![The Drum Beat]() The Drum Beat – 641 – HIV/AIDS, Young People and Research |
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| This Drum Beat explores The CI’s HIV/AIDS, Young People, Research theme site, developed in partnership with the Joint United Nations Programme on HIV/AIDS (UNAIDS) Inter-Agency Task Team (IATT) on HIV and Young People. IATT was created in 2001 to support an accelerated, harmonised, and expanded global, regional, and country-level response to increase young people’s utilisation of HIV prevention, treatment, and care services.
The HIV/AIDS, Young People, Research theme site is part of the IATT website on young people and HIV, which serves as a platform to provide access to a range of resources on HIV and AIDS focused on adolescents and youth. The IATT website also includes a Community of Practice that hosts material and discussions disseminated through webinars on topics linked to programming for adolescents and youth.
The focus of the HIV/AIDS, Young People, Research theme site is on recent research, particularly, though not exclusively, work freely available in full-text format from professional journals and pertinent work done between 2010 and 2013. We recommend that you visit the website’s mainpage to inform your work through its links in the right hand navigation bar to «Recent Journal Articles – HIV Prevention and Young People» with listings aggregated by topic, «Tweets on HIV/AIDS Research», and «Selection of Recent Journal Articles – HIV/AIDS, Young People» with listings by title.
The content of the HIV/AIDS, Young People, Research theme site is divided into 3 research categories: epidemiology, services, and structural prevention; this Drum Beat is organised along these lines and provides a window into the myriad ways in which communication strategies inform and elevate research in this area. We welcome your research contributions of papers on your work in communication for development with HIV/AIDS and young people; just send us a note at AIDS@comminit.com |
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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 |
1. Faidha Gani? What’s the Point: HIV and the Logics of (Non)-Disclosure among Young Activists in Zanzibar
by Eileen Moyer |
| Participatory research involving young people living with HIV and organisations supporting them in Zanzibar led to findings such as this: «Although there is arguably much to be gained by disclosing [HIV status], there is also much at stake, including issues of individual and family honour and the possibility of living a ‘normal’ life.» The research suggests that treatment availability encouraged positive people to disclose to partners and family, if at all, but to remain silent in public in order to live without stigma, including, in one case, having an HIV-negative child through accessing antiretroviral treatment, giving birth through caesarean section, and not breastfeeding.
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| 2. Experiences from the Field: HIV Prevention among Most at Risk Adolescents in Central and Eastern Europe and the Commonwealth of Independent States |
This document shares the results of research, advocacy, and interventions in an effort to support programmers, policymakers, and donors to carry out and strengthen further programming among most-at-risk-adolescents (MARA) and other vulnerable adolescents in the Central and Eastern Europe (CEE) and the Commonwealth of Independent States (CIS) Region and beyond. It presents programming experiences from 7 countries, including Albania, where the United Nations Children’s Fund (UNICEF) supported the Institute of Public Health in collecting data on 121 male injecting drug users (IDUs) aged 15-24 in Tirana. Qualitative research was also carried out to clarify the social dynamics and networks among adolescents and young IDUs. After reviewing the research findings, UNICEF, government partners, and other stakeholders developed a programme that involves: advocating for MARA to be placed on the national agenda and strengthening capacity of policymakers to address them; strengthening capacity and adapting existing HIV prevention and harm reduction services to better respond to the needs of adolescents; and preventing the transition to injecting among adolescent «pre-injectors». [UNICEF, Jan 2013]
- For more on young people who inject drugs, click here.
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3. Keeping Them in «STYLE»: Finding, Linking, and Retaining Young HIV-Positive Black and Latino Men Who Have Sex with Men in Care
by Lisa B. Hightow-Weidman, Justin C. Smith, Erik Valera, Derrick D. Matthews, and Patrick Lyons |
This research evaluates the effectiveness of a social marketing campaign created for HIV-infected African-American and Latino young men who have sex with men (YMSM) in North Carolina, United States, called STYLE (Strength Through Youth Livin’ Empowered). The pre-STYLE cohort attended 67% of their scheduled clinic appointments, compared to 80% of «attended visits» by those enrolled in STYLE. «Future research should evaluate the use of mobile phone and Internet-based interventions such as adherence counseling, and the ability to schedule walk-in appointments online as a way to maintain greater communication and connection between youth and their HIV care providers.» [Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Jan 2011]
- For more on young men who have sex with men (YMSM), click here.
