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Norr KF, Banda CK, Chang C, Krishna S, Kumbani LC, Liu L, McCreary LL, Patil CL. Condom use increased after a peer group intervention implemented by community volunteers in Malawi. BMC Public Health 2024; 24:1483. [PMID: 38831266 PMCID: PMC11145788 DOI: 10.1186/s12889-024-18991-z] [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: 07/06/2023] [Accepted: 05/29/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND HIV prevention remains a global priority, especially in sub-Saharan Africa. Our research team previously developed an evidence-based peer group program for HIV prevention called Mzake ndi Mzake (Friend to Friend). A community-engaged collaboration adapted the program for community ownership and implementation. Here we report whether this HIV prevention program, implemented by community volunteers, increased condom use among sexually active individuals in rural Malawi. METHODS Three communities sequentially rolled out the program. Effectiveness was evaluated using a stepped wedge design. Repeated surveys 11-13 months apart were conducted between 2016 and 2019. At Time 1, no community had offered the intervention. At Time 2, the first community had offered the intervention and two had not (control group). At Time 3, two communities had offered the intervention and one had not (control group). We used two condom use indicators; condom use frequency in the last 2 months (N = 771) and condom use at last sex (N = 880). The analytical sample included all sexually active persons answering that question at one or more time points. Mixed-effects cumulative logit and Generalized Estimating Equation (GEE) models were used to model the two condom indicators over time, controlling for demographic factors, UNAIDS HIV knowledge, safer sex self-efficacy and partner communication. RESULTS This peer group intervention implemented by trained community volunteers increased both condom use indicators at Times 2 and 3. In the final adjusted models with non-significant factors removed, condom use in the last two months increased for the intervention group vs. control group [Time 2: Adjusted Odds Ratio (AOR) = 1.59 (1.15, 2.21); Time 3: AOR 2.01 (1.23, 3.30)]. Similarly, condom use at last sex increased for the intervention group vs. control group [Time 2: AOR = 1.48 (1.08, 2.03); Time 3: AOR 1.81 (1.13, 2.90)]. Other significant predictors of greater condom use were also described. Although the intervention increased UNAIDS HIV knowledge, knowledge did not predict condom use. CONCLUSIONS In this community-engaged implementation study, an evidence-based peer group program for HIV prevention increased condom use when delivered by trained community volunteers. Community ownership and program delivery by trained volunteers offer an innovative and cost-effective strategy to address ongoing HIV prevention needs without overburdening healthcare systems in sub-Saharan Africa. TRIAL REGISTRATION Clinical Trials.gov NCT02765659 Registered May 6, 2016.
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Affiliation(s)
- Kathleen F Norr
- College of Nursing, University of Illinois Chicago, 845 S Damen Ave, Chicago, IL, 60612, USA.
| | - Chimwemwe K Banda
- Malawi Liverpool Wellcome Clinical Research Program, P.O Box 30096, Chichiri, Blantyre 3, Malawi
| | - Cecilia Chang
- School of Public Health, University of Illinois Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA
| | - Shruthi Krishna
- School of Public Health, University of Illinois Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA
| | - Lily C Kumbani
- Kamuzu University of Health Sciences, P/Bag 360, Chichiri, Blantyre 3, Malawi
| | - Li Liu
- School of Public Health, University of Illinois Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA
| | - Linda L McCreary
- College of Nursing, University of Illinois Chicago, 845 S Damen Ave, Chicago, IL, 60612, USA
| | - Crystal L Patil
- School of Nursing, University of Michigan, 400 N. Ingalls St, Ann Arbor, MI, 48109, USA
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Cortina AH, Scanlan J, Paneque RJ, Vasquez Osses MA. Cross-Cultural Adaptation and Psychometric Evaluation of Condom Use Self-Efficacy Scale in Chilean College Students. J Nurs Meas 2023; 31:360-369. [PMID: 37558259 DOI: 10.1891/jnm-2021-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Background and Purpose: Limited culturally relevant condom self-efficacy measures have been adapted for use with Chilean college students. This study aims to culturally adapt and measure the psychometric properties of the Condom Use Self-Efficacy Scale (CUSES) by use in college students in Chile. Methods: This cross-sectional study was carried out in six stages: (a) authorization from original authors, (b) translation, (c) back translation, (d) analysis of equivalences, (e) content analysis, and (f) exploratory factor analysis and reliability assessment. Results: Of the 460 college students who completed the Chilean CUSES (Ch-CUSES), 73.9% were women and 99% were single with a mean age of 20.5. Total scale Cronbach's alpha was 0.845, and factor analysis demonstrated six dimensions with 59.1% of the total variance. The factor loading scores of 21 items ranged between 0.515 and 0.921. Conclusions: Ch-CUSES shows good psychometric properties for assessing self-efficacy for condom use in Chilean college students.
