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Silberg C, Moreau C, Karp C, Bazié F, Gichangi P, Guiella G, Onadja Y, Thiongo M, Anglewicz P. Trends in Adolescent Sexual and Reproductive Health Outcomes Before and Into the COVID-19 Pandemic in Burkina Faso and Kenya: Evidence From Panel Data. J Adolesc Health 2024; 75:344-352. [PMID: 38878048 PMCID: PMC11252117 DOI: 10.1016/j.jadohealth.2024.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 04/10/2024] [Accepted: 04/15/2024] [Indexed: 07/20/2024]
Abstract
PURPOSE Many predicted that COVID-19 would have a substantial impact on the sexual and reproductive health (SRH) trajectories of adolescents in sub-Saharan Africa. The lack of longitudinal data with information collected before and into the pandemic has limited investigation into this topic. METHODS We performed a secondary analysis using nationally representative longitudinal data from Kenya and Burkina Faso, collected at three time points (pre-COVID-19 in late 2019, and during COVID-19 in 2020 and 2021), to determine the extent to which SRH outcomes and behaviors, including pregnancy, contraceptive use, partnership status, and sexual activity, changed during the pandemic among adolescent women. RESULTS Among adolescents aged 15-19 years (Kenya n = 1,893, Burkina Faso n = 1,422), there was a reduction in both partnership and pregnancy in 2021 as compared to pre-COVID 2019. Contraception use significantly increased between 2019 and 2021 in Kenya only (adjusted odds ratio [aOR]: 1.42, 95% confidence interval [CI] 1.03-1.97). COVID-19-related household income loss was associated with a decline in sexual activity among unmarried Kenyan girls (aOR: 0.47, 95% CI 0.25-0.87) and lower odds of pregnancy in Burkina Faso (aOR: 0.13, 95% CI 0.02-0.91). We did not find a relationship between COVID-19 measures and initiation of partnership or marriage in either setting. DISCUSSION Contrary to expectations, our results suggest that COVID-19 did not have a consistent or sustaining impact on adolescent SRH and behaviors in Burkina Faso and Kenya. Further research is needed to assess the longer-term implications of the pandemic on adolescent social and health outcomes.
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Affiliation(s)
- Claire Silberg
- Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
| | - Caroline Moreau
- Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Celia Karp
- Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Fiacre Bazié
- Institut Supérieur des Sciences de la Population (ISSP), Université Joseph KI-Zerbo, Ouagadougou, Burkina Faso
| | - Peter Gichangi
- International Centre for Reproductive Health-Kenya, Nairobi, Kenya
| | - Georges Guiella
- Institut Supérieur des Sciences de la Population (ISSP), Université Joseph KI-Zerbo, Ouagadougou, Burkina Faso
| | - Yentéma Onadja
- Institut Supérieur des Sciences de la Population (ISSP), Université Joseph KI-Zerbo, Ouagadougou, Burkina Faso
| | - Mary Thiongo
- International Centre for Reproductive Health-Kenya, Nairobi, Kenya; Technical University of Mombasa, Mombasa, Kenya
| | - Philip Anglewicz
- Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
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Mantina NM, Ngaybe MGB, Zeiders KH, Osman KM, Wilkinson-Lee AM, Landor AM, Hoyt LT. Latinx youth's and parents' covid-19 beliefs, vaccine hesitancy and vaccination rates: Longitudinal associations in a community sample. PLoS One 2024; 19:e0307479. [PMID: 39046951 PMCID: PMC11268593 DOI: 10.1371/journal.pone.0307479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 07/05/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION The Latinx population has the second highest COVID-19 death rate among racial/ethnic groups in the United States and less than half of Latinx youth aged 5-17 years old completed their COVID-19 primary vaccination series as of September 2022. COVID-19 vaccine misinformation detrimentally impacts vaccination rates. In this study, we examined factors that predicted Latinx youth COVID-19 vaccine hesitancy and vaccination status. METHODS A community-based sample of 290 Latinx parent and adolescent dyads from a Southwestern metropolitan area of the United States who were recruited to complete an online survey at baseline at T1 (August 2020 -March 2021) and one year later. We tested a longitudinal mediation model in which we examined individual and family factors that would predict youth COVID-19 vaccine hesitancy and vaccination status over time. RESULTS Youth's pandemic disbelief (i.e., the belief that the COVID-19 pandemic is a conspiracy or not real) predicted greater youth's COVID-19 vaccine hesitancy, and in turn, a lower likelihood of youth's COVID-19 vaccination. Youth's pandemic disbelief also predicted greater parent's vaccination hesitancy which, in turn, predicted greater youth's vaccination hesitancy and a lower likelihood of COVID-19 vaccination. Parents' pandemic disbelief predicted their own COVID-19 hesitancy, but not youth hesitancy. DISCUSSION Our study findings provide initial evidence that general pandemic disbelief was a significant driver of vaccine hesitancy and vaccination among Latinx families. The study contributes to the limited research investigating COVID-19 vaccination in the Latinx community and among Latinx youth, further aiding how COVID-19 vaccine disparities can be mitigated among racial/ethnic populations.
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Affiliation(s)
- Namoonga M. Mantina
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| | - Maiya G. Block Ngaybe
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| | - Katharine H. Zeiders
- Norton School of Human Ecology, University of Arizona, Tucson, Arizona, United States of America
| | - Kayla M. Osman
- Norton School of Human Ecology, University of Arizona, Tucson, Arizona, United States of America
| | - Ada M. Wilkinson-Lee
- Department of Mexican American Studies, University of Arizona, Tucson, Arizona, United States of America
| | - Antoinette M. Landor
- Department of Human Development and Family Science, University of Missouri, Columbia, Missouri, United States of America
| | - Lindsay T. Hoyt
- Department of Psychology, Fordham University, Bronx, New York, United States of America
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Closson K, Dong E, Zulu B, Dietrich JJ, Zharima C, Jesson J, Pakhomova T, Beksinska M, Kaida A. 'Life became harder with COVID-19': exploring the experiences of the COVID-19 pandemic among youth living in eThekwini district, South Africa. BMC Public Health 2024; 24:1922. [PMID: 39020372 PMCID: PMC11256542 DOI: 10.1186/s12889-024-19238-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 06/24/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND In South Africa, pervasive age and gender inequities have been exacerbated by the COVID-19 pandemic and public health response. We aimed to explore experiences of the COVID-19 pandemic among youth in eThekwini district, South Africa. METHODS Between December 2021-May 2022 we explored experiences of the COVID-19 pandemic on youth aged 16-24 residing in eThekwini, South Africa. We collated responses to the open-ended question "Has the COVID-19 pandemic affected you in any other way you want to tell us about?" in an online survey focused on understanding the pandemic's multi-levelled health and social effects. We used a thematic analysis to summarise the responses. RESULTS Of 2,068 respondents, 256 (12.4%, median age = 22, 60.9% women) completed the open-ended survey question (11% in isiZulu). Results were organized into three main themes encompassing (1) COVID-19-related loss, fear, grief, and exacerbated mental and physical health concerns; (2) COVID-19-related intensified hardships, which contributed to financial, employment, food, education, and relationship insecurities for individuals and households; and (3) positive effects of the pandemic response, including the benefits of government policies and silver linings to government restrictions. CONCLUSIONS We found that South African youth experienced significant grief and multiple losses (e.g., death, income, job, and educational) during the COVID-19 pandemic. Trauma-aware interventions that provide economic and educational opportunities must be included in post-COVID recovery efforts.
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Affiliation(s)
- Kalysha Closson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
- Center of Gender Equity and Health, University of California San Diego, La Jolla, CA, United States.
| | - Erica Dong
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Bongiwe Zulu
- Wits MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Janan J Dietrich
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Health Systems Research Unit, South African Medical Research Council, Bellville, South Africa
- African Social Sciences Unit of Research and Evaluation (ASSURE), Wits Health Consortium, Johannesburg, South Africa
| | - Campion Zharima
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Julie Jesson
- Center for Epidemiology and Research in POPulation Health (CERPOP), Inserm, Université de Toulouse, Université Paul Sabatier, Toulouse, France
| | - Tatiana Pakhomova
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Mags Beksinska
- Wits MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
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Anthony MG, Hoddinott G, Van Niekerk M, Dewandel I, McKenzie C, Bekker C, Rabie H, Redfern A, van der Zalm MM. The socioeconomic impact of the COVID-19 lockdown on families affected by childhood respiratory illnesses in Cape Town, South Africa. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003020. [PMID: 38547177 PMCID: PMC10977803 DOI: 10.1371/journal.pgph.0003020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 02/22/2024] [Indexed: 04/12/2024]
Abstract
The COVID-19 pandemic impacted families globally, directly and indirectly. Children presenting with respiratory illnesses are affected by emerging health systems and socioeconomic changes in the COVID-19 era. We explored the socioeconomic impacts of the COVID-19 lockdown on families with a respiratory illness diagnosed in their child in Cape Town, South Africa. This study was nested in a prospective observational cohort of children presenting with respiratory symptoms presumptive of COVID-19. We conducted 21 semi-structured interviews to explore the socioeconomic impact of the COVID-19 pandemic on families with a child affected by respiratory illnesses. We used case descriptive analysis and thematically organised common and divergent experiences. We found that socioeconomic challenges in low-income communities were exacerbated: 1) loss of pre-COVID sources of income (loss of income, employment and working hours), 2) shrinking employment opportunities due to business closures and strict preventative measures, 3) family network dependence to cope with financial pressures, 4) impact on education, implicating additional pressures due to lack of resources for adequate home schooling and 5) caregivers' mental health and wellbeing being impacted, causing stress and anxiety due to loss of income. This study shows that the COVID-19 lockdown impacted the socioeconomic aspects of families caring for a child with a respiratory illness. Care became more complicated and adversely impacted the family's emotional well-being and health-seeking behaviour. These impacts should be more carefully considered in order to strengthen health services and global health messaging in future pandemics.
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Affiliation(s)
- Michaile G. Anthony
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Graeme Hoddinott
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Margaret Van Niekerk
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Isabelle Dewandel
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Carla McKenzie
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Carien Bekker
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Helena Rabie
- Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
| | - Andrew Redfern
- Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
| | - Marieke M. van der Zalm
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Wagner F, Wagner RG, Makuapane LP, Masango M, Kolanisi U, Gómez-Olivé FX. Mental distress, food insecurity and university student dropout during the COVID-19 pandemic in 2020: evidence from South Africa. Front Psychiatry 2024; 15:1336538. [PMID: 38380123 PMCID: PMC10876832 DOI: 10.3389/fpsyt.2024.1336538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/19/2024] [Indexed: 02/22/2024] Open
Abstract
Background Student dropout has been a key issue facing universities for many years. The COVID-19 pandemic was expected to exacerbate these trends; however, international literature has produced conflicting findings. Limited literature from Africa has investigated the impact of COVID-19 on student dropout trends, despite the documented devastation, including increased risk of food insecurity and mental distress, caused by the pandemic. Objective This work seeks to understand the impact of food insecurity and mental distress on student dropout during the COVID-19 pandemic. Methods Using a cross-sectional research design, first-year undergraduate students from a large South African university were recruited via email to participate in a survey between September and October 2020. The Household Food Insecurity Access Scale (HFIAS) was used to measure food insecurity and the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) was used to measure mental distress. Multivariate regression was used to investigate factors associated with student dropout. Results The student dropout rate was 10.5% (95% CI: 8.2-13.2). The prevalence of severe food insecurity was 25.7% (95% CI: 22.3-29.4) and the prevalence of severe mental distress symptoms was 26.7% (95% CI: 23.3-30.4). Dropout rates and levels of food insecurity were highest among students residing in remote areas during the lockdown at 19.2% and 43.6%, respectively. The multivariate logistic regression revealed that being male increased the probability of dropout almost three-fold (odds ratio (OR) = 2.70; 95% CI: 1.48-4.89, p =0.001)). Being moderately food insecure increased the odds of dropout more than two-fold (OR=2.50; 95% CI:1.12-5.55, p=0.025), and experiencing severe mental distress symptoms increased the odds of dropout seven-fold (OR=7.08; 95% CI:2.67-18.81, p<0.001). Conclusion While acknowledging that various factors and complexities contribute to student dropout, the increased vulnerability to food insecurity and mental distress, stemming from issues such as widespread job losses and isolation experienced during the pandemic, may have also had an impact on dropout. This work reiterates the importance of directing additional support to students who are food insecure and those who are experiencing mental distress in order to mitigate university student dropout.