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4. Vulnerabilities, Health Needs and Predictors of High-Risk Sexual Behaviour among Female Adolescent Sex Workers in Kunming, China
by Xu-Dong Zhang, Marleen Temmerman, Yan Li, Wei Luo, and Stanley Luchters |
| Adolescent female sex workers (FSWs) who accessed sexually transmitted infection (STI) prevention services, including peer-education-based health promotion and condom access, reported improved sexual behaviour. This is one of the findings of a study that assessed social and behavioural predictors for sexual risk taking and STIs, including HIV, among adolescent FSWs from Kunming, China. The study found that FSWs 15-19 years of age reported a very low rate of consistent condom use (22.2%), and STI prevalence was high overall (30.4%). The majority of women reported a need for additional health knowledge (77.1%), free condom distribution (50.8%), and low-cost STI diagnosis and treatment services (53.7%). One recommendation is to reorient and evaluate existing sex worker drop-in centres to make health services relevant and accessible to young people. This could include recruitment and training of adolescent sex worker peer educators, as well as efforts to offer confidential, non-judgmental counselling and testing. [Dec 2012]
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SERVICES
Including: condoms, HIV testing and counselling, sexuality education and lifeskills, harm reduction, male circumcision, treatment for adolescents and young people living with HIV, and social and behaviour change |
5. Pinch, Leave an Inch and Roll: Applying the Communication-for-Behavioural-Impact (COMBI) Approach to the Promotion of Proper Male Condom Usage in Jamaica
by Livingston A. White, Lovette Byfield, Sannia Sutherland, and Roshane S. Reid |
| This article describes reasons that various age groups in Jamaica may not use condoms, including complexity of use, which became the basis for developing the edutainment campaign «Pinch, Leave an Inch and Roll». It then describes Communication for Behavioural Impact (COMBI) as a form of strategic communications planning and mobilisation, including 5 major areas used in commercial marketing efforts and 10 steps of the COMBI framework for the campaign. Short- and long-term interventions were measured for evaluation by: number of persons reached; number of condoms distributed; number of HIV tests conducted; number of peer educators trained; number of condom access points established; and number of social service referrals, among others. Suggestions include: use existing structures, persevere for the long term (including responding to market research trends), ensure strong programme leadership and base activities on epidemiological data (not moral views on risky behaviour), establish good working relationships with planners and the creative team, and spend funds wisely. [Caribbean Quarterly (Special Issue on Communication in Action), Jan 2012]
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6. Where Do Young Men Want to Access STI Screening? A Stratified Random Probability Sample Survey of Young Men in Great Britain
by John M. Saunders, Catherine H. Mercer, Lorna J. Sutcliffe, Graham J. Hart, Jackie Cassell, and Claudia S. Estcourt |
| In this United Kingdom (UK) study, researchers explored the acceptability of various medical, recreational, and sports venues as settings to access self-collected testing kits for STIs and HIV among men in the general population and those who participate in sport. The majority of men were willing to provide a self-collected sample for STI/HIV testing (85.1%) across all ages. However, men rejected many of the proposed sport and social venues for fear of the stigma of being seen to take a test. Men also appeared to perceive a degree of incongruity between attending these locations for recreation and the health message of screening. The researchers conclude that «[y]oung men are willing to test for STIs and primary care settings are the most acceptable locations.» [Apr 2012]
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| 7. Smart Science: An HIV/AIDS Education Initiative Aiming to Prevent New Infections in School Going Children by Encouraging a Correct Understanding of Current Health Research through a Scientific Approach |
| This South African health education initiative stressed a correct scientific understanding of the issues surrounding the HIV/AIDS pandemic as the basis for sensible lifestyle choices. The entertainment-education project involved an interactive, multimedia show focused on delivering scientifically-based HIV/AIDS education. Amongst the small sample interviewed, students reported substantial behavioural changes following the programme, including refusing to have unprotected sex and moving to single-partner relationships. The results demonstrate that the programme affected not only intentions and attitudes, but – crucially – the way young people actually acted.
