A Qualitative Exploration of Factors Influencing Non-Use of Sexual Reproductive Health Services among University Students in South Africa.

(1) Background: There is growing concern in South Africa about risky sexual behaviour, sexual transmitted infections (STIs), and unplanned pregnancy among young people. Many sexually active students engage in several risky behaviours, including sex with multiple sexual partners, low condom use, and low contraceptive use. This paper qualitatively explores factors influencing non-use of sexual reproductive health services by students at Mangosuthu University of Technology in South Africa (MUT). (2) Methods: Data was collected through 20 in-depth interviews with MUT students and subjected to inductive thematic analysis. Informed consent was obtained before all data collection. (3) Results: The main themes identified were risky sexual behaviours translating to multiple intimate partners, perceived quality of condom use, perceived benefits of contraceptives, negotiating safer sex with partners, developing a greater sense of autonomy, alcohol and drug abuse, perceived benefits of health education provided by the MUT, and lack of open communication. (4) Conclusions: The findings suggest that university students need multi-faceted interventions designed to address challenges with risky sexual behaviours including knowledge and benefits of condom and contraceptive use to prevent STIs and unwanted pregnancies, as well as providing psychosocial interventions to support these students' autonomy.

Psychosocial Support Programme Improves Adherence and Health Systems Experiences for Adolescents on Antiretroviral Therapy in Mpumalanga Province, South Africa.

(1) Background: Psychosocial support (PSS) plays a significant role in persistent adherence to and retention in antiretroviral therapy (ART) for adolescents living with the human immunodeficiency virus (ALHIV). This paper qualitatively explores the experiences of ALHIV on ART, who participated in a PSS programme in five public primary healthcare facilities in Mpumalanga Province in South Africa during the COVID-19 pandemic. (2) Methods: Data were collected through 24 focus group discussions with 173 ALHIV on ART and subjected to inductive thematic analysis. Informed consent was obtained before all data collection. (3) Results: The PSS programme facilitated the process of full HIV disclosure to these adolescents with the support of parents/guardians while motivating adherence through peer support groups and health education for improved treatment literacy. Participants reported positive health systems experiences, improved healthcare provider-client relations, and prompt access to health services. (4) Conclusions: The PSS programme successfully kept ALHIV engaged in ART care despite the health service disruptions encountered during the COVID-19 pandemic. We recommend rigorous evaluation of the effects of the PSS intervention on adherence to and retention in ART among ALHIV in HIV-endemic settings.

Monkeypox during COVID-19 era in Africa: Current challenges and recommendations.

In May 2022, monkeypox virus (MPXV) outbreak was confirmed amid the coronavirus disease 2019 (COVID-19) pandemic in many parts of the world including Africa. This is the largest outbreak since monkeypox (MPX) was first detected in humans in 1970. The MPX outbreak in Africa is an added burden to the fragile healthcare systems that are already overburdened with several reoccurring epidemics. Although several efforts are in place to effectively contained the outbreak. Several measures such as improved surveillance and diagnostic are necessary to contain the spread of the disease in Africa. This commentary highlights the challenges with the MPX outbreak in Africa and discusses the measures that can be taken to limit the spread of the disease, particularly in high-risk countries.

Applying the biopsychosocial model to unpack a psychosocial support intervention designed to improve antiretroviral treatment outcomes for adolescents in South Africa.

Adolescents (10 to 19 years) living with HIV (ALHIV) experience disproportionately poor adherence to antiretroviral treatment (ART) compared to other age groups. Several barriers, including psychosocial challenges, contribute to this observation. Psychosocial support (PSS) interventions show promising results as a strategy to deal with the biological and psychosocial challenges faced by ALHIV. However, there is dearth of information on how psychosocial support interventions designed to improve treatment adherence and retention in care among ALHIV are effective. In this commentary, we used the biopsychosocial model to formulate hypotheses on how the components of a PSS intervention could improve adherence and retention in ART care. Psychological wellbeing, coping strategies, social support, self-efficacy, and disclosure are key components in the intervention designed to improve ART adherence and retention in care. The management of ALHIV for improved ART adherence and retention requires recognising and addressing the complex biological, psychological and social issues peculiar to them.

Marburg virus disease outbreak amidst COVID-19 in the Republic of Guinea: A point of contention for the fragile health system?

In August 2021, the Marburg virus disease (MVD) outbreak was confirmed amid the coronavirus disease 2019 (COVID-19) pandemic in the Republic of Guinea. This is the first time it is detected in Guinea and West Africa. Marburg virus is one of the world's most threatening diseases, causing severe haemorrhagic fever, with a case fatality rate of 90%. Currently, there are no vaccines and specific antiviral drugs for MVD. Technical teams and community health care workers that were set up as part of the recent Ebola virus disease (EVD) outbreak that was declared over on June 19, 2021, are now redeployed to support governments response activities of the MVD outbreak in the country. The MVD is an added burden to the fragile healthcare systems that are already overburdened with multiple reoccurring epidemics and the COVID-19 pandemic. Previous epidermic strategies are needed to contain the spread of the disease, amid the COVID-19 pandemic, so the health care systems are not overwhelmed. This commentary discusses the available evidence regarding the epidemic of MVD in Guinea amid the COVID-19 pandemic, and highlights the efforts, challenges to be prioritized, and provides evidence-based recommendations.

Understanding varying COVID-19 mortality rates reported in Africa compared to Europe, Americas and Asia.

The SARS-CoV-2 infection, which causes the COVID-19 disease, has impacted every nation on the globe, albeit disproportionately. African countries have seen lower infection and mortality rates than most countries in the Americas Europe and Asia. In this commentary, we explore some of the factors purported to be responsible for the low COVID-19 infection and case fatality rates in Africa: low testing rate, poor documentation of cause of death, younger age population, good vitamin D status as a result of exposure to sunlight, cross-immunity from other viruses including coronaviruses, and lessons learnt from other infectious diseases such as HIV and Ebola. With the advent of a new variant of COVID-19 and inadequate roll-out of vaccines, an innovative and efficient response is needed to ramp up testing, contact tracing and accurate reporting of infection rates and cause of death in order to mitigate the spread of the infection.