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Affiliation(s)
- Fezile Wagner
- Analytics and Institutional Research Unit (AIRU), University of the Witwatersrand, Johannesburg, South Africa
| | - Ryan G. Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lerato P. Makuapane
- Analytics and Institutional Research Unit (AIRU), University of the Witwatersrand, Johannesburg, South Africa
| | - Mxolisi Masango
- Department of Institutional Planning (DIP), University of Pretoria, Pretoria, South Africa
| | - Unathi Kolanisi
- Department of Consumer Sciences, Faculty of Science, Agriculture and Engineering, University of Zululand, KwaDlangezwa, South Africa
| | - Francesc Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Zharima C, Singh R, Closson K, Beksinska M, Zulu B, Jesson J, Pakhomova T, Dong E, Dietrich J, Kaida A, Basham CA. Economic hardship and perpetration of intimate partner violence by young men in South Africa during the COVID-19 pandemic (2021-2022): a cross-sectional study. Inj Epidemiol 2024; 11:2. [PMID: 38229136 PMCID: PMC10790426 DOI: 10.1186/s40621-024-00483-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/01/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Economic hardship is a potential trigger for intimate partner violence (IPV) perpetration. While higher IPV rates have been reported in low-income regions, few African studies have focused on IPV being triggered by economic hardship among young men during the COVID-19 pandemic. We therefore estimated economic hardship's effect on IPV perpetration by young men in eThekwini District, South Africa, during the COVID-19 pandemic. METHODS A cross-sectional survey of COVID-19 pandemic experiences was conducted among youth aged 16-24 years through an anonymous self-administered questionnaire, including questions about economic hardship (increased difficulty accessing food or decreased income) and IPV perpetration. A prespecified statistical analysis plan with a directed acyclic graph of assumed exposure, outcome, and confounder relationships guided our analyses. We measured association of economic hardship and IPV perpetration through odds ratios (ORs) computed from a multivariable logistic regressions adjusted for measured confounders. Secondary outcomes of physical and sexual IPV perpetration were analyzed separately using the same specifications. Propensity score matching weights (PS-MW) were used in sensitivity analyses. Analysis code repository: https://github.com/CAndrewBasham/Economic_Hardship_IPV_perpetration/ RESULTS: Among 592 participants, 12.5% reported perpetrating IPV, 67.6% of whom reported economic hardship, compared with 45.6% of those not reporting IPV perpetration (crude OR = 2.49). Median age was 22 years (interquartile range 20-24). Most (80%) were in a relationship and living together. Three quarters identified as Black, 92.1% were heterosexual, and half had monthly household income < R1600. We estimated an effect of economic hardship on the odds of perpetrating IPV as OR = 1.83 (CI 0.98-3.47) for IPV perpetration overall, OR = 6.99 (CI 1.85-36.59) for sexual IPV perpetration, and OR = 1.34 (CI 0.69-2.63) for physical IPV perpetration. PS-MW-weighted ORs for IPV perpetration by economic hardship were 1.57 (overall), 4.45 (sexual), and 1.26 (physical). CONCLUSION We estimated 83% higher odds of self-reported IPV perpetration by self-reported economic hardship among young South African men during the COVID-19 pandemic. The odds of sexual IPV perpetration were The seven-times higher by economic hardship, although with limited precision. Among young men in South Africa, economic hardship during COVID-19 was associated with IPV perpetration by men. Our findings warrant culturally relevant and youth-oriented interventions among young men to reduce the likelihood of IPV perpetration should they experience economic hardship. Further research into possible causal mechanisms between economic hardship and IPV perpetration could inform public health measures in future pandemic emergencies.
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Affiliation(s)
- Campion Zharima
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Rishav Singh
- Vaccine Evaluation Centre, BC Children's Hospital and Research Institute, Vancouver, BC, Canada
| | - Kalysha Closson
- Center On Gender Equity and Health, School of Medicine, University of California San Diego, La Jolla, CA, USA
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A1S6, Canada
| | - Mags Beksinska
- MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Bongiwe Zulu
- MRU (MatCH Research Unit), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Julie Jesson
- Center for Epidemiology and Research in POPulation Health (CERPOP), Inserm, Université de Toulouse, Université Paul Sabatier, Toulouse, France
| | - Tatiana Pakhomova
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A1S6, Canada
| | - Erica Dong
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A1S6, Canada
| | - Janan Dietrich
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Health Systems Research Unit, South African Medical Research Council, Bellville, South Africa
- African Social Sciences Unit of Research and Evaluation (ASSURE), A Division of the Wits Health Consortium, Johannesburg, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A1S6, Canada.
- Women's Health Research Institute, Vancouver, BC, Canada.
| | - C Andrew Basham
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall Rm 10522, 8888 University Drive, Burnaby, BC, V5A1S6, Canada
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA
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Kim AW, Said Mohamed R, Norris SA, Naicker S, Richter LM, Kuzawa CW. Childhood adversity during the post-apartheid transition and COVID-19 stress independently predict adult PTSD risk in urban South Africa: A biocultural analysis of the stress sensitization hypothesis. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023; 182:620-631. [PMID: 37283092 PMCID: PMC10700668 DOI: 10.1002/ajpa.24791] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 04/28/2023] [Accepted: 05/24/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The COVID-19 pandemic in South Africa introduced new societal adversities and mental health threats in a country where one in three individuals are expected to develop a psychiatric condition sometime in their life. Scientists have suggested that psychosocial stress and trauma during childhood may increase one's vulnerability to the mental health consequences of future stressors-a process known as stress sensitization. This prospective analysis assessed whether childhood adversity experienced among South African children across the first 18 years of life, coinciding with the post-apartheid transition, exacerbates the mental health impacts of psychosocial stress experienced during the 2019 coronavirus (COVID-19) pandemic (ca. 2020-2021). MATERIALS AND METHODS Data came from 88 adults who participated in a follow-up study of a longitudinal birth cohort study in Soweto, South Africa. Childhood adversity and COVID-19 psychosocial stress were assessed as primary predictors of adult PTSD risk, and an interaction term between childhood adversity and COVID-19 stress was calculated to evaluate the potential effect of stress sensitization. RESULTS Fifty-six percent of adults exhibited moderate-to-severe PTSD symptoms. Greater childhood adversity and higher COVID-19 psychosocial stress independently predicted worse post-traumatic stress disorder symptoms in adults. Adults who reported greater childhood adversity exhibited non-significantly worse PTSD symptoms from COVID-19 psychosocial stress. DISCUSSION These results highlight the deleterious mental health effects of both childhood trauma and COVID-19 psychosocial stress in our sample and emphasize the need for greater and more accessible mental health support as the pandemic progresses in South Africa.
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Affiliation(s)
- Andrew Wooyoung Kim
- Department of Anthropology, University of California, Berkeley, Berkeley, California, USA
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rihlat Said Mohamed
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
- Global Health Research Institute, School of Human Development and Health, University of Southampton, Southampton, UK
| | - Sara Naicker
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Linda M Richter
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Christopher W Kuzawa
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
- Institute for Policy Research, Northwestern University, Evanston, Illinois, USA
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Paredes-Ruvalcaba N, Kim AW, Ndaba N, Cele L, Swana S, Bosire E, Moolla A. Coping mechanisms during the COVID-19 pandemic and lockdown in metropolitan Johannesburg, South Africa: A qualitative study. Am J Hum Biol 2023; 35:e23958. [PMID: 37427489 PMCID: PMC10776812 DOI: 10.1002/ajhb.23958] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has caused prolonged stress on numerous fronts. While the acute health impacts of psychosocial stress due to the pandemic are well-documented, less is known about the resources and mechanisms utilized to cope in response to stresses during the pandemic and lockdown. OBJECTIVE The aim of this study was to identify and describe the coping mechanisms adults utilized in response to the stressors of the COVID-19 pandemic during the 2020 South African lockdown. METHODS This study included adults (n = 47: 32 female; 14 male; 1 non-binary) from the greater Johannesburg region in South Africa. Interviews with both closed and open-ended questions were administered to query topics regarding the COVID-19 pandemic. Data were coded and thematically analyzed to identify coping mechanisms and experiences. RESULTS Adults engaged in a variety of strategies to cope with the pandemic and the ensued lockdown. The ability to access or engage in multiple coping mechanisms were either enhanced or constrained by financial and familial situations. Participants engaged in seven major coping mechanisms: interactions with family and friends, prayer and religion, staying active, financial resources, mindset reframing, natural remedies, and following COVID-19 prevention protocols. CONCLUSIONS Despite the multiple stressors faced during the pandemic and lockdown, participants relied on multiple coping strategies which helped preserve their well-being and overcome pandemic-related adversity. The strategies participants engaged in were impacted by access to financial resources and family support. Further research is needed to examine the potential impacts these strategies may have on people's health.
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Affiliation(s)
| | - Andrew Wooyoung Kim
- Department of Anthropology, University of California, Berkeley, Berkeley, CA, USA
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nokubonga Ndaba
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lindile Cele
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Someleze Swana
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Edna Bosire
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Aneesa Moolla
- Health Economics and Epidemiology Research Office, Wits Health Consortium, Johannesburg, South Africa
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Carey RL, Bailey MJ, Polanco CI. How the COVID-19 pandemic shaped adolescents' future orientations: Insights from a global scoping review. Curr Opin Psychol 2023; 53:101655. [PMID: 37540938 DOI: 10.1016/j.copsyc.2023.101655] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 08/06/2023]
Abstract
Throughout adolescence, youth imagine what the future holds and determine plans to achieve their educational, professional, and personal goals. In this article, we review research that explores how adolescents' future orientations were shaped by the societal unpredictability, physical and mental health risks, and educational disruptions brought on by the COVID-19 pandemic. Findings show that the pandemic, which exacerbated existing societal inequities, also heightened adolescents' social awareness, provoked feelings of uncertainty, and altered adolescents' short- and long-term plans for educational and career prospects. Throughout school building closures and program cancellations, families played a greater role in fostering adolescents' plans. With prospects for more societal uncertainty on the horizon, future directions point toward supporting adolescents in developing adaptable and flexible future orientations.
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Affiliation(s)
- Roderick L Carey
- University of Delaware, College of Education and Human Development, Newark, DE, USA.
| | - Michelle J Bailey
- University of Delaware, College of Education and Human Development, Newark, DE, USA
| | - Camila I Polanco
- University of Delaware, College of Education and Human Development, Newark, DE, USA
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10
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Mayman YR, van Wyk B. The impact of COVID-19 on HIV treatment of adolescents in sub-Saharan Africa: A scoping review. Health SA 2023; 28:2226. [PMID: 37795154 PMCID: PMC10546235 DOI: 10.4102/hsag.v28i0.2226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 07/19/2023] [Indexed: 10/06/2023] Open
Abstract
Background Adolescents living with HIV are a key population who are susceptible to poor health. The global coronavirus disease 2019 pandemic and widespread national COVID-19 restrictions has disrupted health service delivery and HIV support services, affecting treatment adherence among adolescents with HIV. Aim This study aimed to review the available literature on the impact of the COVID-19 pandemic on the HIV treatment of adolescents in sub-Saharan Africa. Method Seven online databases were searched for articles published between 2020 and 2022 that focused on the impact of COVID-19 on adolescents living with HIV on antiretroviral therapy. A data charting extraction form and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA) flowchart were used for screening and reporting the articles in this review. A narrative synthesis was conducted. Results Five overarching themes emerged from the articles in this review, which highlighted the mental, social, and economic impacts of the COVID-19 pandemic, as well as the impact of the reallocation of healthcare services and challenges to accessing HIV care services on the antiretroviral therapy (ART) adherence of adolescents living with HIV. Conclusion The global COVID-19 pandemic affected adolescents living with HIV in sub-Saharan Africa in many ways, but very little research has been done to describe the various ways in which the physical and mental well-being of adolescents were impacted. Contribution The findings of this review can be used to further inform policies and interventions aimed at the care and well-being of adolescents on antiretroviral therapy within sub-Saharan Africa.
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Affiliation(s)
- Yolanda R Mayman
- Department of Psychology, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Brian van Wyk
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
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11
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Theron LC, Cockcroft K, Annalakshmi N, Rodgers JG, Akinduyo TE, Fouché A. Emerging Adult Resilience to the Early Stages of the COVID-Pandemic: A Systematic Scoping Review. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01585-y. [PMID: 37698747 DOI: 10.1007/s10578-023-01585-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/13/2023]
Abstract
Human resilience to COVID-19 related stressors remains a pressing concern following the aftereffects of the pandemic and in the face of probable future pandemics. In response, we systematically scoped the available literature (n = 2030 records) to determine the nature and extent of research on emerging adults' adaptive responses to COVID-19 stressors in the early stages of the pandemic. Using a multisystem resilience framework, our narrative review of 48 eligible studies unpacks the personal, relational, institutional and/or physical ecological resources that enabled positive emerging adult outcomes to COVID-18 stressors. We found that there is a geographical bias in studies on this topic, with majority world contexts poorly represented. Resources leading to positive outcomes foregrounded psychological and social support, while institutional and ecological supports were seldom mentioned. Multisystemic combinations of resources were rarely considered. This knowledge has valuable implications for understanding resilience in the context of other large-scale adverse conditions.
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Affiliation(s)
- L C Theron
- Department of Educational Psychology, University of Pretoria, Pretoria, South Africa.