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8. Policy Environment and Male Circumcision for HIV Prevention: Findings from a Situation Analysis Study in Tanzania
by Joseph R Mwanga, Mwita Wambura, Jacklin F Mosha, Gerry Mshana, Frank Mosha, and John Changalucha |
This Tanzanian study is part of a situation analysis to understand the attitudes of policymakers and other key community and health authority decisionmakers towards male circumcision (MC), which has been shown to be effective against heterosexual acquisition of HIV infection. Amongst the findings: (i) appropriate bylaws and regulations are needed so that MC services are accessible and provided safely without discrimination; (ii) advantages and disadvantages of medically performed MC need to be communicated to the people (e.g., through public meetings) to raise their levels of knowledge and awareness on the issue and to dispel fears, misconceptions, and stigma; (iii) health care providers should work closely with traditional circumcisers (locally known as Omusari in the Kurya language), because they, together with clan leaders, are «the custodian of Kurya traditions and chief spokesmen and decision makers on when and who has to undergo circumcision.» [Jun 2011]
- For more on medical male circumcision, click here.
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9. Effectiveness of HIV Prevention for Youth in Sub-Saharan Africa: Systematic Review and Meta-Analysis of Randomized and Nonrandomized Trials
by Kristien Michielsen, Matthew Chersich, Stanley Luchters, Petra De Koker, Ronan Van Rossem, and Marleen Temmerman |
Findings from this systematic review and a meta-analysis to assess effectiveness of interventions to reduce sexual risk behaviours and consequent HIV infection among young people (10-25 years) in sub-Saharan Africa: «[T]aken together the evidence indicates that sex education and condom promotion activities among youth does not increase sexual activity, nor promote risky sexual behaviour. However, we could not observe large positive changes either. Youth did not significantly reduce sexual activity, and condom use at last sex only increased notably among males….This finding corresponds with other reviews, who find significant changes in knowledge and attitudes, but a small degree of risk reduction.» [Jan 2010]
- For more on sexuality education and lifeskills, click here.
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10. The Need to Promote Behaviour Change at the Cultural Level: One Factor Explaining the Limited Impact of the MEMA kwa Vijana Adolescent Sexual Health Intervention in Rural Tanzania
by Daniel Wight, Mary Plummer, and David Ross |
Both the qualitative process evaluation and the biological trial outcomes showed that, despite the school component of this school-based programme being delivered and engaged in by pupils (largely as intended), sexual risk behaviours were not reduced. The take-home message: Efforts to modify participants’ attitudes and norms that do not sufficiently account for local community norms and culture may not succeed. The paper identifies these broad implications for future behavioural sexual health interventions: (i) Interventions are most likely to be effective if multi-level – addressing individual factors but also collective and structural barriers to behaviour change. (ii) For new norms to endure and generate different patterns of behaviour, multi-level interventions need to be confirmed and reinforced through social interaction. Therefore, the broader the group involved within a community, the more opportunity there is for such social interactions to occur, and their repetition sustains the impact of the original intervention. [BMC Public Health Journal, Sep 2012]
- For more on social and behaviour change, click here.
