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  • 1 Darabi L, Bankole A, Serumaga K, et al. Protecting the Next Generation in Uganda: New Evidence on Adolescent Sexual and Reproductive Health Needs. New York, NY: Guttmacher Institute; 2008.
  • 1 The Alan Guttmacher Institute. Adolescents in Uganda: Sexual and reproductive health. 2005:1-4. http://www.guttmacher.org/pubs/rib/2005/03/30/rib2-05.pdf.
  • Biraro S, Shafer LA, Kleinschmidt I, et al. Is sexual risk taking behaviour changing in rural south-west Uganda? Behaviour trends in a rural population cohort 1993-2006UNAIDS. Uganda 2004 Update. Epidemiological Fact Sheets on HIV/AIDS and Sexually Transmitted Infections: UNAIDS; 2005.
  • Do adolescents have access to the Internet?In the absence of interventions, where do they ‘naturally’ look for health information?
  • Respondents were asked when they needed more information about health and disease, how they found it.

Transcript

  • 1. CyberSenga Dissemination Meeting This project was funded by the United States National Institute of Mental Health (Award Number R01MH080662). The project was led by the Center for Innovative Public Health Research (also known as Internet Solutions for Kids); and is a collaboration with colleagues at the Mbarara University of Science and Technology, Internet Solutions for Kids – Uganda, and the University of Colorado The content is solely the responsibility of the researchers and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health. * Thank you for your interest in this presentation. Please note that analyses included herein are preliminary. More recent, finalized analyses may be available by contacting CiPHR for further information.
  • 2. CyberSenga Dissemination Meeting SESSION 1: THE MOTIVATION FOR CYBERSENGA Michele Ybarra MPH PhD Center for Innovative Public Health Research Julius Kiwanuka MD Mbarara University of Science & Technology Tonya Prescott BA Center for Innovative Public Health Research Conducted at the Acacia Hotel, Mbarara, Uganda, May 29, 2012
  • 3. ADOLESCENT SEXUALITY AND HIV RISK IN UGANDA THE MOTIVATION FOR CYBERSENGA
  • 4. Adolescence and sexuality  Adolescence and young adulthood is a time where one becomes sexually active, and Uganda is no exception ◦ One of every two 15-19 year olds have had sex  Early sexual activity is associated with risks: ◦ Unintended pregnancy ◦ Sexually transmitted infections ◦ HIV Darabi L, Bankole A, Serumaga K, et al. Protecting the Next Generation in Uganda: New Evidence on Adolescent Sexual and Reproductive Health Needs. New York, NY: Guttmacher Institute; 2008. The Alan Guttmacher Institute. Adolescents in Uganda. Facts in Brief. New York, NY: Guttmacher Institute; 2006: http://www.guttmacher.org/pubs/2006/07/26/fb_AdolUganda.pdf
  • 5. HIV prevalence among Ugandan adolescents  Policymakers around the world look to Uganda as a role model in the fight against HIV/AIDS because of its success in reducing HIV rates during the late 1980’s and early 1990’s.  HIV prevalence in Uganda peaked at around 15% in 1991 and then fell to 5% in 2001.  Currently, an estimated 4.3% of females and 1.1% of males between the ages of 15 and 24 years are HIV positive in Uganda Government of Uganda. UNGASS Country Progress Report Uganda. 2010; http://data.unaids.org/pub/Report/2010/uganda_2010_country_progress_report_en.pdf The Alan Guttmacher Institute. Adolescents in Uganda: Sexual and reproductive health. 2005; http://www.guttmacher.org/pubs/rib/2005/03/30/rib2-05.pdf. Chaya N, Amen KA. Condoms count: meeting the need in the era of HIV/AIDS. Washington, DC: Population Action International; 2002.
