Exposure to and interest in HIV prevention education among adolescents in Cape Town, South Africa
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Exposure to and interest in HIV prevention education among adolescents in Cape Town, South Africa Presentation Transcript

  • 1. 11th International AIDS Impact Conference Barcelona, Spain Tuesday, October 1, 2013 Exposure to and interest in HIV prevention education among adolescents in Cape Town, South Africa Michele L. Ybarra MPH PhD, Center for Innovative Public Health Research, San Clemente, California, USA Kelvin Mwaba PhD, University of Western Cape, Cape Town, South Africa * 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. Acknowledgements The project described was supported by Grant Number R03MH094238 from the National Institute of Mental Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health. We would like to thank our collaborators at CiPHR and UWC, as well as our consultants: Drs. Sheana Bull and Leickness Simbayi. We’d also like to thank the schools for their support of the research and the participants for their time taking the survey.
  • 3. Study motivation  Estimates suggest that if the current HIV infection rates remain stable in South Africa, 50% of 15-year-olds alive today will die from AIDS.  The need to develop effective, scalable HIV programs for South African adolescents cannot be overstated. Joint United Nations Programme On HIV/AIDS (UNAIDS) (2000). AIDS epidemic update: December 2000. Geneva: Joint United Nations Programme on HIV/AIDS (UNAIDS) and World Health Organization (WHO). Available on the world wide web at: http://www.unaids.org/en/media/unaids/contentassets/dataimport/publications/irc- pub05/aidsepidemicreport2000_en.pdf
  • 4. Study motivation  Programs are only as impactful as they are interesting and engaging to youth, however.  Needs assessments are critical in this regard so that researchers can understand the type of information youth are currently receiving and the kinds of topics that they would find compelling. Image from: http://www.nspreview.org/wp- content/uploads/2013/06/youth.jpg
  • 5. Cape Town Adolescent Health Survey  In 2012, 1,107 10th – 11th graders completed a paper-and-pencil survey.  Respondents were enrolled in one of three public high schools located in predominantly black, lower income neighborhoods in Cape Town.  Youth answered questions about experiences and exposures related to sex and HIV; and about opportunities for HIV prevention programming that might be particularly salient and interesting for youth.
  • 6. Survey sample characteristics  Respondents were on average, 17.6 years of age (SD: 1.3, Range: 16-24).  59% percent were female  96% were Black.  44% percent of respondents’ fathers had completed secondary school or less (equivalent to a high school education in the U.S.). Image from: http://conceptovihsida.blogspot.com.es/p/metodos-de- prevencion-y-enalces.html
  • 7. Sexual behavior and HIV testing among high school students in low income Cape Town schools 51% 15% 62% 49% 85% 11% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Vaginal sex (ever) Anal sex (ever) HIV testing Yes No
  • 8. Frequency of condom use among youth who have ever had sex 23% 31% 46% Never Sometimes Always
  • 9. My parents have talked to me about.. 54% 63% 60% 59% 59% 64% 57% 40% 31% 11% 34% 34% 30% 37% 6% 7% 7% 7% 7% 6% 7% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Sex How pregnancy happens Contraception / pregnancy… Abstinence STIs How to prevent HIV Puberty Yes No Don't know
  • 10. At school, I have learned about.. 74% 75% 75% 76% 77% 77% 70% 20% 18% 11% 17% 16% 16% 22% 6% 7% 7% 7% 7% 7% 7% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Sex How pregnancy happens Contraception / pregnancy… Abstinence STIs How to prevent HIV Puberty Yes No Don't know
  • 11. I am tired of hearing about how to prevent HIV/AIDS 5% 47% 12% 15% 21% Don't know Strongly disagree Somewhat disagree Strongly agree Somewhat agree
  • 12. I would be interested in learning about… 40% 29% 20% 36% 39% 21% 40% 15% 53% 63% 11% 56% 52% 71% 52% 77% 8% 8% 8% 8% 8% 8% 8% 8% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% How to use condoms Contraception Where to get an HIV test How drugs and alcohol… How to avoid sex How to refuse sex from a… How to end a relationship How to start a relationship Yes No Don't know
  • 13. Additional indicators  Most youth reported their parents had talked to them about pregnancy (60%) and HIV (64%) prevention.  School also was a common source for both topics (77% and 76%, respectively).  Perhaps accordingly, one in three youth (36%) somewhat or strongly agreed that they were tired of hearing  Few expressed interest in learning: how to use a condom (40%), about birth control (29%), and how to ‘refuse sex’ (40%). ◦ Even topics posited to be of interest to adolescents (e.g., how to develop a relationship; how to break up with someone) were endorsed by less than half of youth.
  • 14. Limitations  Data are from three purposefully selected high schools in Cape Town, South Africa. The generalizability of these data to greater South Africa, and youth not enrolled in high school is unknown.  Given the sensitivity of the topic and the stigma related to both HIV/AIDS and sexual behavior among adolescents in South Africa, it is possible that some youth did not answer honestly.
  • 15. Conclusions  It is not uncommon for youth to be tired of hearing messages about HIV prevention and many of the typical topics key to HIV prevention have low interest levels among youth.  At the same time, the current study suggests reasons for optimism: ◦ HIV testing is common, ◦ A high percentage of sexually active youth report consistent condom use, and ◦ Many parents and schools are talking to children about how to keep themselves safe.
  • 16. Conclusions  HIV prevention researchers need to be mindful of the extent of existing programming that youth are exposed to – even if it is not accurate, the messages can begin to sound like ‘yet another talk about HIV’.  It is absolutely critical that evidence-based programs be engaging and interactive so that young people can hear even the same messages in a new way.
  • 17. Thank you Michele@InnovativePublicHealth.org http://utgaap.info/tag/gaap-2