B Click: HIV/AIDS, Young People, Research
January 2012
http://www.comminit.com/hivaids-youngpeople/
Below, to inform your work, are summaries of research and action that are based on research results relating to young people and HIV/AIDS. The focus is on very recent research, particularly, though not exclusively, work freely available in full-text format from professional journals and pertinent historical work done between 2009 and 2012.
NEW: The following links are from The CI’s HIV/AIDS, Young People, Research Theme Site – http://www.comminit.com/hivaids-youngpeople/ – done in partnership with the Inter-Agency Task Team on HIV Prevention and Young People (IATT-YP). They are organised in research categories according to three priorities: Epidemiology, Services, and Structural Prevention.
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EPIDEMIOLOGY
Including: young women and girls, young people who inject drugs, young men who have sex with men, and young people involved in sex work.
http://www.comminit.com/hivaids-youngpeople/search/apachesolr_search/Epidemiology?filters=tid:4939
1. The Effectiveness of Interventions to Change Six Health Behaviours: A Review of Reviews
«This paper [from the United Kingdom] reports the findings of a review of reviews of behavioural change interventions to reduce unhealthy behaviours or promote healthy behaviours.» Specific to youth sexual risk taking: «…[T]wo conclusions can be drawn. First, in the area of risk reduction and prevention programmes, interventions are most effective in promoting the uptake of condom use, with some success in reducing the number of sexual partners and the frequency of sex. Second, interventions seeking to promote the use of contraception are more effective than interventions that promote abstinence…»
http://www.comminit.com/hivaids-youngpeople/content/effectiveness-interventions-change-six-health-behaviours-review-reviews
2. Alcohol Consumption, Sexual Partners, and HIV Transmission in Namibia
This report presents the results of a qualitative research study undertaken to examine the impact of alcohol consumption on sexual partnerships and the implications for HIV transmission in Namibia. The report presents its findings on aspects including multiple concurrent partnerships, condom use, underage drinking, and transactional sex before concluding with possible interventions focused largely on behaviour change and condom promotion. According to the research findings, nearly everyone in a boyfriend/girlfriend relationship uses condoms regularly or all the time, but many people often do not consistently use condoms after drinking. In addition, underage drinking was common and particularly risky for schoolgirls as young as 14 years of age, who often willingly or unwillingly engaged in transactional sex with older men in exchange for alcohol…
http://www.comminit.com/hivaids-youngpeople/content/alcohol-consumption-hiv-transmission-namibia
3. Improving Access to HIV Prevention Messages and Services among Men Who Have Sex with Men in Togo
This brief explores a peer-education-based programme launched in an effort to reach men who have sex with men (MSM) in Lomé, Togo, with HIV prevention messages and products, referrals to appropriate HIV counselling and testing (CT) services, psychosocial counselling, and diagnosis and treatment of sexually transmitted infections (STIs). PSI has learned that:
* Engaging local MSM communities and/or associations in programme design, message development, and programme implementation (including monitoring) is crucial.
* Employing community-based participatory research methods is essential to understanding MSM while building their trust and facilitating access to subsequent programme activities.
* Developing a referral system for HIV prevention and other services must be centred on the development of providers who are sensitive to the specific needs of MSM.
* Establishing condom and lubricant distribution channels that respond to the needs of the population is especially important with MSM.
* Empowering leaders in the MSM population requires significant time and effort but has the potential to maximise the sustainability of programme efforts, particularly with respect to mobilising MSM for HIV testing, healthy decisions, and developing local responses to harassment and stigma.
* Assuring security and privacy is important.