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Affiliation(s)
- Abdul Hernández Cortina
- Universidad Autónoma de Chile, Providencia, Región Metropolitana, Chile
- Universidad Finis Terrae, Providencia, Región Metropolitana, Chile
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Norr KF, Banda CK, Chang C, Krishna S, Kumbani LC, Liu L, McCreary LL, Patil CL. Condom use increased after a peer group intervention implemented by community volunteers in Malawi. RESEARCH SQUARE 2023:rs.3.rs-3120974. [PMID: 37461672 PMCID: PMC10350185 DOI: 10.21203/rs.3.rs-3120974/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Background HIV prevention remains a global priority, especially in sub-Saharan Africa. Our research team previously developed an evidence-based peer group program for HIV prevention called Mzake ndi Mzake (Friend to Friend). A community-engaged collaboration adapted the program for community ownership and implementation. Here we report whether this HIV prevention program, implemented by community volunteers, increased condom use among sexually active individuals in rural Malawi. Methods Three communities sequentially rolled out the program. Effectiveness was evaluated using repeated surveys. At Time 1, no community had offered the intervention. At Time 2, the first community had offered the intervention and two had not (control group). At Time 3, two communities had offered the intervention and one had not (control group). We used two condom use indicators; condom use frequency in the last 2 months (N = 776) and condom use at last sex (N = 880). For each indicator, the sample included all sexually active persons answering that question at one or more time points. Regression analyses were used to model the two condom indicators over time, controlling for demographic factors, UNAIDS HIV knowledge, safer sex self-efficacy and partner communication. Results This peer group intervention implemented by trained community volunteers increased both condom use indicators at Times 2 and 3. In the final regression models. Other predictors of greater condom use for at least one condom use indicator included younger age group (13-19), male gender, not married/cohabiting, high involvement in religiously affiliated activities, higher safer sex self-efficacy, and greater partner communication. Although the intervention increased UNAIDS HIV knowledge, knowledge did not predict condom use. Conclusions This community engaged implementation study found that an evidence-based peer group program for HIV prevention increased condom use when delivered by trained community volunteers. Leveraging community strengths and human capital resources facilitated implementation of this effective HIV prevention program in rural Malawi. Community ownership and program delivery by trained local volunteers offers an innovative and cost-effective strategy to address ongoing HIV prevention needs without overburdening heathcare systems in sub. Trial registration Clinical Trials.gov NCT02765659 Registered May 6, 2016.
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Affiliation(s)
| | | | - Cecilia Chang
- School of Public Health, University of Illinois Chicago
| | | | | | - Li Liu
- School of Public Health, University of Illinois Chicago
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Exploring Self-efficacy for Condom Use in Spanish People: A Trend Analyses by Gender from 2004 to 2020. AIDS Behav 2022; 27:2041-2053. [PMID: 36441411 PMCID: PMC9707195 DOI: 10.1007/s10461-022-03937-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2022] [Indexed: 11/30/2022]
Abstract
Self-efficacy seems to be one of the most important resources for the different stages underlying condom use and STI prevention. For this reason, this study evaluates trends in self-efficacy by gender, from 2004 to 2008, 2013 and 2020 in Spain. Throughout these years, 6,698 people ranging from 17 to 40 years old, participated filling the Brief scale of condom use self-efficacy. According to our findings, despite the slight improvement in the recent years, self-efficacy still maintains a risky profile for safe sex, especially among the youngest people. Moreover, most of the traditional gender differences continue over the years with women reporting lower scores for condom purchase and men for putting them. However, these differences are not relevant in other dimensions such as using condoms despite drug consumption where women reveal worse results over the years. Therefore, our findings reaffirm the need of intensifying gendered preventive efforts aimed at Spanish people and, particularly, among the youngest.
