Reducing the vulnerability of adolescents and young people to HIV and STIs

The increasing burden of sexually transmitted diseases and the vulnerability of youth and tribal population to it have formed basis for the present study. This is part of a larger study conducted for academic purpose among 414 male tribal youth of two Primitive Tribal Groups in the state of Orissa, India namely, Juang and Lodha. Findings reveals that early age at marriage and early age at sexual debut along with pre-marital and extra-marital relations with multiple partners are serious concerns among these primitive tribal youth. Exposure to non-traditional world has changed their viewpoint that makes them lesser accountable towards their traditional life-ways. Lack of definite or diminished social system for imparting sexual knowledge is reflected in having no knowledge or incorrect knowledge about sex and related aspects among these tribal youth. Having sex with strangers or co-workers, especially as migrant labourer is also evident and this has direct bearing on sexual behaviour of the youth. It also highlights that presence or absence of youth dormitory or any institutionalised norms is not responsible for determining the sexual behaviour but it is the existence of social system like village exogamy, patterns of marriage, people’s life style and extent of social control mechanism.

Prior research has been concerned with the small correlation between high levels of HIV prevention awareness and actual contraceptive use among South African youths, suggesting that alternative explanations are needed to explain youths’ contraceptive use in a high HIV-prevalence society. One potential explanation is the ability of youths’ to effectively negotiate contraceptive use, especially among girls. This research uses the Cape Area Panel Study (n=1,380) to examine whether HIV prevention-related knowledge prior to first sexual intercourse and characteristics of youths’ first sex partner predict condom and other contraceptive use at first sex. We find that, similar with prior research, HIV prevention-related knowledge does not predict condom use for either males or females, however among females, having a partner who was two or more years older at first sex decreased the likelihood of using a condom by over 40%. This study extends prior research by using longitudinal data to predict behavior based on HIV knowledge and awareness prior to sexual debut and exploring other potential pathways, such as power dynamics within relationships that may influence the ability of youths to effectively negotiate contraceptive use. These findings have important implications for reproductive and sexual health programs in Sub-Saharan Africa.

We conducted a randomized controlled field trial to test whether short-term financial incentives have an impact on sexual behavior and the incidence of HIV and curable STIs among young people in Lesotho. The intervention linked eligibility to participate in a lottery to negative results for rapid tests for curable STIs: syphilis and Trichomonas vaginalis. The 3454 study participants were randomly allocated to two main arms: a treatment arm which is eligible to receive lottery tickets, and a control arm which is not. Both study arms received STI testing, counseling, and STI treatment at baseline and then every four months for two years. The treatment arm further allows sub-study of the effect of varying sizes of lottery prizes. Village level lotteries were organized every 4 months in which STI negative individuals from the treatment arm were eligible to participate. The study outcomes are HIV, syphilis and Trichomonas vaginalis incidence. Data analysis is currently finalized and preliminary results are encouraging, suggesting an impact of the intervention in significantly reducing HIV incidence, at least among females. The 2 year impact results will be available and fully analyzed by the time of the conference

Aims: Past studies on age at first sexual intercourse among South African youth have been largely cross-sectional and lack theoretical basis. This paper investigates factors influencing first sexual intercourse among South African youth using Waves 1-3 of Cape Area Panel Study data, based on Social Cognitive Theory. Methods: This quantitative data was analysed using Stata 12, and employs descriptive statistics, correlation and Cox Proportional Hazard Regression models. Results: The results showed that age, sex, racial origin, having attained secondary or tertiary educational level, and not attending school wielded a delaying effect on the rate of transition to first sexual intercourse at the three waves. On the other hand, not being happy about life, being from single-parent or both-parents family structures exerted a positive effect on the rate of transition into first sexual intercourse in Wave 1. Low level of happiness significantly encouraged the respondents to initiate their first sexual intercourse during the second wave. At the third wave, having low educational aspiration associated significantly with higher age at first sexual intercourse in 2005. Conclusions: This study concluded that personal and socio-economic/demographic factors were mostly important as far as the timing of first sexual intercourse is concerned.

Background: The epidemiology of HIV in children in sub-Saharan Africa remains poorly understood. We describe patterns of HIV infection in children aged 2-14 years in eastern Zimbabwe in 2009-2011.
Methods: Data on possible socio-demographic correlates of HIV prevalence, sources of childhood infection, and the effects of HIV were collected in a general population survey and analysed using multi-variable logistic regression. The possibility of horizontal transmission was assessed by comparing the age-pattern of HIV prevalence with a mathematical model of the pattern expected from survival of infants infected through mother-to-child transmission (MTCT).
Results: HIV prevalence in children was 2.2% (73/3,399). Prevalence did not differ by sex, age, socio-economic status, location or religion. The age-specific HIV pattern was consistent with the model prediction of that expected from survival of infants infected through MTCT, but 9/73 infected children had living HIV-negative mothers. Infected children were more likely than uninfected ones to be malnourished (21.6% vs 9.9%, p=0.006) and stunted (42.0% vs 30.6%, p=0.03). HIV status was not correlated with physical or psychological ill-health, or school drop-out.
Conclusion: Childhood HIV infection in Zimbabwe is due primarily to MTCT and is linked with poor physical development.

