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BACKGROUND: Sexual transmission of HIV frequently occurs in the context of a primary relationship between two partners; however, HIV prevention interventions generally focus on individuals at risk, rather than specifying couples as a unit of change and analysis, neglecting the crucial role that partners may play in sexual behaviour. This article reviews published scientific literature addressing couple-oriented HIV counselling and testing and other behavioural interventions using an online search for peer-reviewed papers. METHODS: A systematic review was conducted to evaluate what has been published on psychosocial interventions in HIV serodiscordant couples in Africa. Electronic databases were searched from January 1990 to December 2015. Quality assessment of included studies was conducted using the Systematic Appraisal of Quality in Observational Research tool. RESULTS: The electronic database searches initially retrieved 493 records; after cross-referencing, removing duplicates and applying strict inclusion and exclusion criteria, only eight papers were included in this review. All the studies under review showed that couples-focused counselling and educational programmes were associated with positive outcomes including reduced HIV transmission, reduced unprotected sex, increased rates of status disclosure and high levels of treatment adherence. CONCLUSIONS: The literature on interventions for HIV serodiscordant couples is sparse. However, most interventions indicate that couples-focused interventions are effective in HIV risk reduction. In spite of the limited available data and repeated recommendations by different health authorities, couple-centred approaches to HIV prevention have not been implemented on a large scale.
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BACKGROUND: Research on suicide attempts during pregnancy is limited as these are considered to be rare in the perinatal period. AIM: A retrospective pilot study was undertaken to establish what percentage of suicide attempters admitted to a hospital were pregnant and to identify their clinical and sociodemographic characteristics. SETTING: The study was conducted at a tertiary hospital in Durban, South Africa. METHODS: A retrospective chart review was undertaken of all female patients admitted following suicide attempts over a period of 1 year. Clinical and sociodemographic data of pregnant suicide attempters were extracted. RESULTS: Of 27 charts reviewed, 33% (n = 9) patients were pregnant at the time of the attempt. V Code diagnoses predominated, followed by major depressive disorder. Past psychiatric diagnoses and suicide attempts were also present. CONCLUSION: Suicide attempts during pregnancy are not rare. Pregnant women should be routinely screened for prior suicide attempts, depression and stressors as part of perinatal assessments.
ABSTRACT
Background: Research on suicide attempts during pregnancy is limited as these are considered to be rare in the perinatal period. Aim: A retrospective pilot study was undertaken to establish what percentage of suicide attempters admitted to a hospital were pregnant and to identify their clinical and sociodemographic characteristics. Setting: The study was conducted at a tertiary hospital in Durban, South Africa. Methods: A retrospective chart review was undertaken of all female patients admitted following suicide attempts over a period of 1 year. Clinical and sociodemographic data of pregnant suicide attempters were extracted. Results: Of 27 charts reviewed, 33% ( n = 9) patients were pregnant at the time of the attempt. V Code diagnoses predominated, followed by major depressive disorder. Past psychiatric diagnoses and suicide attempts were also present. Conclusion: Suicide attempts during pregnancy are not rare. Pregnant women should be routinely screened for prior suicide attempts, depression and stressors as part of perinatal assessments
Subject(s)
Patients , Pregnancy , Pregnant Women , South Africa , SuicideABSTRACT
Background: Sexual transmission of HIV frequently occurs in the context of a primary relationship between two partners; however, HIV prevention interventions generally focus on individuals at risk, rather than specifying couples as a unit of change and analysis, neglecting the crucial role that partners may play in sexual behaviour. This article reviews published scientific literature addressing couple-oriented HIV counselling and testing and other behavioural interventions using an online search for peer-reviewed papers. Methods: A systematic review was conducted to evaluate what has been published on psychosocial interventions in HIV serodiscordant couples in Africa. Electronic databases were searched from January 1990 to December 2015. Quality assessment of included studies was conducted using the Systematic Appraisal of Quality in Observational Research tool. Results: The electronic database searches initially retrieved 493 records; after cross-referencing, removing duplicates and applying strict inclusion and exclusion criteria, only eight papers were included in this review. All the studies under review showed that couples-focused counselling and educational programmes were associated with positive outcomes including reduced HIV transmission, reduced unprotected sex, increased rates of status disclosure and high levels of treatment adherence. Conclusions: The literature on interventions for HIV serodiscordant couples is sparse. However, most interventions indicate that couples-focused interventions are effective in HIV risk reduction. In spite of the limited available data and repeated recommendations by different health authorities, couple-centred approaches to HIV prevention have not been implemented on a large scale
Subject(s)
HIVABSTRACT