* Recruiting peer educators who represent the diversity of the local MSM population enables the programme to reach all sectors of the population…
http://www.comminit.com/hivaids-youngpeople/content/improving-access-hiv-prevention-messages-and-services-among-men-who-have-sex-men-togo
4. Assessment of Utilization of the HIV Interventions by Sex Workers in Selected Brothels in Bangladesh
This study examines the strategy of peer education for reaching female sex workers (FSWs) with messages related to STI and HIV and AIDS prevention in 4 large brothels in 4 different geographic sites in Bangladesh. In summary, the peer educators were found to be acceptable and credible facilitators to the FSWs in brothels. However, the FSWs’ high levels of knowledge of STIs/HIV/AIDS were not always supported by skills to negotiate with their clients. Therefore, it is recommended that more life skills training and role-playing exercises be integrated into FSW education. Beyond this, in order to increase FSWs’ control over condom use and access to healthcare, the programme should evolve to include all the relevant individuals in the power structure, such as the owner of the brothel, local police department, and service providers at the referral centres, to motivate them to facilitate sex workers’ need for protected sex…
http://www.comminit.com/hivaids-youngpeople/content/assessment-utilization-hiv-interventions-sex-workers-selected-brothels-bangladesh
5. HIV and Drug Use: Community Responses to Injecting Drug Use and HIV
This guide is designed for people who are developing and delivering HIV and harm reduction programmes or services at a community level in resource-poor settings. It distills some of the findings, concerns, issues, and considerations found to be effective, such as: (i) special attention brought to women, children and young people, and people in prison or detention; (ii) intervention programmes, behavioural change and health promotion, and the development of «social capital» to promote healthy decision making and education; and (iii) approaches including harm reduction programming, community mobilisation, and gender-sensitive programming…
http://www.comminit.com/hivaids-youngpeople/content/hiv-and-drug-use-community-responses-injecting-drug-use-and-hiv
6. Mobile Clinics in India Take to the Road
This report explores the process and results of delivering HIV and STI testing via mobile testing clinics designed to reach most-at-risk populations (MARPs) in India, including sex workers, people who inject drugs, and men who have sex with men. The rationale for using mobile clinics, instead of referring clients to existing HIV testing and counselling centres, was based on several assumptions – including that it would be easier for MARPs and bridge populations to access services if a mobile clinic came to select locations near them and during convenient times and that these groups might thereby enjoy greater anonymity, respect, and attention than at venues such as government hospitals. A typical day brings in 35 to 40 clients from high-priority groups. The non-governmental organisations (NGOs) and their outreach workers and peer educators assert that they are reaching greater numbers of high-risk clients than they did before the programme began…
http://www.comminit.com/hivaids-youngpeople/content/mobile-clinics-india-take-road
7. Male Circumcision for HIV Prevention: Cross-sectional Study on Awareness Among Young People and Adults in Rural Uganda
This journal article published by BMC Public Health shares findings from a survey that sought to identify factors determining awareness of male circumcision (MC) for HIV prevention. According to the article, it has been shown that awareness of the protective effect of male circumcision leads to high acceptability towards the introduction of medical MC services within countries. In the Ugandan survey, youth, women, and participants with a low educational level were considerably less informed about MC as a preventive measure to reduce the risk of contracting HIV. However, it was found that women play a decision-making role in deciding whether their sons and partners are circumcised…
http://www.comminit.com/hivaids-youngpeople/content/male-circumcision-hiv-prevention-cross-sectional-study
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SERVICES
Including: condoms, HIV testing and counselling, information/communication, sexuality education and lifeskills, harm reduction, male circumcision, and treatment for adolescents and young people living with HIV.
http://www.comminit.com/hivaids-youngpeople/search/apachesolr_search/Services
8. Needs, Challenges & Opportunities: Adolescents and Young People Living with HIV in Zambia
The aims of this qualitative study were to: (i) explore and document the psychosocial, sexual, and reproductive health (SRH) needs of adolescents (10-19) living with HIV in Zambia and (ii) identify gaps between these needs and existing SRH/HIV services. Findings included: immediate social networks have significant impact on the ability of young people to adhere to treatment and to come to terms with their HIV diagnosis. Also, responses from young people indicate appreciation of tailored and participatory events for information and social needs and for people working in services who are welcoming, empowering, and willing to share specific information…
http://www.comminit.com/hivaids-youngpeople/content/needs-challenges-opportunities-adolescents-and-young-people-living-hiv-zambia
9. Making Sense of Condoms: Social Representations in Young People’s HIV-Related Narratives from Six African Countries
From the Abstract: «In order to inform education and communication efforts to increase condom use, we examined social representations of condoms among young people aged 10-24 in six African countries/regions with diverse HIV prevalence rates: Swaziland, Namibia, Kenya, South-East Nigeria, Burkina Faso, and Senegal. Moralization emerged as a key impediment to positive representations of condoms, while humour was an appealing means to normalize them. The social representations in the narratives identify communication needs in and across settings and provide youth-focused ideas and perspectives to inform future intervention efforts…»
http://www.comminit.com/hivaids-youngpeople/content/making-sense-condoms-social-representations-young-peoples-hiv-related-narratives-six-afr
10. Effect of Communication on HIV Prevention and Living with HIV/AIDS
Developed for advocacy purposes, this resource from the Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs offers 10 key points for discussion around the impact of communication on HIV prevention and living with HIV/AIDS. Excerpts include: «A new meta-analysis of 72 published studies finds that condom use is 18 percentage points higher on the average among those exposed to mass media interventions for HIV prevention….For any statistically significant effect size, mass media interventions are always much more cost-effective than alternative interventions if they reach a large percentage of the population…»
http://www.comminit.com/hivaids-youngpeople/content/effect-communication-hiv-prevention-and-living-hivaids
11. The Role of Non-Formal Education in Combating the HIV Epidemic in the Philippines and Taiwan
«Earlier education programmes employed non-formal educational training techniques in the southern Philippines to [focus on] high-risk groups such as female sex workers [FSW] and their establishment managers; the effort was expanded to [focus on] males in the community….In summary, the non-formal educational programmes in each country highlight the importance of environmental factors and their predictive ability in modifying HIV prevention behaviours among [female sex workers] in the Philippines and [injecting drug users] in Taiwan….»