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Hamid NC, Malek KA, Mat-Nasir N, Mohamad M, Nasir NM. Prevalence of Good Condom Usage and Its Association with Condom Use Self-Efficacy among Youth Attending HIV/STDs Clinics in Primary-Care Settings in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912179. [PMID: 36231478 PMCID: PMC9565083 DOI: 10.3390/ijerph191912179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/08/2022] [Accepted: 09/16/2022] [Indexed: 05/30/2023]
Abstract
The low prevalence of condom usage among youth with Human Immunodeficiency Virus/Sexually Transmitted Diseases (HIV/STDs) is a concern. Condom use self-efficacy has been identified as a significant predictor of condom usage. This cross-sectional study examines the prevalence of good condom usage and its association with condom use self-efficacy among Malaysian urban youth, aged between 18 to 24 years old attending HIV/STDs clinics in primary-care settings, Selangor. Utilising the Harmonised Malay version of Condom Use Self-Efficacy Scale (CUSES M-H) questionnaire, the data from 218 responders were analysed using univariate and multiple logistic regression. The prevalence of good condom usage was 61% (95% CI: 54%, 68%). The average mean score of condom use self-efficacy was 3.07. Condom use self-efficacy was divided into four subscales of mechanics, perceived barriers, assertiveness and intoxicants. The assertiveness subscale had the highest average mean score of 3.42, while the intoxicant subscale score had the lowest average mean score of 2.24. Good condom usage was significantly associated with condom use during first sexual intercourse (aOR = 5.81, 95% CI: 1.97, 17.14), duration diagnosis of HIV/STDs of more than 12 months (aOR = 6.40, 95% CI: 2.30, 17.86) and the high assertiveness subscale score (aOR = 1.19, 95% CI: 1.03, 1.36). A behavioural change campaign that targets high-risk youth in primary care settings could promote condom use self-efficacy particularly assertiveness to increase condom usage among the youth.
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Affiliation(s)
- Norbainun Che Hamid
- Department of Primary Care Medicine, Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi MARA (UiTM), Sungai Buloh 47000, Malaysia
| | - Khasnur Abd Malek
- Department of Primary Care Medicine, Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi MARA (UiTM), Sungai Buloh 47000, Malaysia
| | - Nafiza Mat-Nasir
- Department of Primary Care Medicine, Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi MARA (UiTM), Sungai Buloh 47000, Malaysia
| | - Mariam Mohamad
- Department of Public Health Medicine, Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi MARA (UiTM), Sungai Buloh 47000, Malaysia
| | - Nik Munirah Nasir
- Department of Primary Care Medicine, Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi MARA (UiTM), Sungai Buloh 47000, Malaysia
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Lys C, Logie CH, Mackay KI, MacNeill N, Loppie C, Gittings L, Yasseen A. Exploring uptake of HIV/STI knowledge and safer sex-efficacy in an arts-based sexual health workshop among Northern and Indigenous adolescents in the Northwest Territories, Canada. AIDS Care 2022; 35:411-416. [PMID: 35722818 DOI: 10.1080/09540121.2022.2089617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ABSTRACTLimited research has evaluated sexual health promotion projects with adolescents living in Arctic regions. The study objective was to examine changes in STI knowledge and safer sex efficacy among youth in the Northwest Territories (NWT), Canada who participated in arts-based sexual health workshops. We used a pre/post-test design with a convenience sample of students aged 13-18 years recruited from 17 NWT communities. We conducted summary statistics and comparisons between pre and post-test scores using paired t-tests. Among participants (n = 610), we found statistically significant increases in STI knowledge overall (mean difference = 3.9; p < 0.001) and across gender and age stratifications. There were statistically significant increases in safer sex efficacy overall (mean difference = 0.9, p < 0.001), across genders, and among participants: aged <15 years, in rural communities, reporting food insecurity, reporting dating violence, and Indigenous youth. No statistically significant differences in safer sex efficacy were observed among participants who were aged ≥15, sexually active, reporting consistent condom use, and using drugs/alcohol. Findings signal the promise of youth-targeted, arts-based sexual health workshops for improving STI knowledge and safer sex efficacy among adolescents in the NWT. Further research can explore how safer sex efficacy may be shaped by age, substance use, and sexual experience to inform tailored interventions.