Background: The Uganda 2010 situation analysis reports that 96% of the children are vulnerable. The high vulnerability level is largely attributed to HIV/AIDS. These children have been subjected to sexual abuse and early marriages, forced out of school, engaged in hard labor, prostitution or high risk behaviors.

Methods: The National OVC Strategic plan provides the overall programming framework that guides the CSF sub-grantees implementation. CSF provided services in the Core Programme Areas of Socio-economic support; Food and Nutrition; Legal Support, Basic Care; Health; Education; with the integration of Psychosocial Support and Child Protection into all the mentioned CPAs.

Results: As a result, in the period of July 2010 and June 2011, CSF supported over 90,000 OVC which constitutes 12% contribution to the national target of serving 750,000. A total of 45,824 received comprehensive services, that is, at least 4 CPAs.

Conclusion: Integration of Child protection and psychosocial support into other CPAs rather than as parallel interventions is effective in comprehensively meeting the needs of the OVC even with the limited resources available.

The research was carried out to study sexual behavior, knowledge and attitude towards HIV/AIDs among six senior secondary school of age 12 – 20 years which was selected by a random sampling method. Ninety-seven percents of the students heard of HIV/AIDs, 84.7% reported it causes death and 18.7% reported there is a cure for HIV/AIDs. Twenty-three percent of the students have had their first sexual intercourse within mean age of 15.60 ± 2.30. Of those that have sexual intercourse, 66% have a regular partner while 34% do not have. Of the 47 students (23%) who became sexually active, 15 (31.9%) had sexual intercourse three months before the survey, 25 students (53.2%) cannot remember the number of times they had sex in the past three months. The use of condom was reported in 57.4% of the sexual active students while others did not see the need of using it. There was a high level of knowledge about ways of preventing HIV transmission. However, a considerable portion of the students harbored incorrect beliefs regarding mosquito bites. In conclusion, there is a pressing need for HIV/AIDs campaign especially school based AIDs education programs and activities in secondary schools to change their behavior.

Youths are a priority age group for the policy makers, due to the fact that they are at higher risk to HIV/ADS and STIs. Their less knowledge and risky behavior may lead to make them more vulnerable. Government of India launched a nation-wide campaign, namely the Red Ribbon Express Train to create awareness among general population. The present study examined the impact of the second round of this intervention on increasing comprehensive knowledge and awareness about testing facilities. Findings reveals that youth have less knowledge about linkages between HIV/AIDS and testing facility as compare to adults, moreover, youth aged 15-19 years are found to be at higher risk due to having less knowledge of HIV/AIDS. The impact assessment findings suggest that overall RRE has been successful in increasing the knowledge levels in all concerned variables, and the average treatment effect is found to be 12 percent which is consistent in different models. The paper recommends reaching out to those segments of the youth population which are more vulnerable such as females, illiterate and those who are not exposed to any form of media to achieve better results in its next rounds.

Since HIV was identified as the cause of AIDS, variety of tests have been developed to help diagnose HIV infection and to determine its progress. Voluntary counseling and testing was introduced to prepare clients for HIV test because it is accompanied by fear.
The study analyses perceptions on HIV/AIDS among University of Cape Coast students. It is a quantitative study which employed questionnaires to collect data. Chi-square statistic was used to test the relationship between fear and decision to test for HIV.
Results indicate that 93% had knowledge about HIV test. More students (73%) were frightened to go for HIV test. Students (76.3%) perceived that when tested positive to HIV, they would be stigmatized, grieved or rejected. The students (26%) who tested for HIV were compelled: the prominent reasons were traveling requirements and medical conditions. Females were more frightened than males to test for HIV. Most of the married students were prepared to go for the test than unmarried students.
It is profitable to test for HIV but its perceptions make it difficult. Therefore, opinion leaders and healthcare professionals should educate students to correct wrong perceptions about HIV/AIDS to eliminate fear to reduce the spread and burden of HIV/AIDS pandemic.

Current U.S. public health policies recommend routine chlamydial screening among women but not men. While data are available on trends in diagnosed infections reported to local health departments, comparable data are not available on trends in undiagnosed infections prevalent in the population. We compare undiagnosed infections in Baltimore, MD using population surveys of probability samples of Baltimore adults aged 18 to 35 years conducted in 1997-1998 and 2006-2009. Annual surveillance counts of infections diagnosed and reported to the Baltimore City Health Department are tabulated by sex and race.

Among men undiagnosed chlamydial infection increased from 1.6% to 4.0% between 1997-98 and 2006-09 (p=0.05) whereas prevalence among women declined from 4.3% to 3.1% (p=0.41; p=0.028 for test of interaction). The annual (average) number of diagnosed infections was substantially higher among women than men in both time periods and increased among men (391 in 1997-98 and 878 in 2006-09) and women (3255 in 1998 and 4475 in 2006-09). In both survey periods, undiagnosed infection was substantially higher among black than non-black adults (4.0% vs 1.2%, p=0.042 in 1997-98 and 5.5% vs 0.7%, p<0.001 in 2006-09).

Divergent trends in chlamydial infection by sex parallel the divergence in current screening policies