opportunities for technology-based hiv prevention among secondary students in cape town, south...
DESCRIPTION
TRANSCRIPT
APHABoston, MA
Monday, November 4, 2013
Opportunities for technology-based HIV prevention among secondary students in Cape Town, South Africa
Michele L. Ybarra MPH PhD, Center for Innovative Public Health Research, San Clemente, CA
Kelvin Mwaba PhD, University of Western Cape, Cape Town, South Africa
Nicolette Roman PhD, University of Western Cape, South Africa
Bronwyn Rooi BA, University of Western Cape, South Africa
Tonya Prescott BA, Center for Innovative Public Health Research. , San Clemente, California
Sheana Bull PhD, University of Colorado, Denver, Colorado, USA
DisclosureThe authors have no conflicts to declare.
AcknowledgementsThe 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 University Western Cape, as well as Dr. Leickness Simbayi, our consultant. We’d also like to thank the schools for their support of the research and the participants for their time taking the survey.
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.
Effective programs exist in South Africa, but they are not having the intended impact.
Programs that are easily scaled up and that address structural and fidelity challenges, are urgently needed.
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
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 acceptability of program delivery across modes.
Image from: http://www.nspreview.org/wp-content/uploads/2013/06/youth.jpg
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.
Survey sample characteristics
Respondents were on average, 17.6 years of age (SD: 1.3, Range: 16-24).
59% percent were female96% 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
Access to technology
Internet
Text messaging
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
15%
1%
81%
81%
4%
8%10%
No Yes Don't Know Decline to answer
Likelihood of accessing an HIV prevention program if it were available via…
School
Relgious organization
Text messaging
Internet
12%
14%
16%
15%
15%
10%
17%
32%
26%
20%
5%
11%
15%
12%
10%
30%
36%
19%
24%
23%
44%
22%
19%
23%
32%
Decline to answer Not at all likely Somewhat unlikely Somewhat likely
Interest by mode and biological sex
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
68%
52%
32%38%
55%
77%
62%
41%
52%56%
MaleFe-male
** p<0.01*** p<0.001
Interest by mode and self-appraised likelihood of getting HIV
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
74%
58%
38%
47%
56%
71%
54%
31%
46%51%
Less than average chance
Interest by mode and self-appraised HIV programming fatigue
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
76%
58%
37%
47%
58%
69%
57%
38%
47%51%
All other
Somewhat/very extremely tired of HIV prevention messages
* p<0.05
LimitationsData 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.
ConclusionsAccess to the Internet and SMS is high
among low income adolescents attending high school in Cape Town.
Internet programs may be more acceptable, and therefore have the potential to reach more youth than SMS.
Given the preference for school-based programming, embedding the intervention within a school setting is recommended.