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Affiliation(s)
- Candice Lys
- Fostering Open eXpression among Youth (FOXY), 5029 57th Street, Yellowknife, NT, Canada.,Strength, Masculinities, and Sexual Health (SMASH), 5029 57th Street, Yellowknife, NT, Canada.,Aurora College, 5004 54th Street, Yellowknife, NT, Canada
| | - Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St. West, Toronto, ON, Canada.,Women's College Research Institute, Women's College Hospital, 76 Grenville Street, Toronto, ON, Canada.,Centre for Gender & Sexual Health Equity, 1190 Hornby St., Vancouver, V6Z 2K5 BC, Canada.,United Nations University Institute for Water, Environment and Health, 204-175 Longwood Rd S, Hamilton, L8P 0A1 ON, Canada
| | - Kayley Inuksuk Mackay
- Fostering Open eXpression among Youth (FOXY), 5029 57th Street, Yellowknife, NT, Canada.,Strength, Masculinities, and Sexual Health (SMASH), 5029 57th Street, Yellowknife, NT, Canada
| | - Nancy MacNeill
- Fostering Open eXpression among Youth (FOXY), 5029 57th Street, Yellowknife, NT, Canada.,Strength, Masculinities, and Sexual Health (SMASH), 5029 57th Street, Yellowknife, NT, Canada
| | - Charlotte Loppie
- School of Public Health and Social Policy, University of Victoria, 3800 Finnerty Road, Victoria, BC, Canada
| | - Lesley Gittings
- Fostering Open eXpression among Youth (FOXY), 5029 57th Street, Yellowknife, NT, Canada
| | - Abdool Yasseen
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, Canada.,Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, Canada
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Edison B, Coulter RWS, Miller E, Stokes LR, Hill AV. Sexual Communication and Sexual Consent Self-Efficacy Among College Students: Implications for Sexually Transmitted Infection Prevention. J Adolesc Health 2022; 70:282-289. [PMID: 34620545 PMCID: PMC9028224 DOI: 10.1016/j.jadohealth.2021.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE Obtaining affirmative consent, a hallmark of sexual violence prevention education on college campuses, may influence sexual communication and behaviors such as condom use. This study examined the relationship between self-efficacy to obtain sexual consent with sexual health communication and behaviors among a sample of U.S. college students. METHODS Data were from 2,291 students enrolled in a cluster-randomized controlled trial conducted on 28 college campuses from 2015 to 2017. Students reported their self-efficacy to obtain sexual consent, communication about sexual health, and sexual health behaviors. Multivariable logistic regression, adjusted for school clustering, history of violence victimization, and sexually transmitted infection history, estimated odds ratios and 95% confidence intervals (CIs) for sexual consent self-efficacy and sexual health communication. RESULTS Females (n = 1,150) reported higher self-efficacy to obtain consent than males (b1 = .32, 95% CI = .23, .41), but lower odds of communication about condom use (adjusted odds ratio [AOR] = .75, 95% CI = .60, .96) and HIV prevention (AOR = .63, 95% CI = .48, .81). Black and other race students reported higher odds of HIV/sexually transmitted infection prevention communication than white students. Odds of consistent condom use were highest among students reporting condom use communication and high self-efficacy to obtain sexual consent (AOR = 1.99, 95% CI = 1.58, 2.51). CONCLUSIONS Campus sexual assault prevention education that focuses narrowly on obtaining sexual consent may be missing an opportunity to enhance sexual health communication broadly, including condom and contraceptive use discussion to promote overall sexual health.