Background: Sexual transmission of HIV frequently occurs in the context of a primary relationship between two partners; however, HIV prevention interventions generally focus on individuals at risk, rather than specifying couples as a unit of change and analysis, neglecting the crucial role that partners may play in sexual behaviour. This article reviews published scientific literature addressing couple-oriented HIV counselling and testing and other behavioural interventions using an online search for peer-reviewed papers. Methods: A systematic review was conducted to evaluate what has been published on psychosocial interventions in HIV serodiscordant couples in Africa. Electronic databases were searched from January 1990 to December 2015. Quality assessment of included studies was conducted using the Systematic Appraisal of Quality in Observational Research tool. Results: The electronic database searches initially retrieved 493 records; after cross-referencing, removing duplicates and applying strict inclusion and exclusion criteria, only eight papers were included in this review. All the studies under review showed that couples-focused counselling and educational programmes were associated with positive outcomes including reduced HIV transmission, reduced unprotected sex, increased rates of status disclosure and high levels of treatment adherence. Conclusions: The literature on interventions for HIV serodiscordant couples is sparse. However, most interventions indicate that couples-focused interventions are effective in HIV risk reduction. In spite of the limited available data and repeated recommendations by different health authorities, couple-centred approaches to HIV prevention have not been implemented on a large scale
Subject(s)
Acquired Immunodeficiency Syndrome , Mental Health , Public Health Systems Research , South AfricaABSTRACT
OBJECTIVE: Adolescent suicidal behavior is a public health concern in South Africa. The purpose of this article is to report on the development of a screening tool for teachers to identify South African students who are most at risk for suicidal behavior. This need is addressed within the context of the limited number of mental health professionals available to provide screening and care services in South Africa. METHOD: Grade 8 students participated by completing sociodemographic questionnaires and self-report psychometric instruments. A screening tool for suicidal behavior was developed using a 4-phase approach. RESULTS: Twelve factors for high-risk suicidal behavior were identified and included in the screening tool. While further research is needed to validate the screening tool, the findings provide a useful preliminary starting point for teachers to refer students at high risk for suicidal behavior to mental health services for treatment. CONCLUSION: This screening tool is based on factors that were identified as being associated with suicidal behavior from local research on South African adolescents. The tool contributes to research on adolescent mental health, particularly suicidal behavior, in developing low and middle income countries like South Africa, with the aim of creating African prevention and intervention programs. (PsycINFO Database Record
Subject(s)
Mental Health Services , Mental Health , Suicidal Ideation , Suicide, Attempted/psychology , Surveys and Questionnaires , Adolescent , Adolescent Behavior/psychology , Child , Developing Countries , Female , Humans , Psychometrics , Risk Assessment , Risk Factors , Self Concept , South Africa , Stress, Psychological/psychology , Students/psychologyABSTRACT
Background: For every suicide; a minimum of six people are affected. Given the increasing number of suicide deaths in South Africa; the associations between the suicide of a family member and personal suicidal behaviour were explored in grade 8 students.Method: Grade 8 students were asked to participate with parental consent and child assent. Demographic questionnaires were completed and formal psychometric assessment instruments were used.Results: Thirty-five (15.98) students reported knowing that a family member had committed suicide. The mean age was 13.3 years (range 13-15 years). There were significant associations between family suicide and students' self-reported involvement in physical fights; use of alcohol and concerns about physical health. Family suicide was associated with personal suicidal ideation; suicidal plans and suicide attempts. Higher scores were reported on the scales assessing depression; perceived stress and feelings of hopelessness by those having had a family member commit suicide. There were low scores for having a sense of mastery; self-esteem and perceived social support among those who had experienced a family member commit suicide.Conclusion: Significant associations were found between the suicide of a family member and personal suicidal behaviour among the participants. There appear to be negative associations at a psychological level for the youth in a family in which a family member has committed suicide. Family practitioners play an important role in the identification and management of suicidal behaviour. While there are organisations in South Africa that offer help to the family and friends of those who have committed suicide; specific programmes directed towards child/adolescent survivors appear to be limited; and this needs to be addressed. The limitations of the study are discussed
Subject(s)
Adolescent , Child , Family , Self-Injurious Behavior , Stress, Physiological , SuicideABSTRACT
In the past suicidal behavior among Black South Africans has been largely underresearched. Earlier studies among the other main ethnic groups in the country showed suicidal behavior in those groups to be a serious problem. This article briefly reviews some of the more recent research on suicidal behavior in Black South Africans. The results indicate an apparent increase in suicidal behavior in this group. Several explanations are offered for the change in suicidal behavior in the reported clinical populations. This includes past difficulties for all South Africans to access health care facilities in the Apartheid (legal racial separation) era, and present difficulties of post-Apartheid transformation the South African society is undergoing, as the people struggle to come to terms with the deleterious effects of the former South African racial policies, related socio-cultural, socio-economic, and other pressures.