- Faculty of Education, University of Pretoria, Groenkloof Campus, Pretoria, 0002, South Africa.
| | - K Cockcroft
- Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - N Annalakshmi
- Psychology Department, Bharathiar University, Coimbatore, India
| | - J G Rodgers
- Department of Psychology, School of Health Sciences, North-West University, Vanderbijlpark, South Africa
| | - T E Akinduyo
- Department of Educational Psychology, University of Pretoria, Pretoria, South Africa
| | - A Fouché
- Department of Social Wellbeing, United Arab Emirates University, Al Ain, United Arab Emirates
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12
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Kvalsvig JD, Taylor M, Watt KG, Desmond C. The impact of family support and organization on adolescents during school closure under Covid-19 lockdown regulations in an area of South Africa. PLoS One 2023; 18:e0288501. [PMID: 37561806 PMCID: PMC10414574 DOI: 10.1371/journal.pone.0288501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 06/28/2023] [Indexed: 08/12/2023] Open
Abstract
The Covid-19 pandemic and resultant disruptions to schooling presented significant challenges for many families. Well organised families have been shown to have a protective effect on adolescent wellbeing in periods of shock. At the onset of the Covid-19 pandemic, Asenze, a population-based cohort study, was conducting a third wave of data collection in peri-urban South Africa, examining risk and protective factors during adolescence. By March 2020, n = 272 adolescents and their caregivers (n = 241) in the cohort had been assessed when in-person data collection was halted by lockdown measures countrywide. During this cessation we undertook a brief telephonic qualitative sub-study to explore whether families enrolled in the cohort were able to cohabit cohesively and undertake distance learning during lockdown. A purposeful sample of 20 families (caregivers n = 20, adolescents n = 24) recently assessed in the Wave 3 of the main study, participated in semi-structured interviews. Quantitative data from Waves 1-3 of the main study was used to measure family function, adolescent cognitive function, and profile adolescent and caregivers. The quantitative and qualitative data were integrated to illustrate the dynamics of the participants' lives before and during lockdown. We found that families classified as well-organized before lockdown, were more likely to report co-operation during lockdown. Adolescents who were self-motivated, had access to smartphones or the internet, and were supported by both family and educators, were well-placed to continue their education without much disruption. However, few schools instituted distance learning. Of the adolescents who were not assisted- some studied on their own or with peers, but others did no schoolwork, hindered by a lack of digital connectivity, and poor service delivery. The experience of adolescence and caregivers in the Asenze Cohort during lockdown highlight the importance of family functioning for adolescent wellbeing in crisis, as well as the need for access to health, mental health, and social services, communication upgrades, and enhancements to the education system during peaceful times, to make a difference to young lives in times of crisis.
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Affiliation(s)
- Jane D. Kvalsvig
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Myra Taylor
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Kathryn G. Watt
- Centre for Rural Health School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Chris Desmond
- Centre for Rural Health School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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13
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Okegbe T, Williams J, Plourde KF, Oliver K, Ddamulira B, Caparrelli K. Impact of COVID-19 on HIV Adolescent Programming in 16 Countries With USAID-Supported PEPFAR Programs. J Acquir Immune Defic Syndr 2023; 93:261-271. [PMID: 36989134 PMCID: PMC10287048 DOI: 10.1097/qai.0000000000003201] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 03/07/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has disrupted access to critical health services, resulting in diminished gains in HIV epidemic control. This review assesses the magnitude of the impact that the COVID-19 pandemic has had on HIV services for adolescents. METHODS PEPFAR Monitoring, Evaluation, and Reporting programmatic data were analyzed from across 16 USAID-supported adolescent care and treatment programs for fiscal year 2020 (FY20; October 2019-September 2020). Descriptive statistics were used to calculate absolute number and percent change between the pre-COVID-19 (Quarters 1-2; October 2019-March 2020) and COVID-19 periods (Quarters 3-4; April 2020-September 2020) for clinical cascade indicators. All analyses were conducted in Microsoft Excel. RESULTS The number of HIV tests conducted during COVID-19 decreased by 21.4% compared with pre-COVID-19, with a subsequent 28% decrease in adolescents identified living with HIV. The rate of proxy linkage to antiretroviral therapy increased between periods, from 86.9% to 90.4%. There was a 25.9% decrease in treatment initiations among adolescents during COVID-19. During FY20, viral load coverage rates for adolescents dropped from 81.6% in FY20Q1 to 76.5% in FY20Q4, whereas the rates of viral load suppression for adolescents increased from 76.1% in FY20Q1 to 80.5% in FY20Q4. CONCLUSION There was a substantial decrease in case-finding, treatment initiations, and viral load coverage rates for adolescents supported in USAID/PEPFAR programs during the COVID-19 pandemic. Additional health systems adaptations and strategies are required to ensure adolescents have continued access to HIV services during pandemic disruptions.
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Affiliation(s)
- Tishina Okegbe
- GHTASC, Credence Management Solutions LLC, Supporting the United States Agency for International Development (USAID), Office of HIV/AIDS, Washington, DC
| | - Jessica Williams
- United States Agency for International Development (USAID), Maputo, Mozambique
| | | | | | - Barbara Ddamulira
- United States Agency for International Development (USAID), Dar es Salaam, Tanzania; and
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14
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Gumede D, Sibiya MN. Ethical and methodological reflections: Digital storytelling of self-care with students during the COVID-19 pandemic at a South African University. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001682. [PMID: 37315009 DOI: 10.1371/journal.pgph.0001682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 05/15/2023] [Indexed: 06/16/2023]
Abstract
The enforcement of the coronavirus disease 2019 (COVID-19) pandemic restrictions disrupted the traditional face-to-face qualitative data collection in public health. The pandemic forced qualitative researchers to transition to remote methods of data collection such as digital storytelling. Currently, there is a limited understanding of ethical and methodological challenges in digital storytelling. We, therefore, reflect on the challenges and solutions for implementing a digital storytelling project on self-care at a South African university during the COVID-19 pandemic. Guided by Salmon's Qualitative e-Research Framework, reflective journals were used in a digital storytelling project between March and June 2022. We documented the challenges of online recruitment, obtaining informed consent virtually, and collecting data using digital storytelling as well as the efforts of overcoming the challenges. Our reflections identified major challenges, namely online recruitment and informed consent compromised by asynchronous communication; participants' limited research knowledge; participants' privacy and confidentiality concerns; poor internet connectivity; quality of digital stories; devices with a shortage of storage space; participants' limited technological skills; and time commitment required to create digital stories. Strategies adopted to address these challenges included an ongoing informed consent process; flexible timelines for the creation of digital stories; one-on-one guidance on creating digital stories; and multiple online platforms to share digital stories. Our critical reflection offers practical guidance for the ethical conduct of digital storytelling in public health research and makes a significant contribution to methodological considerations for use in future pandemics. These ethical and methodological challenges should be recognized as features of the context of the research setting including restrictions imposed by the COVID-19 pandemic than disadvantages of digital storytelling.
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Affiliation(s)
- Dumile Gumede
- Centre for General Education, Durban University of Technology, Berea, Durban, South Africa
| | - Maureen Nokuthula Sibiya
- Division of Research, Innovation and Engagement, Mangosuthu University of Technology, Umlazi, Durban, South Africa
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15
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Steventon Roberts KJ, Du Toit S, Mawoyo T, Tomlinson M, Cluver LD, Skeen S, Laurenzi CA, Sherr L. Protocol for the OCAY study: a cohort study of orphanhood and caregiver loss in the COVID-19 era to explore the impact on children and adolescents. BMJ Open 2023; 13:e071023. [PMID: 37263702 DOI: 10.1136/bmjopen-2022-071023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Globally, no person has been untouched by the COVID-19 pandemic. Yet, little attention has been given to children and adolescents in policy, provision and services. Moreover, there is a dearth of knowledge regarding the impact of COVID-19-associated orphanhood and caregiver loss on children. This study aims to provide early insights into the mental health and well-being of children and adolescents experiencing orphanhood or caregiver loss in South Africa. METHODS AND ANALYSIS Data will be drawn from a quantitative longitudinal study in Cape Town, South Africa. A sample of children and adolescents between the ages of 9 and 18 years, experiencing parental or caregiver loss from COVID-19, will be recruited together with a comparison group of children in similar environments who did not experience loss. The study aims to recruit 500 children in both groups. Mental health and well-being among children will be explored through the use of validated and study-specific measures. Participants will be interviewed at two time points, with follow-up data being collected 12-18 months after baseline. A combination of analytical techniques (including descriptive statistics, regression modelling and structural equation modelling) will be used to understand the experience and inform future policy and service provision. ETHICS AND DISSEMINATION This study received ethical approval from the Health Research Ethics Committee at Stellenbosch University (N 22/04/040). Results will be disseminated via academic and policy publications, as well as national and international presentations including high-level meetings with technical experts. Findings will also be disseminated at a community level via various platforms.
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Affiliation(s)
- Kathryn J Steventon Roberts
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Institute for Global Health, University College London, London, UK
| | - Stefani Du Toit
- Institute for Life Course Health Reseach, Department of Global Health, Stellenbosch Univeristy, Stellenbosch, South Africa
| | - Tatenda Mawoyo
- Institute for Life Course Health Reseach, Department of Global Health, Stellenbosch Univeristy, Stellenbosch, South Africa
| | - Mark Tomlinson
- Institute for Life Course Health Reseach, Department of Global Health, Stellenbosch Univeristy, Stellenbosch, South Africa
- School of Nursing & Midwifrey, Queens University, Belfast, UK
| | - Lucie D Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Department of Psychiatry & Mental Health, Univeristy of Cape Town, Cape Town, South Africa
| | - Sarah Skeen
- Institute for Life Course Health Reseach, Department of Global Health, Stellenbosch Univeristy, Stellenbosch, South Africa
- Amsterdam Institute for Social Science Research, Faculty of Social & Behavioural Sciences, Univeristy of Amsterdam, Amsterdam, Netherlands
| | - Christina A Laurenzi
- Institute for Life Course Health Reseach, Department of Global Health, Stellenbosch Univeristy, Stellenbosch, South Africa
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
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16
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Ahmed CV, Brooks MJ, DeLong SM, Zanoni BC, Njuguna I, Beima-Sofie K, Dow DE, Shayo A, Schreibman A, Chapman J, Chen L, Mehta S, Mbizvo MT, Lowenthal ED. Impact of COVID-19 on Adolescent HIV Prevention and Treatment Services in the AHISA Network. AIDS Behav 2023; 27:84-93. [PMID: 36574183 PMCID: PMC9792928 DOI: 10.1007/s10461-022-03959-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 12/28/2022]
Abstract
We investigated perceived impacts of COVID-19 on the delivery of adolescent HIV treatment and prevention services in sub-Saharan Africa (SSA) by administering a survey to members of the Adolescent HIV Prevention and Treatment Implementation Science Alliance (AHISA) from February to April 2021. We organized COVID-19 impacts, as perceived by AHISA teams, under three themes: service interruptions, service adjustments, and perceived individual-level health impacts. AHISA teams commonly reported interruptions to prevention programs, diagnostic testing, and access to antiretroviral therapy (ART). Common service adjustments included decentralization of ART refills, expanded multi-month ART distribution, and digital technology use. Perceived individual-level impacts included social isolation, loss to follow-up, food insecurity, poverty, and increases in adolescent pregnancies and sexually transmitted infections. The need for collaboration among stakeholders were commonly cited as lessons learned by AHISA teams. Survey findings highlight the need for implementation science research to evaluate the effects of pandemic-related HIV service adaptations in SSA.
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Affiliation(s)
- Charisse V Ahmed
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Merrian J Brooks
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Children's Hospital of Philadelphia Global Health Center, Philadelphia, PA, USA
| | - Stephanie M DeLong
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Brian C Zanoni
- Departments of Medicine and Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Irene Njuguna
- Kenyatta National Hospital, Research and Programs, Nairobi, Kenya
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | - Dorothy E Dow
- Department of Pediatrics, Duke University Medical Center, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | - Aisa Shayo
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | | | - Jennifer Chapman
- Children's Hospital of Philadelphia Global Health Center, Philadelphia, PA, USA
| | - Lydia Chen
- University of Pennsylvania, Philadelphia, PA, USA
| | - Shreya Mehta
- University of Pennsylvania, Philadelphia, PA, USA
| | | | - Elizabeth D Lowenthal
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
- Children's Hospital of Philadelphia Global Health Center, Philadelphia, PA, USA.
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
- CHOP Roberts Center for Pediatric Research, 734 Schuylkill Ave, 19146, Philadelphia, PA, USA.
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17
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Brumwell AN, Babatunde GB, Wilson MW, le Roux K, Marks MM, Adam JK, Ivanova E, Batheja D, Goel S, Shilton S, Martínez-Pérez GZ. Values of COVID-19 Self-Testing among Urban and Rural South Africans: A Cross-Sectional Survey. Prev Med Rep 2023; 32:102114. [PMID: 36686721 PMCID: PMC9847323 DOI: 10.1016/j.pmedr.2023.102114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023] Open
Abstract
Self-testing for COVID-19 may be a preferable strategy for identifying SARS-CoV-2 infection among populations in low- and middle-income settings. To determine South Africans' values related to COVID-19 self-testing should it become widely available, a cross-sectional survey was administered in Durban, KwaZulu-Natal Province and the King Sabata Dalindyebo sub-district of the Eastern Cape. A 35-question survey was administered to 531 participants (268 female) in one urban and one rural setting of South Africa. Survey participants were randomly selected by household in the rural setting, while in the urban setting participants were approached in randomly selected public places. The survey assessed participants' likelihood of using and willingness to pay for a COVID-19 self-test and actions they would take following a COVID-19 self-test. The results were analysed using descriptive statistics and bivariate and multivariate regression. Overall, 93.03% of participants supported COVID-19 self-testing, 61.62% of participants were willing to pay for self-testing, and 90.15% indicated they would communicate their results if they tested positive. Rural participants were more positively associated with each of these outcomes compared with urban-based participants. Should they test positive, most participants said they would: go in-person to a health facility for counselling (76.45%), self-isolate (95.85%), notify close contacts (97.74%), and inform their employer (95.14%). COVID-19 self-testing was a preferable option for most participants, although this varied with setting and demographic characteristics. Self-testing may overcome barriers to care for South Africans, but to achieve this, policies for self-testing and delivery methods must not exacerbate individuals' underlying economic vulnerabilities.