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Affiliation(s)
- Briana Edison
- Department of Infectious Diseases & Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Division of Adolescent and Young Adult Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
| | - Robert W. S. Coulter
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA USA,Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Lynissa R. Stokes
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - Ashley V. Hill
- Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
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Olamijuwon E, Clifford O, Adjiwanou V. Understanding how young African adults interact with peer-generated sexual health information on Facebook and uncovering strategies for successful organic engagement. BMC Public Health 2021; 21:2153. [PMID: 34819036 PMCID: PMC8611981 DOI: 10.1186/s12889-021-12165-x] [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: 09/05/2020] [Accepted: 11/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background The use of social media for sexual health communication is gaining intense discussion both globally and in Africa. Despite this reality, it remains unclear whether and how young African adults use digital innovations like social media to access sexual health information. More importantly, the unique properties of messages that increase message reach and propagation are not well understood. This study aims to fill the gaps in scholarship by identifying post features and content associated with greater user engagement. Methods We analyzed a corpus of 3533 sexual and reproductive health messages shared on a public Facebook group by and for young African adults between June 1, 2018, and May 31, 2019, to understand better the unique features associated with higher engagement with peer-generated sexual health education. Facebook posts were independently classified into thematic categories such as topic, strategy, and tone of communication. Results The participants generally engaged with posts superficially by liking (x̃ = 54; x̄ = 109.28; σ = 159.24) rather than leaving comments (x̃ = 10; x̄ = 32.03; σ = 62.65) or sharing (x̃ = 3; x̄ = 11.34; σ = 55.12) the wallposts. Messages with fear [IRR:0.75, 95% CI: 0.66–0.86] or guilt [IRR:0.82, 95% CI: 0.72–0.92] appeals received a significantly lower number of reactions compared to neutral messages. Messages requesting an opinion [IRR:4.25, 95% CI: 3.57–5.10] had a significantly higher number of comments compared to status updates. The use of multimedia and storytelling formats were also significantly associated with a higher level of engagement and propagation of sexual health messages on the group. Conclusion Young adults in our sample tend to superficially interact with peer-communicated sexual health information through likes than engage (comments) or propagate such messages. Message features that increase engagements and propagation of messages include multimedia and engaging styles like storytelling. Our findings provide valuable insight and pave the way for the design of effective and context-specific sexual health information use of features that attract young African adults.
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Affiliation(s)
- Emmanuel Olamijuwon
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa. .,Department of Statistics and Demography, School of Social Science, University of Eswatini, Kwaluseni Campus, Kwaluseni, Eswatini. .,Population and Health Research Group, School of Geography and Sustainable Development, University of St Andrews, Fife, UK.
| | - Odimegwu Clifford
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Visseho Adjiwanou
- Department of Sociology, Université du Québec à Montréal, Montreal, Canada
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Rahim NK, Waluyo A, Yona S. The relationship between self-efficacy and spirituality in condom use behaviour among MSM-PLWHA in Bandung, indonesia. J Public Health Res 2021; 10. [PMID: 34060743 PMCID: PMC9309638 DOI: 10.4081/jphr.2021.2339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background The prevalence of HIV/AIDS, especially among Men Who Have Sex With Men (MSM),
is increasing. Disease transmission occurs because of the low use of
condoms. This study aimed to identify the relationship between condom
self-efficacy and spirituality in condom use behavior. Design and Methods This study used a cross-sectional design with consecutive sampling
techniques. It involved 251 people living with HIV & AIDS (PLWH) MSM.