http://www.comminit.com/hivaids-youngpeople/content/role-non-formal-education-combating-hiv-epidemic-philippines-and-taiwan
12. How Well Do International Drug Conventions Protect Public Health?
«The international conventions severely restrict the ability of national governments to experiment with alternative drug control systems by requiring all signatories to criminalise non-medical drug use. Research lends support to harm reduction services for problem drug users (e.g., opioid substitution treatment, needle and syringe programmes, antiretroviral treatment, and other psychosocial interventions), most of which the international system now supports. Eight countries have provided supervised injecting centres to reduce blood-borne virus transmission and overdose and to increase drug users’ contact with treatment services…»
http://www.comminit.com/hivaids-youngpeople/content/how-well-do-international-drug-conventions-protect-public-health
13. Stay Healthy: A Gender-Transformative HIV Prevention Curriculum for Youth in Namibia
This interactive curriculum from EngenderHealth and LifeLine/ChildLine is designed to apply a gender-transformative approach to HIV prevention in Namibian schools. «A total of 25 distinct psychosocial determinants….The 25 determinants fall within the following 10 broad categories: (1) knowledge, (2) attitudes, (3) beliefs, (4) values, (5) peer norms, (6) gender norms, (7) skills and self-efficacy, (8) future goals, (9) parent-child communication, and (10) intentions…»
http://www.comminit.com/hivaids-youngpeople/content/stay-healthy-gender-transformative-hiv-prevention-curriculum-youth-namibia
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STRUCTURAL PREVENTION
Including: incentives for change (e.g. cash transfers, microfinance, economic empowerment), laws and policies, and gender-based violence.
http://www.comminit.com/hivaids-youngpeople/search/apachesolr_search/Structural%20prevention?filters=tid:4939
14. Building Support for Gender Equality among Young Adolescents in School
This report shares evaluation results from the 3-year (2008-2011) Gender Equity Movement in Schools (GEMS) programme, which the International Center for Research on Women (ICRW) implemented in Goa, Kota, and Mumbai, India, in an effort to explore the potential for school-based curricula to influence the formation of more gender-equitable attitudes and norms among adolescents. As detailed in the report, GEMS consisted of a week-long campaign and group education activities (GEA), which used participatory methodologies such as role plays, games, debates, and discussions to engage students in meaningful and relevant interactions and reflection about key issues of gender and violence. The report details 8 key findings…
http://www.comminit.com/hivaids-youngpeople/content/building-support-gender-equality-among-young-adolescents-school
15. Supporting Adolescent Orphan Girls to Stay in School as HIV Risk Prevention: Evidence from a Randomized Controlled Trial in Zimbabwe
Published in the American Journal of Public Health, this paper describes research to test whether comprehensive support to keep Zimbabwean orphan adolescent girls in school could reduce HIV risk. All primary schools received a universal daily feeding programme; intervention participants received fees, uniforms, and a school-based helper to monitor attendance and resolve problems. It was found that the intervention reduced school dropout by 82% and marriage by 63% after 2 years. Compared with control participants, the intervention group reported greater school bonding, better future expectations, more equitable gender attitudes, and more concerns about the consequences of sex…
http://www.comminit.com/hivaids-youngpeople/content/supporting-adolescent-orphan-girls-stay-school-hiv-risk-prevention-evidence-randomized-c
16. Structural Determinants of Adolescent Girls’ Vulnerability to HIV: Views from Community Members in Botswana, Malawi, and Mozambique
Published in Social Science & Medicine, this study, led by researchers at the Johns Hopkins Bloomberg School of Public Health, shows that community members in sub-Saharan Africa correlate an increase in HIV vulnerability among adolescent girls with weak structural support systems. The basis for the study was that, in sub-Saharan Africa, adolescent girls are three to four times more likely than adolescent boys to be living with HIV/AIDS. The study found that structural factors, especially insufficient economic, educational, socio-cultural, and legal support for adolescent girls, were identified as the root causes of girls’ vulnerability to HIV through exposure to unprotected sexual relationships, primarily relationships that are transactional and age-disparate…
http://www.comminit.com/hivaids-youngpeople/content/structural-determinants-adolescent-girls
17. What Role Should Criminal Justice Play in the Fight against STIs?
In this editorial from the journal Sexually Transmitted Infections, the author asks: «Can criminal justice make a positive contribution to the way states respond to sexually transmitted infections (STIs)? In many countries, the passing on of infections through unsafe sexual activity is criminalized, either through specific legislation, or by adapting general prohibitions against inflicting bodily harm. If particular STIs (such as HIV) are harms to be taken at least as seriously as a broken leg then it makes sense to a criminal lawyer to treat both its intentional and ‘reckless’ transmission as a criminal offence…»
http://www.comminit.com/hivaids-youngpeople/content/what-role-should-criminal-justice-play-fight-against-stis
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DB Click: HIV/AIDS, Young People, Research is one of two special issues which complement DB Click: HIV/AIDS and The Drum Beat through a specific focus on HIV/AIDS, youth, and development.
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