Contribution: Improved screening, health education and pharmacological interventions for older PLWH in primary health care settings enable Type 2 Diabetes reduction.

Physical activity and diet for Type 2 Diabetes reduction among older people living with HIV in Harare.

Background: People living with HIV (PLWH) are ageing, and face increased risk for developing Type 2 Diabetes. Physical activity and diet are effective in reducing Type 2 Diabetes risk. However, there is variation in how older PLWH engage in physical activity and healthy eating. Aim: To describe older PLWHs' engagement in physical activity and diet for Type 2 Diabetes risk reduction in Harare. Setting: The study was conducted in five polyclinics in Harare urban district from low socio-economic areas. Methods: A qualitative approach and an exploratory descriptive design was used. Twenty-three participants were selected purposively based on the researchers' judgement of age among PLWH. Data were collected using a semi-structured interview schedule and analysed using Braun and Clark's six steps of thematic content analysis. Ethical approval was obtained, and each participant provided informed consent. Results: The mean age of participants was 62 years. Participants performed varied physical activities through; economic activities, walking, exercise, and domestic chores. Diet included indigenous, unrefined grains, vegetables and fruit, influenced by rural background. Diet consisted of larger proportions of carbohydrates with lesser varying portions of protein and vegetables and fruit. Healthy eating among participants was facilitated by the proximity of markets and family. Conclusion: Health education to reduce Type 2 Diabetes risk should focus on fostering current physical activities to meet prescribed standards and increasing fruit and vegetable consumption. Contribution: The physical activity and diet self-care practices among older PLWH are inadequate in reducing Type 2 Diabetes risk, emphasising the need for appropriate health education.

Psychosocial effects of gender-based violence among women in Vhembe district: A qualitative study.

Background: The phenomenon of gender-based violence is a pertinent social problem in South Africa. The fear of reporting gender-based violence contributes to its continuation, marginalisation and silencing of victims. Objectives: The study sought to explore the psychosocial effects of gender-based violence among women in Vhembe district. Methods: An exploratory phenomenological research design was used and sampling was performed purposively from a population of women who experienced gender-based violence in a low-resource, rural setting of Vhembe district. Semi-structured telephonic interviews were used as the main method of data collection after permissions and informed consent were sought for conducting the study. Thematic content analysis was applied to convert the participants' statements into a meaningful framework to derive the findings. Results: A total of 15 participants aged from 19 to 35 years participated in the study. Their psychosocial experiences of gender-based violence were depression, worthlessness, social isolation and anger directed towards children. Conclusion: This research confirms that gender-based violence remains one of the most challenging problems associated with mental health problems in Vhembe district. It affirms the need to focus on awareness in rural areas afflicted by patriarchal attitudes, norms and stereotypes. Gender-based violence should to be viewed as human rights violation for victims' protection. Contribution: The study contributes to the body of knowledge on the experiences of gender-based violence among marginalised women from rural areas.

Risks of Type 2 diabetes among older people living with HIV: A scoping review.

BACKGROUND: The effectiveness of antiretroviral therapy has enabled people living with human immunodeficiency virus (HIV) (PLWH) to live longer. With this longevity, there is the risk of developing age-related chronic conditions like Type 2 diabetes. Older PLWH have an increased risk of Type 2 diabetes mellitus (Type 2 DM) because of the natural physiological processes of ageing and risks posed by HIV infection and antiretroviral therapy use. The purpose of this scoping review is to describe risk factors associated with the development of Type 2 DM among older PLWH. METHODS: The study adopted a framework for scoping reviews. The first step identified the research question, followed by identifying studies from three databases: PubMed, Mendeley and Cochrane Library. A total of 618 nonduplicate studies were screened, with a final selection of 15 full-text studies from 2012 to 2022. Data were extracted using the Souza (2010) data extraction tool and analysed numerically and with thematic content analysis. RESULTS: Most studies were from Italy, with 60% being cross-sectional studies. On thematic analysis, the risks associated with Type 2 DM among older PLWH were long duration of HIV infection; the use of older-generation antiretroviral therapy; a high body mass index; the presence of hypertension and a lack of knowledge on modifiable risk factors for Type 2 DM. CONCLUSION: The identification of the risks that increase the likelihood of Type 2 DM among older PLWH facilitates effective screening and focused health education for older PLWH to reduce the development of Type 2 DM.Contribution: The findings of this study of excess risks of Type 2 DM specific to older PLWH complement risk factors of Type 2 DM in the general population. These excess risks facilitate case finding of older PLWH at risk of Type 2 DM especially in primary healthcare settings.

A plea of those who are affected most by HIV: The utterances by women who inject Nyaope residing in the City of Tshwane Municipality, Gauteng.

BACKGROUND: Nyaope injecting practice brought the field of Human Immunodeficiency Virus (HIV) prevention and Substance Use Disorder (SUD) together. It is complex and requires multidisciplinary approach. Women who use drugs face individual, social, and structural factors that fuel their vulnerability to contract HIV, and other blood-borne infections. Women Who Inject Drugs (WWID) are a subpopulation that is neglected from HIV prevention and SUD treatment interventions, and are hardly the subject of surveys. In order to fully address the HIV epidemic among WWID it is imperative that they become part of the process of finding solutions. AIM: This study explored the strategies to curb HIV incidence among Women Who Inject Nyaope (WWIN), residing in City of Tshwane Municipality, Gauteng Province. SETTING: The research was conducted within COSUP. COSUP was considered more appropriate as it is a harm reduction based organisation. METHODS: The study utilised the qualitative research approach. Semi structured interviews were conducted with 24 women with a history of injecting Nyaope aged between 19 to 35 years. The data was analysed using thematic data analysis. RESULTS: Health intervention, economic intervention and educational intervention was stressed as key strategies to curb HIV among WWIN. Needle exchange programmes, condom distribution, PrEP, HIV Testing and Counselling, employment opportunities, support groups and awareness campaigns if implemented, can yield positive outcomes in curbing HIV among WWID. CONCLUSION: Mechanisms to curb HIV among WWIN exist, and when implemented, they have the potential to address high HIV incidence among women who inject Nyaope.