Chi-square test was used in bivariate analysis and then continued with the
logistic regression analysis for multivariate analysis. Results The results show that there was a significant relationship between condom
self-efficacy and condom use behavior with p value <0.05 (OR = 11.298;
95% CI: 4.35-20.1, p value=0.000) and spirituality towards condom use
behavior p-value < 0.05 (OR = 3.405; 95% CI : 0.85-3.21, p value : 0.00).
In multivariate analysis of multiple logistic regression, condom
self-efficacy is the factor that predominantlyinfluences condom use
behaviour. Conclusions To improve the consistency of condom use, nurses need to prioritize
interventions such as counselling activities that focus on increasing
self-confidence (self-efficacy).
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Affiliation(s)
| | - Agung Waluyo
- Department of Medical surgical Nursing Faculty of Nursing, Universitas Indonesia, Depok, West Java.
| | - Sri Yona
- Department of Medical surgical Nursing Faculty of Nursing, Universitas Indonesia, Depok, West Java.
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Zia Y, Mugo N, Ngure K, Odoyo J, Casmir E, Ayiera E, Bukusi E, Heffron R. Psychosocial Experiences of Adolescent Girls and Young Women Subsequent to an Abortion in Sub-saharan Africa and Globally: A Systematic Review. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:638013. [PMID: 36303958 PMCID: PMC9580653 DOI: 10.3389/frph.2021.638013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/22/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction: Unmet need for contraception, unintended pregnancy, and access to safe abortion remain global challenges preventing adolescent girls and young women (AGYW) from achieving optimal reproductive health. Furthermore, AGYW face difficulties navigating sexual autonomy, lack of agency or experience negotiating sexual acts, and challenges accessing sexual health information and services. The aim of this systematic review is to assess the psychosocial outcomes of AGYW who have experienced an abortion with particular focus on sub-Saharan Africa, which bears the global burden of unintended pregnancy and risk of death due to unsafe abortion. Materials and Methods: The systematic review was registered and used search terms to identify peer-reviewed articles relevant to “post-abortion,” “psychosocial,” “adolescent girls,” and “young women” from PubMed, Embase, PsycInfo, and Cumulative Index to Nursing and Allied Health Literature. Examples of psychosocial experiences include quality of life, stigma, and mental health outcomes. Rayyan software (Qatar, 2020) was used by two reviewers to assess the relevance of each article to psychosocial outcomes of AGYW any time after an abortion or accessing post-abortion services. Analysis was conducted with a focus on data from Africa and comparisons are made to non-African settings. Results: A total of 2,406 articles were identified and 38 articles fit the criteria. Six selected articles were from Africa, including Ghana, Kenya, Uganda, and Zambia, and the remaining articles were from other regions. Themes around stigma, shame, and abandonment associated with the experience of abortion were prevalent in all regions. Studies of psychosocial outcomes of AGYW in sub-Saharan Africa highlight social isolation as well as learned resilience among young women who abort. Discussion: Navigating abortion as an AGYW involves managing internalized and perceived stigma, fear of violence, secrecy, and growing resilient in order to overcome the significant barriers that society and culture place on access to an essential service in sexual and reproductive health. Post-abortion psychosocial outcomes highlight the need for support services and investigation of contexts that perpetuate and necessitate unsafe abortion. Empowerment of AGYW may present an important opportunity to build self-agency and positive coping mechanisms to withstand social pressures during stigmatizing circumstances associated with abortion.