  • 6. The C in the ABC Model The A, B, and C of HIV prevention is widely acknowledged as the influential factor in this reduction – Abstinence, Be Faithful, and Condom Use. We do not know why there is an increase in HIV. Some researchers think this may be because of reduced promotional efforts of the C and increased attention towards the A. Efforts to promote abstinence by talking poorly about condoms may increase the likelihood that people will fail to use condoms when they do have sex, thus putting themselves at unnecessary risk. Blum RW. Uganda AIDS prevention: A, B, C and politics. Journal of Adolescent Health. 2004;34:428-432. Boonstra H. Public health advocates say campaign to disparage condoms threatens STD prevention efforts. The Guttmacher Report on Public Policy. 2003;6(1):1-3. http://www.guttmacher.org/pubs/tgr/06/1/gr060101.html.
  • 7. Conclusion  HIV infection is preventable. Individuals have several prevention strategies to choose from.  We need to help youth make responsible choices.  The effectiveness of one’s choice to prevent HIV depends largely on the individual. Those who practice abstinence as a prevention strategy will find it effective only if they always abstain. Similarly, those who choose any of the other recommended prevention strategies, including condoms, will find them highly effective if used correctly and consistently.
  • 8. Conclusion  Given the increase in HIV transmission, increasing availability of engaging, evidence-based HIV prevention programs targeted to young people in Uganda is needed  Programs need to do a better job of promoting condom use among those that are sexually active; and ongoing abstinence for those who are not sexually active.
  • 9. THE INTERNET AND HIV PREVENTION THE MOTIVATION FOR CYBERSENGA
  • 10. Uganda Media and You Survey  In June-July, 2005, we surveyed: ◦ 500 adolescents (Secondary 1-4) ◦ 5 schools took part  The aim of the survey was to examine whether the Internet was a feasible delivery mechanism
  • 11. Characteristics of youth participants  61% Male  46% between 15-16 years of age  71% thought they would probably or definitely finish secondary school  44% of fathers attended/completed university  29% of mothers attended/completed university
  • 12. Exposure to the Internet (n=500)  88% of youth have been exposed to the Internet  45% of youth (n=223) have used the Internet (ever)  An additional 43% (n=214) knew someone who had gone online
  • 13. Where youth access the Internet (n=223) 82% 57% 17% 11% 10% 20% 30% 40% 50% 60% 70% 80% 90% School Internet café Home Another house
  • 14. Reasons for not using the Internet (n=277) 43% 39% 15% 12% 9% 8% 0% 10% 20% 30% 40% 50% Too expensive Don't know where to access it Don't know how to use it Too slow Don't want to Parental rules
  • 15. Sources of health information (n=500) 81% 56% 50% 38% 75% 45% 56% 20% 79% 59% 51% 35% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Adult Book/library Sibling Computer/Internet Health and disease Sexual health HIV/AIDS
  • 16. Number of different sources by type of information resource (n=500) 19% 9% 4% 10% 28% 26% 24% 22% 36% 44% 47% 31% 16% 22% 25% 37% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 1 source 2 sources 3 sources 4 sources *13 youth indicated they did not use any of the 4 sources for HIV/AIDS information
  • 17. Profile of computer/Internet health information seekers (n=223) Youth characteristics aOR P- value Going online in the past week 2.4 0.04 Accessing the Internet at school 0.2 0.002 Online activities Visiting chat rooms 3.8 <.001 Emailing 2.5 0.03 Playing games 2.8 0.002
  • 18. Conclusion  The Internet is a familiar technology: ◦ Most (4 in 5) have used or know someone who has used the Internet.  Among Internet users, school is the most frequently cited log in location.  One in three youth (35%) have used the Internet or computer to access information about HIV/AIDS.
  • 19. Conclusion  Internet health information seekers are likely to use multiple sources for health information.  Adults are the most common source of health information for adolescents.  Computers and the Internet appear to be enhancing rather than replacing other sources of HIV and other health-related
  • 20. Acknowledgements  We would like to thank the entire CyberSenga Study team from Center for Innovative Public Health Research, Internet Solutions for Kids – Uganda, Mbarara University of Science and Technology, the University of Colorado, and Harvard University, who contributed to the planning and implementation of the study. Finally, we thank the schools and the students their time and willingness to participate in this study.