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Affiliation(s)
| | | | - Michael W. Wilson
- Advance Access & Delivery South Africa (AA&D SA), Durban, South Africa
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Karl le Roux
- Zithulele Hospital, Zithulele, Mqanduli, South Africa
| | | | | | - Elena Ivanova
- FIND, the global alliance for diagnostics, Geneva, Switzerland
| | | | - Srishti Goel
- Centre for Disease Dynamics, Economics and Policy, India
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18
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Mohangi K. Risks and opportunities for children's well-being in resource-constrained multigenerational households during COVID-19: Implications for school psychology interventions. SCHOOL PSYCHOLOGY INTERNATIONAL 2023; 44:236-254. [PMID: 38603399 PMCID: PMC9768532 DOI: 10.1177/01430343221144407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The coronavirus disease (COVID-19) pandemic had a global impact on family social and economic well-being. Individuals and families sought alternative living arrangements as a result of the financial crisis, health implications, and housing insecurity, with many joining multigenerational households. However, it is unknown how multigenerational family life affects children's well-being. Therefore, this qualitative study explored risks and resilience-building opportunities for children's psychological and social well-being in resource-constrained multigenerational households during the COVID-19 pandemic in South Africa. Five multigenerational families were selected through snowball sampling and case design. The three generations of participants were grandparents (n = 5), parents (n = 7), and children (n = 4). Data were gathered through a questionnaire and interviews. The study received institutional ethics approval. After thematic analysis, two themes and six sub-themes were identified. Risks were related to interpersonal conflict, family collective fear of COVID-19, and children's multiple other fears. Opportunities were identified as academic support, shared responsibilities, life skills and values acquisition, and family cohesion. Results demonstrated the potential risks and resilience-building opportunities multigenerational households present for children's psychosocial well-being. Multisystemic influences in a multigenerational household contribute to children's adjustment. These outcomes necessitate systemic school psychology interventions. Longitudinal studies are recommended to explore child well-being trends in multigenerational households in varying socioeconomic contexts.
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Affiliation(s)
- Kamleshie Mohangi
- Department of Psychology of Education, University of South Africa, Pretoria, South Africa
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N’dure Baboudóttir F, Jandi Z, Indjai B, Einarsdóttir J, Gunnlaugsson G. "Just Standing Still": A Qualitative Study on Adolescents' Experiences of School Closures Due to Emerging COVID-19 in Bissau, Guinea-Bissau. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5265. [PMID: 37047881 PMCID: PMC10094378 DOI: 10.3390/ijerph20075265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
The COVID-19 pandemic affected the lives of children in a myriad of ways across the world. It exposed and aggravated existing inequalities between children within countries and across continents and hampered education. In Guinea-Bissau, school closure was one of the first restrictions implemented to confront the emerging pandemic. The aim was to describe and analyse the experiences of adolescents of school closures in the capital Bissau, their concerns about their future and manifestations of inequality. Data were collected by semi-structured, open-ended interviews with 30 adolescents aged 15-17 years three months into the pandemic during an enforced state of emergency. A thematic analysis identified five themes: appreciation of education, feeling left behind, being stuck in confinement, suggestions for support, and a disrupted future. The results highlight global rather than local inequalities in the demographic, manifested by a lack of targeted educational support for public and private school students; they knew about such efforts elsewhere. The school-attending participants suggested ways to mitigate disruptions in their education, while those out of school aiming to return saw their possibilities fading away. They appreciated education for personal and national benefits, and participants worried about the long-term effects of the pandemic. The study highlighted education loss for all and disrupted future expectations.
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Affiliation(s)
- Fatou N’dure Baboudóttir
- Faculty of Sociology, Anthropology and Folkloristics, University of Iceland, IS-102 Reykjavik, Iceland; (F.N.B.); (J.E.)
| | - Zeca Jandi
- National Institute for Studies and Research (INEP), Avenida dos Combatentes da Liberdade da Pátria, Complexo Escolar 14 de Novembro, Bissau CP 112, Guinea-Bissau; (Z.J.); (B.I.)
| | - Bucar Indjai
- National Institute for Studies and Research (INEP), Avenida dos Combatentes da Liberdade da Pátria, Complexo Escolar 14 de Novembro, Bissau CP 112, Guinea-Bissau; (Z.J.); (B.I.)
| | - Jónína Einarsdóttir
- Faculty of Sociology, Anthropology and Folkloristics, University of Iceland, IS-102 Reykjavik, Iceland; (F.N.B.); (J.E.)
| | - Geir Gunnlaugsson
- Faculty of Sociology, Anthropology and Folkloristics, University of Iceland, IS-102 Reykjavik, Iceland; (F.N.B.); (J.E.)
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20
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Haag K, Du Toit S, Mikus N, Skeen S, Steventon Roberts K, Marlow M, Notholi V, Sambudla A, Chideya Y, Sherr L, Tomlinson M. Does pre-COVID impulsive behaviour predict adherence to hygiene and social distancing measures in youths following the COVID-19 pandemic onset? Evidence from a South African longitudinal study. BMC Public Health 2023; 23:533. [PMID: 36941589 PMCID: PMC10027426 DOI: 10.1186/s12889-023-15310-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 02/22/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Engagement in protective behaviours relating to the COVID-19 pandemic has been proposed to be key to infection control. This is particularly the case for youths as key drivers of infections. A range of factors influencing adherence have been identified, including impulsivity and risk taking. We assessed the association between pre-COVID impulsivity levels and engagement in preventative measures during the COVID-19 pandemic in a longitudinal South African sample, in order to inform future pandemic planning. METHODS Data were collected from N = 214 youths (mean age at baseline: M = 17.81 (SD = .71), 55.6% female) living in a South African peri-urban settlement characterised by high poverty and deprivation. Baseline assessments were taken in 2018/19 and the COVID follow-up was conducted in June-October 2020 via remote data collection. Impulsivity was assessed using the Balloon Analogue Task (BART), while hygiene and social distancing behaviours were captured through self-report. Stepwise hierarchical regression analyses were performed to estimate effects of impulsivity on measure adherence. RESULTS Self-rated engagement in hygiene behaviours was high (67.1-86.1% "most of the time", except for "coughing/sneezing into one's elbow" at 33.3%), while engagement in social distancing behaviours varied (22.4-57.8% "most of the time"). Higher impulsivity predicted lower levels of hygiene (β = .14, p = .041) but not social distancing behaviours (β = -.02, p = .82). This association was retained when controlling for a range of demographic and COVID-related factors (β = .14, p = .047) and was slightly reduced when including the effects of a life-skills interventions on hygiene behaviour (β = -.13, p = .073). CONCLUSIONS Our data indicate that impulsivity may predict adolescent engagement in hygiene behaviours post COVID-19 pandemic onset in a high risk, sub-Saharan African setting, albeit with a small effect size. For future pandemics, it is important to understand predictors of engagement, particularly in the context of adversity, where adherence may be challenging. Limitations include a small sample size and potential measure shortcomings.
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Affiliation(s)
- Katharina Haag
- Institute for Global Health, University College London, London, UK
- Present affiliation: Department of Child Health and Development, Norwegian Institute for Public Health, Oslo, Norway
| | - Stefani Du Toit
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Nace Mikus
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
- Interacting Minds Centre, Aarhus University, Aarhus, Denmark
| | - Sarah Skeen
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
- Amsterdam Institute for Social Science Research, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, Netherlands
| | | | - Marguerite Marlow
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Vuyolwethu Notholi
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Akhona Sambudla
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Yeukai Chideya
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
| | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa.
- School of Nursing and Midwifery, Queens University, Belfast, UK.
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Morales-Vives F, Ferrando PJ, Dueñas JM, Martín-Arbós S, Varea MD, Castarlenas E. Are older teens more frustrated than younger teens by the covid-19 restrictions? The role of psychological maturity, personality traits, depression and life satisfaction. CURRENT PSYCHOLOGY 2023:1-13. [PMID: 36747915 PMCID: PMC9891900 DOI: 10.1007/s12144-023-04317-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 02/04/2023]
Abstract
Many studies have shown the negative impact of lockdowns on adolescents, but there is less evidence on how they are affected by other stages of the COVID-19 pandemic, and, especially, whether there are any differences between early and late adolescence. The current study focuses on the frustration felt by adolescents because of the severe COVID-19 restrictions in a non-lockdown situation. We aimed to (a) assess the role of maturity and two personality traits (emotional stability and extraversion) in predicting their frustration, and (b) compare the levels of frustration, depressive symptoms, and life satisfaction in older and younger adolescents. The sample of older adolescents was also compared with a paired sample of the same age collected in 2018, before the pandemic. The results suggest that maturity, extraversion and emotional stability are predictors of frustration in both older and younger adolescents, although older adolescents reported higher levels of frustration and depressive symptoms, and lower levels of life satisfaction. Older adolescents also reported higher levels of depressive symptoms than adolescents of the same age before the pandemic. These results show the negative impact of the pandemic, especially on older adolescents, and the important role of maturity and some personality traits in predicting their frustration.
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Affiliation(s)
- Fabia Morales-Vives
- Psychology Department, Universitat Rovira i Virgili, Tarragona, Spain
- Research Center for Behavior Assessment (CRAMC), Tarragona, Spain
| | - Pere J. Ferrando
- Psychology Department, Universitat Rovira i Virgili, Tarragona, Spain
- Research Center for Behavior Assessment (CRAMC), Tarragona, Spain
| | - Jorge-M. Dueñas
- Psychology Department, Universitat Rovira i Virgili, Tarragona, Spain
- Research Center for Behavior Assessment (CRAMC), Tarragona, Spain
| | | | - M. Dolores Varea
- Pedagogy Department, Universitat Rovira i Virgili, Tarragona, Spain
| | - Elena Castarlenas
- Psychology Department, Universitat Rovira i Virgili, Tarragona, Spain
- Research Center for Behavior Assessment (CRAMC), Tarragona, Spain
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22
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Demaria F, Vicari S. Adolescent Distress: Is There a Vaccine? Social and Cultural Considerations during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1819. [PMID: 36767187 PMCID: PMC9914691 DOI: 10.3390/ijerph20031819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic had an unprecedented impact on mental health. In particular, the impact on adolescents was likely significant due to vulnerability factors linked to this developmental stage and pre-existing conditions of hardship. The present work aimed at grasping the particular effects of the pandemic on social and cultural aspects of adolescence, providing a cross-sectional picture of this historical moment of contemporary youth culture. Further research is needed to verify the findings.
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Affiliation(s)
- Francesco Demaria
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Viale Ferdinando Baldelli 41, 00146 Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Viale Ferdinando Baldelli 41, 00146 Rome, Italy
- Department of Life Sciences and Public Health, Catholic University, 00168 Rome, Italy
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Shenderovich Y, Sacolo-Gwebu H, Fang Z, Lachman J, Cluver L, Ward C. Adaptations and staff experiences in delivering parenting programmes and other family support services in three community-based organisations in Cape Town, South Africa during the COVID pandemic. Glob Public Health 2023; 18:2129725. [PMID: 36342401 PMCID: PMC10802685 DOI: 10.1080/17441692.2022.2129725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 09/14/2022] [Indexed: 11/09/2022]
Abstract
We explore how organisations working on parenting programmes and other types of family support and violence prevention in low-resource settings experienced the pandemic. In August 2020-May 2021, we interviewed (1) staff from three community-based organisations delivering evidence-informed parenting interventions and other psychosocial services for families in Cape Town, South Africa, (2) staff from a parenting programme training organisation and (3) staff from two international organisations supporting psychosocial services in South Africa. Interviews (22) were thematically analysed, with findings in three areas. First, respondents noted changes in the context, including the job losses, food insecurity, and stress experienced by local communities, and reductions in organisational funding. Second, we found that in response to these context changes, the organisations shifted their focus to food provision and COVID prevention. Parenting and psychosocial programmes were adapted - e.g. by changing the physical delivery settings, reducing group sizes, and taking up digital and phone implementation. Participants reported improved perceptions of remote delivery as a feasible approach for working with families - but internet and phone access remained challenging. Third, the pandemic brought new responsibilities for staff, and both the challenges of working from home and the health risks of in-person work.
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Affiliation(s)
- Yulia Shenderovich
- Wolfson Centre for Young People's Mental Health, Cardiff, UK
- Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff, UK
- Department of Social Policy and Intervention, Centre for Evidence-Based Intervention, University of Oxford, Oxford, UK
| | | | - Zuyi Fang
- Department of Social Policy and Intervention, Centre for Evidence-Based Intervention, University of Oxford, Oxford, UK
- School of Social Development and Public Policy, Beijing Normal University, Beijing, People's Republic of China
| | - Jamie Lachman
- Department of Social Policy and Intervention, Centre for Evidence-Based Intervention, University of Oxford, Oxford, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Lucie Cluver
- Department of Social Policy and Intervention, Centre for Evidence-Based Intervention, University of Oxford, Oxford, UK
- Department of Psychiatry and Mental Health, Groote Schuur Hospital Observatory, University of Cape Town, Cape Town, South Africa
| | - Catherine Ward
- Department of Psychology, University of Cape Town, Cape Town, South Africa
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Mukoma G, Bosire EN, Hardy-Johnson P, Barker M, Norris SA. ' We were not allowed to gather even for Christmas.' Impact of COVID-19 on South African young people: Exploring messaging and support. Glob Public Health 2023; 18:2264968. [PMID: 37801722 DOI: 10.1080/17441692.2023.2264968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/21/2023] [Indexed: 10/08/2023]
Abstract
COVID-19 prevention measures including lockdowns, school closures, and restricted movement disrupted young people's lives. This longitudinal qualitative study conducted in Soweto, South Africa aimed to explore young people's knowledge and perceptions of COVID-19, vaccination, and the impact of infections. A convenience sample of 30 young black people (n = 15 men; n = 15 women, aged 16-21 years) from Soweto participated in 24 focus group discussions (FGDs), conducted in six phases - each phase had four FGDs stratified by gender and age. Young people's understanding of COVID-19 deepened throughout the study, however, did not always translate into adherence (following the government's COVID-19 prevention measures). Although deemed inadequate, TV and radio were preferred over internet COVID-19 information. Parents, teachers, and schools were trusted sources of information. Vaccines and limited access to information attributed to low-risk perception, while new COVID-19 variants attributed to high-risk perception. A low-risk perception and conspiracy theories contributed to non-adherence (disregarding COVID-19 preventative measures provided by the government), particularly among young men. Accessing reliable information that considers young people's lives and their living context is important. Communities, scientists, and policymakers must learn from the COVID-19 experience and implement localised preventive strategies for education, awareness, and economic support in future emergencies.