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Affiliation(s)
- Yasaman Zia
- Department of Global Health, University of Washington, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Nelly Mugo
- Department of Global Health, University of Washington, Seattle, WA, United States
- Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Kenneth Ngure
- Department of Global Health, University of Washington, Seattle, WA, United States
- Department of Community Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Josephine Odoyo
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Edinah Casmir
- Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Elizabeth Bukusi
- Department of Global Health, University of Washington, Seattle, WA, United States
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, United States
| | - Renee Heffron
- Department of Global Health, University of Washington, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
- *Correspondence: Renee Heffron
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Olamijuwon EO. Characterizing low effort responding among young African adults recruited via Facebook advertising. PLoS One 2021; 16:e0250303. [PMID: 33989304 PMCID: PMC8121367 DOI: 10.1371/journal.pone.0250303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 04/05/2021] [Indexed: 11/19/2022] Open
Abstract
Multiple studies have successfully used Facebook's advertising platform to recruit study participants. However, very limited methodological discussion exists regarding the magnitude of low effort responses from participants recruited via Facebook and African samples. This study describes a quasi-random study that identified and enrolled young adults in Kenya, Nigeria, and South Africa between 22 May and 6 June 2020, based on an advertisement budget of 9,000.00 ZAR (US $521.44). The advertisements attracted over 900,000 views, 11,711 unique clicks, 1190 survey responses, and a total of 978 completed responses from young adults in the three countries during the period. Competition rates on key demographic characteristics ranged from 82% among those who attempted the survey to about 94% among eligible participants. The average cost of the advertisements was 7.56 ZAR (US $0.43) per survey participant, 8.68 ZAR (US $0.50) per eligible response, and 9.20 ZAR (US $0.53) per complete response. The passage rate on the attention checks varied from about 50% on the first question to as high as 76% on the third attention check question. About 59% of the sample passed all the attention checks, while 30% passed none of the attention checks. Results from a truncated Poisson regression model suggest that passage of attention checks was significantly associated with demographically relevant characteristics such as age and sex. Overall, the findings contribute to the growing body of literature describing the strengths and limitations of online sample frames, especially in developing countries.
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Affiliation(s)
- Emmanuel Olawale Olamijuwon
- Faculty of Social Science, Department of Statistics and Demography, University of Eswatini, Kwaluseni, Eswatini
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Gebeyehu NA, Chanko KP, Yesigat YM. Factors Associated with Condom Use Self-Efficacy Among Preparatory School Students in Sodo Town, Southern Ethiopia 2020: A Cross-Sectional Study. HIV AIDS (Auckl) 2020; 12:363-371. [PMID: 32884362 PMCID: PMC7431454 DOI: 10.2147/hiv.s256683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/03/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Condoms are playing a central role in the prevention of sexually transmitted infections, human immune virus, and unintended pregnancy particularly among young peoples. Therefore, this study aimed to assess factors associated with condom use self-efficacy among preparatory school youths in Sodo town, Ethiopia. METHODS This institution-based cross-sectional study was conducted among 424 study participants from January 25 to February 20, 2020. Data were collected using a validated pretested structured questionnaire. Descriptive analysis was done and results were presented in texts and tables. Those variables at bivariate analysis with p-value <0.2 at 95% confidence level were moved to a multivariate logistic regression model to control potential confounding variables. Odds ratio with 95% confidence interval was computed to ascertain association during multivariate analysis model. Statistical tests at P-value <0.05 were considered as cutoff point to determine statistical significance. RESULTS Out of a total of 424 youths, only 416 had participated in the study yielding a response rate of 98.1%. The prevalence of higher self-efficacy among respondents was 70%. Factors that were independently associated with condom use self-efficacy in multivariate analysis were having sexual experience (AOR=2.047,95% CI:1.141-3.675), having life goals (AOR=1.736, 95% CI: 1.021-2.951), having social support (AOR=2.395,95% CI:1.501-5.458), and having good knowledge about condoms (AOR=2.535,95% CI:1.499-4.282). CONCLUSION The finding of this study showed that participants who had sexual experience, social support, knowledge of the human immune virus, and having life goals were found to be significantly associated with condom use self-efficacy. These results suggest ways to increase self-efficacy for condom use among youth that can increase the effectiveness of future interventions for youth.