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| 11. Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents |
| This section from the AIDSinfo Clinical Guidelines portal summarises factors associated with nonadherence to antiretroviral therapy (ART) in adults and adolescents. «Given that effective response to ART is dependent on good adherence, clinicians should identify barriers to adherence such as a patient’s schedule, competing psychosocial needs, learning needs, and literacy level before treatment is initiated….Establishing a trusting relationship over time and maintaining good communication will help to improve adherence and long-term outcomes.» In its conclusion, this summary links to the Centers for Disease Control and Prevention (CDC) page on «Good-Evidence Medication Adherence Interventions», which lists 8 programmes that have been evaluated for efficacy on adherence to treatment. [Mar 2012]
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STRUCTURAL PREVENTION
Including: incentives for change (e.g., cash transfers, microfinance, economic empowerment), laws and policies, and gender-based violence |
12. Impact of the Kenya Cash Transfer for Orphans and Vulnerable Children Program on HIV Risk Behavior
by Sudhanshu Handa, Carolyn Halpern, PhD, Audrey Pettifor, and Harsha Thirumurthy |
| This study examined the Kenya cash transfer programme for orphans and vulnerable children (CT-OVC). It studied results in the population of economically «ultra-poor» 0-17-year-olds receiving a flat monthly transfer of US$20, a programme covering 125,000 households and 350,000 OVC. It was found that there was 30% lower chance of sexual début; less chance of 3+ unprotected sex acts in last 3 months; and, among females, fewer partners in last year. As far as protective factors in the lives of OVC, schooling was found to be protective, but not a mediator, as was perception of friends’ behaviour. [Oct 2012]
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13. Challenges to Youths Accessing Sexual and Reproductive Health Information and Services in Southern Africa: A Review of Qualitative Research in Seven Countries
by Michael Jana, Itumeleng Mafa, Ken Limwame, and Agnes Shabalala |
| The Soul City Institute for Health and Development Regional Programme, involving partner organisations in Lesotho, Malawi, Namibia, South Africa, Swaziland, Zambia, and Zimbabwe, conducted qualitative formative audience research to explore knowledge, attitudes, and practices on sexual and reproductive health and rights (SRHR) issues among youth. One finding: There is need to conduct research and advocate for ways of aligning national sexual and reproductive policies on youth with current youth sexual practices and envisaged youth sexual and reproductive health outcomes. [Aug 2012]
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14. Multimedia Library on Sexuality, HIV, and Violence – Biblioteca Multimedia sobre Sexualidad, VIH y Violencia
by Erika Miranda, Martha Juárez, Teresita Hernández, and Evelyn Flores |
| Updated monthly, this Spanish language multimedia library from the Nicaraguan organisation Puntos de Encuentro is a compilation of documents in audio, video, and text including theoretical and methodological tools, sites of interest, directors, research, evaluations, and action guides – all which may be useful when addressing the issue of sexual and reproductive rights and a life free of violence. It includes research on HIV and violence against young women and on female sex workers, strategies to combat gender violence, and an evaluation on the impact of violence against women, among others.
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| This issue of The Drum Beat was written by Kier Olsen DeVries. |
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| The Drum Beat is the email and web network of The Communication Initiative Partnership – Partners: ANDI, BBC Media Action, Bernard van Leer Foundation, Breakthrough, Calandria, Citurna TV, DFID, Eldis, FAO, Fundación Imaginario, Fundación Nuevo Periodismo, Heartlines, Iberoamericano (FNPI), IFPRI, Inter-American Development Bank, Johns Hopkins Bloomberg School of Public Health Center for Communication Programs, MISA, Open Society Foundations, Oxfam Novib, PAHO, The Panos Institute, Puntos de Encuentro, The Rockefeller Foundation, SAfAIDS, Sesame Workshop, Soul City, STEPS International, UNAIDS, UNDP, UNFPA, UNICEF, USAID, The Wellcome Trust, World Health Organization (WHO), W.K. Kellogg Foundation.
The Drum Beat seeks to cover the full range of communication for development activities. Inclusion of an item does not imply endorsement or support by The Partners.
Chair of the Partners Group: Garth Japhet, Founder, Soul City garth@heartlines.org.za
Executive Director: Warren Feek wfeek@comminit.com |
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| The Editor of The Drum Beat is Kier Olsen DeVries. |
| Please send additional project, evaluation, strategic thinking, and materials information on communication for development at any time. Send to drumbeat@comminit.com
The Drum Beat seeks to cover the full range of communication for development activities. Inclusion of an item does not imply endorsement or support by The Partners.
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