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Affiliation(s)
- Gudani Mukoma
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Biokinetics, Recreation and Sports Science, Faculty of Health Sciences, University of Venda, Thohoyandou, South Africa
| | - Edna N Bosire
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Polly Hardy-Johnson
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- Primary Care Population Sciences and Medical Education (PPM), Faculty of Medicine, University of Southampton, Southampton, UK
| | - Mary Barker
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Institute for Developmental Science and Global Health Research Institute, School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
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25
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Lupton D, Lewis S. Australians' experiences of COVID-19 during the early months of the crisis: A qualitative interview study. Front Public Health 2023; 11:1092322. [PMID: 36908481 PMCID: PMC9995885 DOI: 10.3389/fpubh.2023.1092322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction The COVID-19 crisis has wrought major changes to people's lives across the globe since the beginning of the outbreak in early 2020. The "Australians' Experiences of COVID-19" qualitative descriptive study was established to explore how Australians from different geographical areas and social groups experienced the COVID-19 crisis. Methods Three sets of semi-structured interviews, each with a diverse group of 40 adults across Australia, were completed between 2020 and 2022. This article reports findings from the first set of interviews, conducted by telephone in mid-2020. Results The participants discussed their experiences of living through this period, which was characterized by strong public health measures to contain the spread of COVID, including a national lockdown and border closures. Interview fieldnotes and verbatim transcripts were used to conduct an interpretive thematic analysis. The analysis is structured around the following five themes covering the quotidian and affective aspects of participants' lives in the early months of the COVID crisis: "disruption to routines;" "habituating to preventive measures;" "social isolation and loneliness;" "changes to work and education;" and "little change to life." A sixth theme concerns how participants responded to our question about what they imagined their lives would be like after the pandemic: "imagining post-COVID life." Discussion The crisis affected participants' experience of daily life variously according to such factors as their social circumstances and obligations as well as their histories of illness, making visible some of the unequal social and economic effects of the pandemic across different genders, ages, localities and socioeconomic groups. Our participants fell into three roughly equal groups: (i) those who found the lockdown and associated restrictions very difficult; (ii) those who reported feeling barely affected by these conditions; and (iii) those who found benefits to the "slowing down" of life during this period.
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Affiliation(s)
- Deborah Lupton
- Vitalities Lab, Centre for Social Research in Health, Social Policy Research Centre, UNSW Sydney, Kensington, NSW, Australia
| | - Sophie Lewis
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
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26
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Kavle JA, Codjia P, Gathi C, Ahoya B, Ramirez L, Katua S, Mugo F, Kiige L. Building forward better-An exploration of nutrition practices, food choice, and coping behaviors among Kenyan adolescents during COVID-19: Experiences and program implications. Food Sci Nutr 2022; 11:FSN33184. [PMID: 36721857 PMCID: PMC9880680 DOI: 10.1002/fsn3.3184] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/02/2022] [Indexed: 12/28/2022] Open
Abstract
This implementation research study sought to examine the impact of the COVID-19 pandemic on adolescent nutrition practices and related behaviors in Nairobi and Uasin Gishu Counties, Kenya. Eight focus group discussions (FGDs) were conducted with adolescents 10-19 years of age, in-depth interviews with 10 health facility providers, and a combination of FGDs (n-4) and key informant interviews with government stakeholder and implementing partners (n = 9). During the pandemic, adolescents tended to avoid commonly consumed junk foods, in favor of "immune boosting, protective" foods. Widespread unemployment and reductions in parental income rendered some food items such as meat, eggs, and fruits unaffordable for families of adolescents. Adolescents relayed experiences of skipping meals and reducing the amount and variety of foods consumed. Adolescents also described employing strategies such as working in the informal sector and selling personal items to support families financially, in response to rising food insecurity. School closures mandated during the pandemic likely contributed to reductions in overall physical activity. To improve the diets of adolescents, programs should build on the healthy mindset brought on by the pandemic, while strengthening, targeting, and improving access to social protection measures and agricultural initiatives for vulnerable families with adolescents to cushion them from rising food insecurity as an effect of COVID-19. Building practical adolescent life skills to encourage healthy nutrition actions will also be key to building forward from the COVID-19 pandemic in Kenya.
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Affiliation(s)
| | | | | | | | - Lacey Ramirez
- Kavle Consulting, LLCWashingtonDistrict of ColumbiaUSA
| | | | - Florence Mugo
- Ministry of Health, Division of Nutrition and DieteticsNairobiKenya
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27
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Li X, Yu J. How has the COVID-19 pandemic affected young people?-Mapping knowledge structure and research framework by scientometric analysis. Front Public Health 2022; 10:1052727. [PMID: 36530726 PMCID: PMC9755507 DOI: 10.3389/fpubh.2022.1052727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022] Open
Abstract
Since the outbreak of COVID-19, there has been a large body of literature focusing on the relationship between the COVID-19 pandemic and young people. The purpose of this study is to explore the current research status and the specific mechanism of COVID-19's effects on young people based on related literature. This paper mainly used VOS viewer and CiteSpace software to conduct a scientometric analysis of 5,077 publications retrieved from the Web of Science database. The results show that the main contributors to the field were mainly from North America and Europe, and the trend of research focus was from shallow to deep. The five main research areas in the field were summarized by keyword clustering analysis as follows: lifestyle changes due to lockdown; changes in stress and emotions; psychological illness and trauma; risk perception and practice toward the epidemic; interventions and social support. Finally, they were linked by four pathways to form a framework that integrates the relationships between the five domains and between elements within each of them, revealing the mechanism of COVID-19's effect on young people. In addition, less studied but promising elements are also presented in the framework, such as research on special groups (disadvantaged socioeconomic groups and sexual minority youth) and extreme suicidal tendencies that deserve our further attention.
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28
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Ertz M, Tandon U, Yao Quenum GG, Salem M, Sun S. Consumers’ coping strategies when they feel negative emotions in the face of forced deconsumption during the Covid-19 pandemic lockdowns. Front Psychol 2022; 13:1018290. [DOI: 10.3389/fpsyg.2022.1018290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/03/2022] [Indexed: 11/30/2022] Open
Abstract
IntroductionThis paper explores consumers’ coping strategies when they feel negative emotions due to forced deconsumption during the Covid-19 pandemic lockdowns.MethodsThe tool used for data collection is the questionnaire. It was made using the LimeSurvey software. A total of 621 complete observations were analyzed.ResultsThe findings demonstrate that anger positively influences the activation of seeking social support, mental disengagement, and confrontive coping strategies. Besides, disappointment activates mental disengagement but only marginally confrontive coping and not behavioral disengagement. Furthermore, regret is positively related to confrontive coping, behavioral disengagement, acceptance, and positive reinterpretation. Finally, worry positively impacts behavioral disengagement, self-control, seeking social support, mental disengagement, and planful problem-solving.DiscussionThe study’s originality lies in its investigation of consumers’ coping strategies when experiencing negative emotions due to forced deconsumption in the context of the Covid-19 pandemic.
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Alaba OA, Hongoro C, Thulare A, Lukwa AT. Drivers of socioeconomic inequalities of child hunger during COVID-19 in South Africa: evidence from NIDS-CRAM Waves 1–5. BMC Public Health 2022; 22:2092. [PMID: 36384525 PMCID: PMC9667840 DOI: 10.1186/s12889-022-14482-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background Child hunger has long-term and short-term consequences, as starving children are at risk of many forms of malnutrition, including wasting, stunting, obesity and micronutrient deficiencies. The purpose of this paper is to show that the child hunger and socio-economic inequality in South Africa increased during her COVID-19 pandemic due to various lockdown regulations that have affected the economic status of the population. Methods This paper uses the National Income Dynamics Study-Coronavirus Rapid Mobile Survey (NIDS-CRAM WAVES 1–5) collected in South Africa during the intense COVID-19 pandemic of 2020 to assess the socioeconomic impacts of child hunger rated inequalities. First, child hunger was determined by a composite index calculated by the authors. Descriptive statistics were then shown for the investigated variables in a multiple logistic regression model to identify significant risk factors of child hunger. Additionally, the decomposable Erreygers' concentration index was used to measure socioeconomic inequalities on child hunger in South Africa during the Covid-19 pandemic. Results The overall burden of child hunger rates varied among the five waves (1–5). With proportions of adult respondents indicated that a child had gone hungry in the past 7 days: wave 1 (19.00%), wave 2 (13.76%), wave 3 (18.60%), wave 4 (15, 68%), wave 5 (15.30%). Child hunger burden was highest in the first wave and lowest in the second wave. The hunger burden was highest among children living in urban areas than among children living in rural areas. Access to electricity, access to water, respondent education, respondent gender, household size, and respondent age were significant determinants of adult reported child hunger. All the concentrated indices of the adult reported child hunger across households were negative in waves 1–5, suggesting that children from poor households were hungry. The intensity of the pro-poor inequalities also increased during the study period. To better understand what drove socioeconomic inequalites, in this study we analyzed the decomposed Erreygers Normalized Concentration Indices (ENCI). Across all five waves, results showed that race, socioeconomic status and type of housing were important factors in determining the burden of hunger among children in South Africa. Conclusion This study described the burden of adult reported child hunger and associated socioeconomic inequalities during the Covid-19 pandemic. The increasing prevalence of adult reported child hunger, especially among urban children, and the observed poverty inequality necessitate multisectoral pandemic shock interventions now and in the future, especially for urban households.
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Affiliation(s)
- Olufunke A. Alaba
- grid.7836.a0000 0004 1937 1151Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925 South Africa
| | - Charles Hongoro
- grid.417715.10000 0001 0071 1142Developmental, Capable and Ethical State, Human Sciences Research Council, Pretoria, Gauteng Province South Africa ,grid.49697.350000 0001 2107 2298School of Health Systems and Public Health (SHSPH), Faculty of Health Sciences, University of Pretoria, Pretoria, Gauteng Province South Africa
| | - Aquina Thulare
- grid.437959.5National Department of Health, Pretoria, Gauteng Province South Africa
| | - Akim Tafadzwa Lukwa
- grid.7836.a0000 0004 1937 1151Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925 South Africa ,grid.11956.3a0000 0001 2214 904XDSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Private Bag X1, Matieland, Stellenbosch, 7602 South Africa
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Repo J, Herkama S, Yanagida T, Salmivalli C. Transition to emerging adulthood during the COVID-19 pandemic: Changes in anxiety and the role of inclusion/exclusion experiences. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2022. [DOI: 10.1080/17405629.2022.2122434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Juuso Repo
- INVEST Flagship Research Center/Psychology, University of Turku, Turku, Finland
| | - Sanna Herkama
- INVEST Flagship Research Center/Psychology, University of Turku, Turku, Finland
| | - Takuya Yanagida
- Department of Developmental and Educational Psychology, University of Vienna, Vienna, Austria
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Sarvan S, Muslu L. In the eyes of adolescents, is the pandemic an obstacle or a gain? A qualitative study based on the ecological theory. J Pediatr Nurs 2022; 66:15-22. [PMID: 35597131 PMCID: PMC9414683 DOI: 10.1016/j.pedn.2022.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE This study was conducted to find out how the COVID-19 pandemic affects the lives of adolescents and their expectations about the future. METHODS Data for the study was collected using a descriptive qualitative research design. The sample included 24 adolescents between the ages of 15 and 17, who were recruited according to the purposive sampling method. The research questions and results were structured according to the Bronfenbrenner's Ecological Theory. Data were collected until saturation was achieved. NVivo 12 program was used to organize the data. The transcribed data were analyzed using the inductive thematic analysis method. FINDINGS According to the adolescents' views on the pandemic, were identified twelve sub-themes connected to four main themes and twenty-four metaphor themes in accordance with the Ecological Theory. These were (a) Microenvironments, (b) Education and social life, (c) Ecological lifestyle, (d) Future expectations, and (e) metaphor themes about COVID-19. Moreover, adolescents reported negative opinions on all metaphors. IMPLICATIONS FOR PRACTICE The restrictions applied as measures of control to the global pandemic mostly negatively affected the family and peer relations of adolescents, their academic and social lives, and their expectations about the future. This study demonstrates that it is possible to monitor the psychosocial development of adolescents according to the Ecological Theory. IMPLICATIONS FOR RESEARCH Similar studies may be conducted based on the Ecological Theory to evaluate the development of adolescents after the pandemic.