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Affiliation(s)
- Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kebreab Paulos Chanko
- Department of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Yibeltal Mesfin Yesigat
- Department of Midwifery, College of Health Science and Medicine, Woliktie University, Wolkitie, Ethiopia
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Chabata ST, Hensen B, Chiyaka T, Mushati P, Busza J, Floyd S, Birdthistle I, Hargreaves JR, Cowan FM. Condom use among young women who sell sex in Zimbabwe: a prevention cascade analysis to identify gaps in HIV prevention programming. J Int AIDS Soc 2020; 23 Suppl 3:e25512. [PMID: 32602611 PMCID: PMC7325503 DOI: 10.1002/jia2.25512] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/31/2020] [Accepted: 04/22/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Adolescent girls and young women (AGYW), including those who sell sex in sub-Saharan Africa, are especially vulnerable to HIV. Reaching them with effective prevention is a programmatic priority. The HIV prevention cascade can be used to track intervention coverage, and identify gaps and opportunities for programme strengthening. The aim of this study was to characterise gaps in condom use and identify reasons underlying these gaps among young women who sell sex (YWSS) in Zimbabwe using data from enrolment into an impact evaluation of the DREAMS programme. DREAMS provided a package of biomedical, social and economic interventions to AGYW aged 10 to 24 with the aim of reducing HIV incidence. METHODS In 2017, we recruited YWSS aged 18 to 24 using respondent-driven sampling in six sites across Zimbabwe. We measured knowledge about efficacy of, access to, and effective (consistent) use of condoms with the most recent three sexual partners, separately by whether YWSS self-identified as female sex workers (FSW) or not. Among YWSS without knowledge about efficacy of, not having access to, and not effectively using condoms, we described the potential reasons underlying the gaps in the condom cascade. To identify socio-demographic characteristics associated with effective condom use, we used logistic regression modelling. All analyses were RDS-II weighted and restricted to YWSS testing HIV-negative at enrolment. RESULTS We enrolled 2431 YWSS. Among 1842 (76%) YWSS testing HIV-negative, 66% (n = 1221) self-identified as FSW. 89% of HIV-negative YWSS demonstrated knowledge about efficacy of condoms, 80% reported access to condoms and 58% reported using condoms consistently with the three most recent sexual partners. Knowledge about efficacy of and effective use of condoms was similar regardless of whether or not YWSS self-identified as FSW, but YWSS self-identifying as FSW reported better access to condoms compared to those who did not (87% vs 68%; age- and site-adjusted (adjOR) = 2.69; 95% CI: 2.01 to 3.60; p < 0.001). Women who reported experiencing sexual violence in the past year and common mental disorder in the past week were less likely to use condoms consistently (43% vs. 60%; adjOR = 0.49; 95% CI: 0.35 to 0.68; p < 0.001) and (51% vs. 61%; adjOR = 0.76; 95% CI: 0.60 to 0.97; p = 0.029), respectively. CONCLUSIONS Despite high knowledge about efficacy of and access to condoms, there remain large gaps in self-reported consistent condom use among YWSS. Addressing the structural determinants of YWSS' inconsistent condom use, including violence, could reduce this gap. YWSS who do not self-identify as FSW have less access to condoms and may require additional programmatic intervention.
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Affiliation(s)
- Sungai T Chabata
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) ZimbabweHarareZimbabwe
| | - Bernadette Hensen
- Faculty of Infectious and Tropical DiseasesLondon School of Hygiene and Tropical MedicineLondonUnited Kingdom
| | - Tarisai Chiyaka
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) ZimbabweHarareZimbabwe
| | - Phillis Mushati
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) ZimbabweHarareZimbabwe
| | - Joanna Busza
- Faculty of Public Health and PolicyLondon School of Hygiene and Tropical MedicineLondonUnited Kingdom
| | - Sian Floyd
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUnited Kingdom
| | - Isolde Birdthistle
- Faculty of Epidemiology and Population HealthLondon School of Hygiene and Tropical MedicineLondonUnited Kingdom
| | - James R Hargreaves
- Faculty of Public Health and PolicyLondon School of Hygiene and Tropical MedicineLondonUnited Kingdom
| | - Frances M Cowan
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) ZimbabweHarareZimbabwe
- Faculty of Clinical Sciences and International Public HealthLiverpool School of Tropical MedicineLiverpoolUnited Kingdom
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