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Affiliation(s)
- Sureyya Sarvan
- Akdeniz University, Faculty of Nursing, Dumlupinar Boulevard, Campus, 07058, Konyaaltı, Antalya, Turkey.
| | - Leyla Muslu
- Akdeniz University, Faculty of Nursing, Dumlupinar Boulevard, Campus, 07058, Konyaaltı, Antalya, Turkey.
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32
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The Interaction between Basic Psychological Needs, Decision-Making and Life Goals among Emerging Adults in South Africa. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11070316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The interaction between emerging adult psychological well-being and decision-making, in South Africa, has not been explicitly explored in Self-Determination Theory. Life goals have been thought to play a role in the interaction between basic psychological needs and decision-making to promote psychological well-being. The current study, therefore, aimed to examine whether the decision-making styles employed, and the life goals which were deemed important, contribute to the understanding of the satisfaction or frustration of the basic psychological needs of emerging adults in South Africa. Data were collected cross-sectionally, using a secure, online survey among 1411 participants. The interaction between decision-making, life goals and basic psychological needs variables were examined using descriptive statistics, Pearson correlations and hierarchical regression analyses. The results in the study suggest that adaptive (vigilant) decision-making and intrinsic life goals were significant predictors for the satisfaction of the basic psychological needs. Some forms of maladaptive decision-making and extrinsic goals were predictors of the frustration of basic psychological needs. The variance explained by the various models were between 15.6–32.6%, with the results suggesting all models were significant. The results provide a novel contribution to emerging adult well-being in South Africa and Self-Determination Theory, with the implications for society, research and practice discussed.
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Theron LC, Levine DT, Ungar M. The inhibitors and enablers of emerging adult COVID-19 mitigation compliance in a township context. S AFR J SCI 2022. [DOI: 10.17159/sajs.2022/13173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Young adults are often scapegoated for not complying with COVID-19 mitigation strategies. While studies have investigated what predicts this population’s compliance and non-compliance, they have largely excluded the insights of African young people living in South African townships. Given this, it is unclear what places young adult South African township dwellers at risk for not complying with physical distancing, face masking and handwashing, or what enables resilience to those risks. To remedy this uncertainty, the current article reports a secondary analysis of transcripts (n=119) that document telephonic interviews in June and October 2020 with 24 emerging adults (average age: 20 years) who participated in the Resilient Youth in Stressed Environments (RYSE) study. The secondary analysis, which was inductively thematic, pointed to compliance being threatened by forgetfulness; preventive measures conflicting with personal/collective style; and structural constraints. Resilience to these compliance risks lay in young people’s capacity to regulate their behaviour and in the immediate social ecology’s capacity to co-regulate young people’s health behaviours. These findings discourage health interventions that are focused on the individual. More optimal public health initiatives will be responsive to the risks and resilience-enablers associated with young people and the social, institutional, and physical ecologies to which young people are connected.
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Affiliation(s)
- Linda C. Theron
- Department of Educational Psychology, University of Pretoria, Pretoria, South Africa
| | - Diane T. Levine
- Deputy Director: Leicester Institute of Advanced Studies, University of Leicester, Leicester, UK
| | - Michael Ungar
- Canada Research Chair: Child, Family and Community Resilience, Dalhousie University, Halifax, Nova Scotia, Canada
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N'dure Baboudóttir F, Jandi Z, Indjai B, Einarsdóttir J, Gunnlaugsson G. Adolescents amid emerging COVID-19 pandemic in Bissau, Guinea-Bissau: a qualitative study. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001417. [PMID: 36053634 PMCID: PMC9020297 DOI: 10.1136/bmjpo-2022-001417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/25/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Worldwide, governments have implemented restrictions on movement and gatherings to contain the COVID-19 pandemic. In the spirit of the Convention on the Rights of the Child, children have a right to express their opinion on matters of concern to them. The study aimed to describe and analyse how adolescents in the capital Bissau understood the unfolding COVID-19 pandemic and their lived experiences during the first 3 months of the pandemic. METHODS Collaborators identified participants in five urban areas in Bissau in June 2020. Semistructured, open-ended interviews were conducted with 30 adolescents aged 15-17 years, attending private and public schools or out-of-school. The interviews were conducted in Kriol, recorded, transcribed, translated and analysed. RESULTS All the participants were heavily affected by the confinement measures during a state of emergency. Almost all believed in the realness of coronavirus while there were some doubts about its arrival in the country. The consequences were staying at home, enforced with increased police violence. At the same time, other violence on the streets or between neighbours had decreased. A few participants said they liked staying at home because they appreciated spending more time with their families. Most participants claimed that they and their family members tried to follow preventive measures. Almost all participants voiced concerns about the worsening financial situation at home, leading to food scarcity. Nearly all the adolescents were tired of the lockdown and worried about the pandemic's implications on their future opportunities. CONCLUSIONS Study participants, here adolescents in Bissau, have a clear notion of their existence and the current situation's potential negative impact on their future. Their voices need to be heard and acted on, which may soften the lockdown's negative impact on adolescents in Guinea-Bissau, as elsewhere.
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Affiliation(s)
- Fatou N'dure Baboudóttir
- Faculty of Sociology, Anthropology and Folkloristics, School of Social Sciences, University of Iceland, Reykjavik, Iceland
| | - Zeca Jandi
- National Institute for Studies and Research (INEP), Republic of Guinea-Bissau, Bissau, Guinea-Bissau
| | - Bucar Indjai
- National Institute for Studies and Research (INEP), Republic of Guinea-Bissau, Bissau, Guinea-Bissau
| | - Jónína Einarsdóttir
- Faculty of Sociology, Anthropology and Folkloristics, School of Social Sciences, University of Iceland, Reykjavik, Iceland
| | - Geir Gunnlaugsson
- Faculty of Sociology, Anthropology and Folkloristics, School of Social Sciences, University of Iceland, Reykjavik, Iceland
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van Staden Q, Laurenzi CA, Toska E. Two years after lockdown: reviewing the effects of COVID-19 on health services and support for adolescents living with HIV in South Africa. J Int AIDS Soc 2022; 25:e25904. [PMID: 35475319 PMCID: PMC9042673 DOI: 10.1002/jia2.25904] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION South Africa's progress towards the 95-95-95 goals has been significantly slower among adolescents living with HIV (ALHIV), among whom antiretroviral therapy (ART) adherence, retention in care and viral suppression remain a concern. After 2 years of living with COVID-19, it is important to examine the direct and indirect effects of the pandemic on healthcare resources, access to HIV services and availability of support structures, to assess their impact on HIV care for ALHIV. DISCUSSION The COVID-19 response in South Africa has shifted healthcare resources towards combatting COVID-19, affecting the quality and availability of HIV services-especially for vulnerable populations, such as ALHIV. The healthcare system's response to COVID-19 has threatened to diminish fragile gains in engaging ALHIV with HIV services, especially as this group relies on overburdened public health facilities for their HIV care. Reallocation of limited health resources utilized by ALHIV disrupted healthcare workers' capacity to form and maintain therapeutic relationships with ALHIV and monitor ALHIV for ART-related side effects, treatment difficulties and mental health conditions, affecting their ability to retain ALHIV in HIV care. Prevailing declines in HIV surveillance meant missed opportunities to identify and manage opportunistic infections and HIV disease progression in adolescents. "Lockdown" restrictions have limited access to healthcare facilities and healthcare workers for ALHIV by reducing clinic appointments and limiting individual movement. ALHIV have had restricted access to social, psychological and educational support structures, including national feeding schemes. This limited access, coupled with reduced opportunities for routine maternal and sexual and reproductive health services, may place adolescent girls at greater risk of transactional sex, child marriages, unintended pregnancy and mother-to-child HIV transmission. CONCLUSIONS Adolescent HIV care in South Africa is often overlooked; however, ART adherence among ALHIV in South Africa is particularly susceptible to the consequences of a world transformed by COVID-19. The current structures in place to support HIV testing, ART initiation and adherence have been reshaped by disruptions to health structures, new barriers to access health services and the limited available education and psychosocial support systems. Reflecting on these limitations can drive considerations for minimizing these barriers and retaining ALHIV in HIV care.
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Affiliation(s)
- Quintin van Staden
- Department of SociologyUniversity of Cape TownCape TownSouth Africa
- Universitas HospitalBloemfonteinSouth Africa
| | - Christina A. Laurenzi
- Institute for Life Course Health ResearchDepartment of Global HealthFaculty of Medicine and Health SciencesStellenbosch UniversityTygerbergSouth Africa
| | - Elona Toska
- Department of SociologyUniversity of Cape TownCape TownSouth Africa
- Centre for Social Science ResearchUniversity of Cape TownCape TownSouth Africa
- Department of Social Policy and InterventionUniversity of OxfordOxfordUK
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Duby Z, Bunce B, Fowler C, Bergh K, Jonas K, Dietrich JJ, Govindasamy D, Kuo C, Mathews C. Intersections between COVID-19 and socio-economic mental health stressors in the lives of South African adolescent girls and young women. Child Adolesc Psychiatry Ment Health 2022; 16:23. [PMID: 35346316 PMCID: PMC8959551 DOI: 10.1186/s13034-022-00457-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 03/14/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND In contexts where poverty and mental health stressors already interact to negatively impact the most vulnerable populations, COVID-19 is likely to have worsened these impacts. Before the COVID-19 pandemic, adolescent girls and young women (AGYW) in South Africa already faced intersecting mental health stressors and vulnerabilities. It is critical to understand how additional challenges brought on by COVID-19 have intersected with existing vulnerabilities and mental health risks AGYW faced, particularly given the intersections between psychological distress and increased risk behaviours that impact sexual and reproductive health. We aimed to examine socio-economic and mental health impacts of COVID-19 on South African AGYW in order to understand how additional challenges brought on by COVID-19 have intersected with existing challenges, compounding AGYW vulnerabilities. METHODS Using qualitative and quantitative methods, framed by the syndemic theory, we examined the intersections between mental health and the COVID-19 epidemic amongst AGYW in six districts of South Africa characterised by high rates of HIV, teenage pregnancy and socio-economic hardship. Between November 2020 and March 2021 we conducted a cross-sectional telephone survey with 515 AGYW, and in-depth interviews with 50 AGYW, aged 15 to 24 years. RESULTS Our findings reveal how COVID-19 restrictions led to increased experiences of stress and anxiety. Poor mental health was compounded by strained family relationships, increased fear of domestic violence, household unemployment, economic stress and food insecurity. Respondents described feelings of boredom, frustration, isolation, loneliness, fear and hopelessness. However, despite the multitude of challenges, some AGYW articulated emotional resilience, describing ways in which they coped and retained hope. CONCLUSION Various psycho-social risk factors already disproportionally affect the mental health of AGYW in these communities; the COVID-19 pandemic intersects with these pre-existing social and environmental factors. Understanding strategies AGYW have used to positively cope with the uncertainty of COVID-19 amongst an array of pre-existing mental health stressors, is key in informing efforts to respond to their needs. Multisectoral interventions are needed to address the drivers of poor mental health among AGYW, and bolster healthy coping mechanisms; interventions seeking to mitigate the mental health impacts on this vulnerable population need to be responsive to the unpredictable pandemic environment.
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Affiliation(s)
- Zoe Duby
- Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Tygerberg, Cape Town, South Africa
- Division of Social and Behavioural Sciences in the School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Brittany Bunce
- Institute for Global Sustainable Development, University of Sheffield, Sheffield, UK
| | - Chantal Fowler
- Division of Social and Behavioural Sciences in the School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Kate Bergh
- Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Tygerberg, Cape Town, South Africa
| | - Kim Jonas
- Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Tygerberg, Cape Town, South Africa
| | - Janan Janine Dietrich
- Perinatal HIV Research Unit (PHRU) and African Social Sciences Unit of Research and Evaluation (ASSURE), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Darshini Govindasamy
- Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Tygerberg, Cape Town, South Africa
| | - Caroline Kuo
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI USA
| | - Catherine Mathews
- Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Tygerberg, Cape Town, South Africa
- Division of Social and Behavioural Sciences in the School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Gittings L, Price Y, Kelly J, Kannemeyer N, Thomas A, Medley S, Ralayo N, Omollo V, Cluver L, Logie CH, Evalia H, Toska E. Health and development-related priorities and challenges of adolescents and young people: findings from South Africa and Kenya prior to and during COVID-19 pandemic. PSYCHOL HEALTH MED 2022; 27:193-218. [PMID: 36242536 DOI: 10.1080/13548506.2022.2108084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/25/2022] [Indexed: 12/13/2022]
Abstract
Growing evidence documents the effects of the COVID-19 pandemic on adolescents in East and Southern Africa. We present and explore the longitudinal health and development-related priorities and challenges of adolescent advisors in South Africa and Kenya, including prior to, and during the COVID-19 pandemic. Findings were co-generated with adolescent advisors in the Eastern Cape Province of South Africa (n=15, ages 18-22 in 2019) and Kisumu, Kenya (n=16, ages 10-14 in 2020). Prior to COVID-19, adolescent advisors engaged in a participatory exercise to share and explore their health and development-related priorities and challenges in 2019 and 2020. During the COVID-19 pandemic in 2020 and 2021, members of the same groups shared their experiences, challenges and coping strategies in semi-structured telephone interviews (Eastern Cape: n=14, aged 19-23; Kisumu n=12, aged 11-16) and group-based remote participatory social media activities (n=27 activities with n=12 advisors, Eastern Cape). We thematically analysed COVID-19 activities, considering them alongside pre-pandemic priorities and challenges. Many of the health and development-related priorities and challenges identified prior to COVID-19 remained issues of concern during COVID-19. These included education; victimization and violence; teenage pregnancy; substance use; household tension, conflict and inadequate family and caregiver support; health and medication concerns (South Africa) and water and food shortages (Kenya). Other issues such as financial insecurity, mental health, and crime were strong themes that emerged during COVID-19, which were not directly reported as priorities prior. Although almost all of adolescent advisors' most pressing pandemic-related challenges were also priorities for them prior to COVID-19, these issues were often discussed as new, and caused by the onset of COVID-19. While demonstrating how COVID-19 has exacerbated pre-existing vulnerabilities, we also suggest that the pandemic may have brought about a new way for adolescents to make sense of, and articulate pre-existing challenges.
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Affiliation(s)
- Lesley Gittings
- School of Health Studies, Faculty of Health Sciences, Western University, London, Canada
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Yusra Price
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Jane Kelly
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Natasha Kannemeyer
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Angelique Thomas
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
- Institute of Humanities in Africa, University of Cape Town, South Africa
| | - Sally Medley
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Nokubonga Ralayo
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | | | - Lucie Cluver
- Department of Social Policy and Intervention University of Oxford, Oxford, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | | | - Elona Toska
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
- Department of Social Policy and Intervention University of Oxford, Oxford, UK
- Department of Sociology, University of Cape Town, Cape Town, South Africa
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Zolopa C, Burack JA, O’Connor RM, Corran C, Lai J, Bomfim E, DeGrace S, Dumont J, Larney S, Wendt DC. Changes in Youth Mental Health, Psychological Wellbeing, and Substance Use During the COVID-19 Pandemic: A Rapid Review. ADOLESCENT RESEARCH REVIEW 2022; 7:161-177. [PMID: 35252542 PMCID: PMC8881192 DOI: 10.1007/s40894-022-00185-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 02/11/2022] [Indexed: 05/09/2023]
Abstract
UNLABELLED Since the onset of the COVID-19 pandemic, researchers around the world have made efforts to assess its impact on youth mental health; however, the breadth of this topic has impeded a clear assessment of pandemic outcomes. This study aimed to address this gap by reviewing changes in youth (age ≤ 25) mental health, psychological wellbeing, substance use, and the use or delivery of relevant services during the pandemic. PubMed and Embase were searched in May 2021 to conduct a rapid review of the literature. The results encompass 156 primary publications and are reported using a narrative synthesis. Studies of mental health (n = 122) and psychological wellbeing (n = 28) generally indicated poor outcomes in many settings. Publications regarding substance use (n = 41) noted overall declines or unchanged patterns. Studies of service delivery (n = 12) indicated a generally positive reception for helplines and telehealth, although some youth experienced difficulties accessing services. The findings indicate negative impacts of the pandemic on youth mental health, with mixed results for substance use. Services must support marginalized youth who lack access to telehealth. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40894-022-00185-6.
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Affiliation(s)
- Camille Zolopa
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CR-CHUM), 900 rue Saint-Denis, porte R6-432, Montreal, QC H2X 0A9 Canada
| | - Jacob A. Burack
- Department of Educational & Counselling Psychology, McGill University, 845 rue Sherbrooke O, Montreal, QC H3A 0G4 Canada
| | - Roisin M. O’Connor
- Department of Psychology, Concordia University, 7141 Sherbrooke St. West, Montreal, QC H4B 1R6 Canada
| | - Charlotte Corran
- Department of Psychology, Concordia University, 7141 Sherbrooke St. West, Montreal, QC H4B 1R6 Canada
| | - Jessica Lai
- Department of Educational & Counselling Psychology, McGill University, 845 rue Sherbrooke O, Montreal, QC H3A 0G4 Canada
| | - Emiliana Bomfim
- Department of Educational & Counselling Psychology, McGill University, 845 rue Sherbrooke O, Montreal, QC H3A 0G4 Canada
| | - Sarah DeGrace
- Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, 5909 Veterans’ Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, Halifax, NS B3H 2E2 Canada
| | - Julianne Dumont
- Department of Psychology, Concordia University, 7141 Sherbrooke St. West, Montreal, QC H4B 1R6 Canada
| | - Sarah Larney
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CR-CHUM), 900 rue Saint-Denis, porte R6-432, Montreal, QC H2X 0A9 Canada
- Department of Family Medicine and Emergency Medicine, Université de Montréal, 2900 boulevard d’Edouard Montpetit, Montreal, QC H3T 1J4 Canada
| | - Dennis C. Wendt
- Department of Educational & Counselling Psychology, McGill University, 845 rue Sherbrooke O, Montreal, QC H3A 0G4 Canada
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Chen-Charles J, Rudgard WE, Doyle AM, Toska DE, Cluver PL. What do adolescents value most and is this affected by HIV status? Aspirations and self-perceptions from a large cohort study in South Africa. PSYCHOL HEALTH MED 2022; 27:97-106. [PMID: 36036247 DOI: 10.1080/13548506.2022.2116059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Hundreds of millions of adolescents across Africa face challenges in many areas of their lives, including elevated risk of HIV exposure and acquisition. Understanding the aspirations and self-perceptions of adolescents could play an important role in better targeting effective investments to break the cycle of adversity for adolescents and into their adulthood. Aiming to understand what adolescents value most for themselves and their future, we analysed and summarised cross-sectional data on the aspirations and self-perceptions of 1519 adolescents living in South Africa, overall and by HIV status. Outcomes were coded from participant responses to two open-ended questions: 'What job do you want to do when you grow up?' and 'What are you most proud of about yourself?'. Associations with HIV status were then evaluated using multivariable logistic regression adjusting for six sociodemographic factors measured from the same cohort. The sample had a mean age of 14 years, 55% were female, and 70% were living with HIV. The five most common job aspirations were: 'Health and Medical Science Professionals' (28%), 'Law Enforcement and Public Safety Professionals' (14%), 'Social Work Associate Professionals' (12%), 'Legal Professionals' (9%), and 'Education Institutions Teaching Professionals' (6%). The top five themes for what adolescents were most proud of about themselves were 'School performance' (22%), 'Outward appearance' (15%), 'Sports skills' (12%), 'Personality' (11%), and 'Behaviour at home/with elders' (7%). Adjusted analysis showed no evidence that HIV status was associated with important differences in aspirations or self-perceptions. In conclusion, adolescents facing high levels of adversity in South Africa hold high value for their education and aspirations for their futures. Policies and initiatives should focus on meeting these aspirations as vehicles for development, independent of their HIV status. Therefore, more needs to be done to not just help adolescents survive but thrive into adulthood.
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Affiliation(s)
- Jenny Chen-Charles
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - William E Rudgard
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Aoife M Doyle
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Dr Elona Toska
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK.,Department of Sociology, University of Cape Town, Cape Town, South Africa
| | - Professor Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK.,Department of Mental Health and Psychiatry, University of Cape Town, Rondebosch, South Africa
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Kelly J, Gittings L, Laurenzi C, Glinski CD, Mangqalaza H, Ralayo N, Langwenya N, Sidloyi L, Mbiko A, Taleni B, Saliwe B, Toska E. HIV and SRH healthcare delivery experiences of South African healthcare workers and adolescents and young people during COVID-19. PSYCHOL HEALTH MED 2022; 27:155-166. [PMID: 36004413 DOI: 10.1080/13548506.2022.2108080] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
While substantial research has emerged from the frontlines of the COVID-19 pandemic, as well as from studies with adolescent populations, there has been a dearth of research focused in South Africa on the context-specific experiences of healthcare workers (HCWs) and the adolescents and young people (AYP) to whom they provide services. This article documents the experiences of provision and receipt of HIV and sexual and reproductive health (SRH) services during the COVID-19 pandemic from the perspective of South African HCWs (n = 13) and AYP (n = 41, ages 17-29). Findings highlight several barriers to accessing comprehensive HIV and SRH services during the pandemic including lockdown-related mobility restrictions (reported by HCWs), prioritisation of COVID-19 above other healthcare needs, longer health facility waiting times, poor treatment by HCWs (reported by AYP), discomfort and perceived stigma from having to queue outside health facilities, and fear of contracting COVID-19 (reported by both groups). While HCWs reported that HIV and SRH services continued to be available during the pandemic, AYP described seeking these services - such as long-acting reversible contraception, check-ups for their babies and medical refills - and being told that because they were not considered emergency cases, they should return on a different date. By capturing diverse experiences and perspectives from both groups, our findings reiterate the growing call for health system investments to strengthen the delivery of adolescent services, including investing in appropriate channels of communication between young people and their healthcare providers (for example, through adolescent peer supporters or community healthcare workers) and differentiated models of service delivery (for example, multi-month ART refills and community pick-ups). Closing the gap between the experiences and needs of adolescents and the healthcare workers who serve them may support young people and HCWs in buffering against changes brought about by the COVID-19 pandemic.
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Affiliation(s)
- Jane Kelly
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa
| | - Lesley Gittings
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa.,Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Christina Laurenzi
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa.,Institute for Life Course Health Research, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Charné Dee Glinski
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa.,Oxford Research South Africa, University of Oxford, Oxford, UK
| | - Hlokoma Mangqalaza
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa
| | - Nokubonga Ralayo
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa
| | | | - Lulama Sidloyi
- Oxford Research South Africa, University of Oxford, Oxford, UK
| | - Amanda Mbiko
- Oxford Research South Africa, University of Oxford, Oxford, UK
| | - Babalwa Taleni
- Oxford Research South Africa, University of Oxford, Oxford, UK
| | - Bongiwe Saliwe
- Oxford Research South Africa, University of Oxford, Oxford, UK
| | - Elona Toska
- Centre for Social Science Research, University of Cape Town, Rondebosch, South Africa
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Pry JM, Sikombe K, Mody A, Iyer S, Mutale J, Vlahakis N, Savory T, Wa Mwanza M, Mweebo K, Mwila A, Mwale C, Mukumbwa-Mwenechanya M, Kerkhoff AD, Sikazwe I, Bolton Moore C, Mwamba D, Geng EH, Herce ME. Mitigating the effects of COVID-19 on HIV treatment and care in Lusaka, Zambia: a before-after cohort study using mixed effects regression. BMJ Glob Health 2022; 7:e007312. [PMID: 35078810 PMCID: PMC8795923 DOI: 10.1136/bmjgh-2021-007312] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/04/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The Zambian Ministry of Health (MoH) issued COVID-19 mitigation guidance for HIV care immediately after the first COVID-19 case was confirmed in Zambia on 18 March 2020. The Centre for Infectious Disease Research in Zambia implemented MoH guidance by: 1) extending antiretroviral therapy (ART) refill duration to 6 multi-month dispensation (6MMD) and 2) task-shifting communication and mobilisation of those in HIV care to collect their next ART refill early. We assessed the impact of COVID-19 mitigation guidance on HIV care 3 months before and after guidance implementation. METHODS We reviewed all ART pharmacy visit data in the national HIV medical record for PLHIV in care having ≥1 visit between 1 January-30 June 2020 at 59 HIV care facilities in Lusaka Province, Zambia. We undertook a before-after evaluation using mixed-effects Poisson regression to examine predictors and marginal probability of early clinic return (pharmacy visit >7 days before next appointment), proportion of late visit (>7 days late for next appointment) and probability of receiving a 6MMD ART refill. RESULTS A total of 101 371 individuals (64% female, median age 39) with 130 486 pharmacy visits were included in the analysis. We observed a significant increase in the adjusted prevalence ratio (4.63; 95% CI 4.45 to 4.82) of early return before compared with after guidance implementation. Receipt of 6MMD increased from a weekly mean of 47.9% (95% CI 46.6% to 49.2%) before to 73.4% (95% CI 72.0% to 74.9%) after guidance implementation. The proportion of late visits (8-89 days late) was significantly higher before (18.8%, 95% CI17.2%to20.2%) compared with after (15.1%, 95% CI13.8%to16.4%) guidance implementation . CONCLUSIONS Timely issuance and implementation of COVID-19 mitigation guidance involving task-shifted patient communication and mobilisation alongside 6MMD significantly increased early return to ART clinic, potentially reducing interruptions in HIV care during a global public health emergency.
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Affiliation(s)
- Jake M Pry
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Kombatende Sikombe
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Aaloke Mody
- Department of Internal Medicine, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA
| | - Shilpa Iyer
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Jacob Mutale
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Natalie Vlahakis
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Theodora Savory
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Mwanza Wa Mwanza
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Keith Mweebo
- Division of Global HIV & Tuberculosis, Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Annie Mwila
- Division of Global HIV & Tuberculosis, Centers for Disease Control and Prevention, Lusaka, Zambia
| | | | | | - Andrew D Kerkhoff
- University of California San Francisco, San Francisco, California, USA
- San Francisco General Hospital and Trauma Center, San Francisco, California, USA
| | - Izukanji Sikazwe
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Carolyn Bolton Moore
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- Department of Infectious Disease, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Daniel Mwamba
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Elvin H Geng
- Department of Internal Medicine, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA
| | - Michael E Herce
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
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Haag K, Du Toit S, Skeen S, Steventon Roberts K, Chideya Y, Notholi V, Sambudla A, Gordon S, Sherr L, Tomlinson M. Predictors of COVID-related changes in mental health in a South African sample of adolescents and young adults. PSYCHOL HEALTH MED 2022; 27:239-255. [PMID: 35950705 DOI: 10.1080/13548506.2022.2108087] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The COVID-19 pandemic has substantially affected the lives of young people living in sub-Saharan Africa (SSA), leading to poorer short-term mental health outcomes. However, longitudinal data investigating changes in mental health from pre-COVID levels and their predictors are lacking. Our longitudinal sample comprised N = 233 young people (mean age: 17.8 years at baseline, 55.6% female) living in a deprived neighbourhood near Cape Town, South Africa. Symptoms of depression (PHQ-9), anxiety (GAD-7) and alcohol use (AUDIT) were assessed during two waves of data collection, pre-pandemic (2018/19) and via phone interviews in June to October 2020, during South Africa's first COVID wave and subsequent case decline. Latent change score models were used to investigate predictors of changes in mental health. Controlling for baseline levels, we found increases in depression and anxiety but not alcohol use symptoms during the COVID-19 pandemic. Higher baseline symptoms were associated with smaller increases on all measures. Socio-economic deprivation (lack of household income, food insecurity) before and during COVID were associated with higher anxiety and depression symptom increases. Having had more positive experiences during COVID was associated with lower post-COVID onset anxiety and depression increases, and marginally with less alcohol use, while negative experiences (household arguments, worries) were linked to stronger symptom increases. Overall, in a sample of young people from an adverse environment in South Africa, we found increased mental health difficulties during the COVID-19 pandemic, though higher baseline symptoms did not necessarily predict stronger increases. Several factors pre- and post-COVID onset were identified that could be relevant for determining risk and resilience. In the long term, it will be key to address these structural drivers of well-being and to ensure mental health needs of young people are being met to support SSA countries in building back successfully from COVID-19 and preparing for future shock events.
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Affiliation(s)
- Katharina Haag
- Institute for Global Health, University College London, London, UK
| | - Stefani Du Toit
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Sarah Skeen
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | | | - Yeukai Chideya
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Vuyolwethu Notholi
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Akhona Sambudla
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Sarah Gordon
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Lorraine Sherr
- Institute for Global Health, University College London, London, UK
| | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.,School of Nursing and Midwifery, Queens University, Belfast, UK
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Casale M, Yates R, Gittings L, Haupt Ronnie G, Somefun O, Desmond C. Consolidate, conceptualize, contextualise: key learnings for future intervention acceptability research with young people in Africa. PSYCHOL HEALTH MED 2022; 27:181-192. [PMID: 35938622 PMCID: PMC10029093 DOI: 10.1080/13548506.2022.2108078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Acceptability has become a key consideration in the development, evaluation and implementation of health and social interventions. This commentary paper advances key learnings and recommendations for future intervention acceptability research with young people in Africa, aimed at supporting the achievement of developmental goals. It relates findings of the adolescent acceptability work conducted within the Accelerate Hub, since mid 2020, to broader inter-disciplinary literatures and current regional health and social priorities. We argue that, in order to strengthen the quality and applied value of future acceptability work with young people, we need to do three things better. First, we need to consolidate prior findings on acceptability, within and across intervention types, to inform responses to current public health and social challenges and further the conceptual work in this area. Second, we need to better conceptualise acceptability research with young people, by developing stronger conceptual frameworks that define acceptability and its constructs, and predict its relationship with intervention engagement. Third, we need to better contextualise findings by considering acceptability data within a broader social and political context, which in turn can be supported by better conceptualisation. In this paper we describe contributions of our work to each of these three inter-connected objectives, and suggest ways in which they may be taken forward by researchers and practitioners. These include aggregating evidence from past interventions to highlight potential barriers and enablers to current responses in priority areas; involving key actors earlier and more meaningfully in acceptability research; further developing and testing behavioural models for youth acceptability; and working collaboratively across sectors towards programmatic guidance for better contextualisation of acceptability research. Progress in this field will require an inter-disciplinary approach that draws from various literatures such as socio-ecological theory, political economy analysis, health behaviour models and literature on participatory research approaches.
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Affiliation(s)
- Marisa Casale
- School of Public Health,University of the Western Cape, Cape Town, South Africa
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Rachel Yates
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
| | - Lesley Gittings
- Centre for Social Science Research, University of Cape Town, Cape Town, South Africa
- Faculty of Social Work, University of Toronto, Canada
| | | | - Oluwaseyi Somefun
- School of Public Health,University of the Western Cape, Cape Town, South Africa
| | - Chris Desmond
- Centre for Rural Health, University of KwaZulu-Natal
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Theron L, Levine D, Ungar M. Resilience to COVID-19-related stressors: Insights from emerging adults in a South African township. PLoS One 2021; 16:e0260613. [PMID: 34932552 PMCID: PMC8691654 DOI: 10.1371/journal.pone.0260613] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 11/14/2021] [Indexed: 12/16/2022] Open
Abstract
There is widespread recognition that stressors related to Coronavirus Disease 2019 (COVID-19) jeopardize the development of emerging adults, more particularly those living in disadvantaged communities. What is less well understood is what might support emerging adult resilience to COVID-19-related stressors. In response, this article reports a 5-week qualitative study with 24 emerging adults (average age: 20) living in a South African township. Using digital diaries and repeated individual interviews, young people shared their lived experiences of later (i.e., month 4 and 7) lockdown-related challenges (i.e., contagion fears; livelihood threats; lives-on-hold) and how they managed these challenges. An inductive thematic analysis showed that personal and collective compliance, generous ways-of-being, and tolerance-facilitators enabled emerging adult resilience to said challenges. Importantly, these resilience-enablers drew on resources associated with multiple systems and reflected the situational and cultural context of the township in question. In short, supporting emerging adult resilience to COVID-19-related stressors will require contextually aligned, multisystemic responses.
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Affiliation(s)
- Linda Theron
- Department of Educational Psychology, University of Pretoria, Pretoria, South Africa
| | - Diane Levine
- Leicester Institute of Advanced Studies, University of Leicester, Leicester, United Kingdom
| | - Michael Ungar
- Resilience Research Center, Dalhousie University, Halifax, Canada
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El-Krab R, Kalichman S, Govindasamy D, Banas E, Kalichman M, Mathews C. Subjective well-being and COVID-19 prevention practices among people living with HIV in Cape Town, South Africa. Glob Public Health 2021; 17:1-12. [PMID: 34882525 DOI: 10.1080/17441692.2021.2005113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
COVID-19 poses significant threats to the health of people with underlying chronic conditions, including people living with HIV. The association between subjective well-being and practicing COVID-19 preventive behaviours among people living with HIV is yet to be empirically tested. The objective of the current study was to test the hypothesis that subjective well-being would be associated with engaging in greater COVID-19 preventive behaviours. A sample of 200 women and 72 men (mean age 38.1, SD = 10.4) receiving HIV treatment at a clinic in Cape Town, South Africa completed interview administered surveys of health behaviours and three dimensions of subjective well-being: emotional, social and psychological well-being. Hierarchical regression models were performed to test subjective well-being as predictors of COVID-19 preventive behaviours adjusting for age, sex, education, TB history, antiretroviral therapy adherence, and concern about contracting COVID-19. Results showed that psychological well-being, along with concerns over COVID-19, predicted greater COVID-19 preventive behaviours over and above the other variables in the model, accounting for 9.2% of the variance. Results support incorporating interventions to foster psychological well-being into existing clinical services for people living with HIV to improve clusters of health behaviours.
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Affiliation(s)
- Renee El-Krab
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Seth Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Darshini Govindasamy
- Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Ellen Banas
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA.,Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Moira Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Catherine Mathews
- Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa
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Muzyamba C. Local characterization of the COVID-19 response: the case of a lockdown in Lusaka, Zambia. Glob Health Res Policy 2021; 6:38. [PMID: 34593052 PMCID: PMC8482737 DOI: 10.1186/s41256-021-00220-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/03/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The onset of the COVID-19 pandemic has sparked heated debate among scholars on the relevance of lockdowns. There are those in favor of the lockdown and others who are critical of it. However, despite the increased interest in understanding the relevance of lockdowns, there still has not been much focus on its relevance in countries like Zambia. Thus, with the help of the Social Representation Theory (SRT), we set out to explore and document the local characterization of the lockdown by residents of Lusaka, Zambia. METHODS We recruited our participants through convenient and purposive sampling techniques. This was done through the use of the ZAMTEL public phone records. Initial contact was made to potential participants, and they were asked of their availability and willingness to participate in the interview. Upon agreeing to participate, they were included in the sample. A total of 68 people were selected to take part in this study. Their age ranged from 20 to 76 years old. 33 of them were male and 35 females. After this, we conducted interviews with the 68 participants. Due to COVID-19 restrictions, our interviews were conducted via telephone in conformity with the recommendations from the IRB in Lusaka and the advice of the ministry of health. We anonymized the demographic characteristics and responses from our participants. Later, thematic analysis was used to analyze the data. RESULTS The lockdown was on one hand lauded for slowing down the incidence rates, preventing fatalities, and protecting the healthcare system from collapse. On the other hand, it was criticized for exacerbating poverty levels, unemployment rates, increasing the rate of mental health problems, aiding gender-based violence, and intensifying political repression and corruption. The results speak to the complexity in the characterization of the lockdown as a response to COVID-19 in Lusaka, Zambia. This observation demonstrates the folly of viewing, applying and characterizing the COVID-19 lockdown as a 'one-size-fits-all' approach in Lusaka, Zambia. CONCLUSION Rather than establishing the lockdown as an incontestable good, as it is depicted by some scholars or as useless by its critics, our findings instead demonstrate the diversity and complexity in how it is locally viewed by Lusaka residents. The study provides grounds for caution on simplistic and binary characterization of lockdowns. It indicates the need for careful dialog between the designers of lockdowns and citizens in order to tailor such interventions to local realities in context-specific ways. It also shows that though the development of such interventions, all the various and complex elements it embodies must be taken into account in order to realize optimum outcomes.
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Affiliation(s)
- Choolwe Muzyamba
- University College Utrecht, Campusplein 1, 3584 ED, Utrecht, The Netherlands.
- , Lusaka, Zambia.
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Myers B, van der Westhuizen C, Pool M, Hornsby N, Sorsdahl KR. Responding to COVID-19 threats to trial conduct: lessons learned from a feasibility trial of a psychological intervention for South African adolescents. Trials 2021; 22:440. [PMID: 34243806 PMCID: PMC8267766 DOI: 10.1186/s13063-021-05400-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/21/2021] [Indexed: 02/08/2023] Open
Abstract
The COVID-19 pandemic has posed challenges to the conduct of clinical trials. Strategies for overcoming common challenges to non-COVID-19 trial continuation have been reported, but this literature is limited to pharmacological intervention trials from high-income settings. The purpose of this paper is to expand the literature to include a low- and middle-income country perspective. We describe the challenges posed by COVID-19 for a randomised feasibility trial of a psychological intervention for adolescents in Cape Town, South Africa, and lessons learned when implementing strategies to facilitate trial continuation in this context. We used a Plan-Do-Study-Act cycle method to explore whether our adaptations were having the desired effect on trial accrual and retention. We found that stakeholder engagement, trial coordination and team communication need to be intensified while testing these procedural changes. We learned that strategies found to be effective in high-income countries required significant adaptation to our resource-constrained setting. The detailed documentation of extraneous influences, procedural changes and trial process information was essential to guiding decisions about which adaptations to retain. This information will be used to examine the potential impact of these changes on study outcomes. We hope that these reflections will be helpful to other trialists from low- and middle-income countries grappling with how to minimise the impact of public health emergencies on their research. TRIAL REGISTRATION: The trial is registered with the Pan African Clinical Trials Registry (PACTR20200352214510). Registered 28 February 2020. https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9795 .
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Affiliation(s)
- Bronwyn Myers
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, PO Box 19070, Tygerberg, 7505, South Africa. .,Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia. .,Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa.
| | - Claire van der Westhuizen
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
| | - Megan Pool
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
| | - Nancy Hornsby
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, PO Box 19070, Tygerberg, 7505, South Africa
| | - Katherine R Sorsdahl
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
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Okumu M, Nyoni T, Byansi W. Alleviating psychological distress and promoting mental wellbeing among adolescents living with HIV in sub-Saharan Africa, during and after COVID-19. Glob Public Health 2021; 16:964-973. [PMID: 33843460 DOI: 10.1080/17441692.2021.1912137] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
COVID-19 social control measures (e.g. physical distancing and lockdowns) can have both immediate (social isolation, loneliness, anxiety, stress) and long-term effects (depression, post-traumatic stress disorder) on individuals' mental health. This may be particularly true of adolescents living with HIV (ALHIV) and their caregivers - populations already overburdened by intersecting stressors (e.g. psychosocial, biomedical, familial, economic, social, or environmental). Addressing the adverse mental health sequelae of COVID-19 among ALHIV requires a multi-dimensional approach that at once (a) economically empowers ALHIV and their households and (b) trains, mentors, and supervises community members as lay mental health services providers. Mental health literacy programming can also be implemented to increase mental health knowledge, reduce stigma, and improve service use among ALHIV. Schools and HIV care clinics offer ideal environments for increasing mental health literacy and improving access to mental health services.
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Affiliation(s)
- Moses Okumu
- School of Social Work, University of North Carolina, Chapel Hill, NC, USA
| | - Thabani Nyoni
- Brown School of Social Work, Washington University, St. Louis, MO, USA
| | - William Byansi
- Brown School of Social Work, Washington University, St. Louis, MO, USA
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