This edition of InfoNet is published on behalf of the Interagency Youth Working Group (IYWG).
To subscribe to Youth InfoNet (and other electronic notices of youth publications and information), or to propose submissions to this newsletter, please send us an email.
For copies of the program resources, please use the contact information supplied with each item.
How to Request Full-Text Copies of Research Articles:
Developing-country users can request full-text copies of most of the research articles listed in each issue of Youth InfoNet. To request a copy of a research article, click on the article title. You will be redirected to the database on the IYWG Web site, where you can add the research article to your Request Basket. To complete your request, click on View Basket at the top right of any page on the IYWG web site [more help on requesting documents].
I. PROGRAM RESOURCES
1. Adolescent Reproductive Health Resources for Egypt
2. Asia-Pacific Operational Framework for Linking HIV/STI Services with Reproductive, Adolescent, Maternal, Newborn and Child Health Services
3. Children and AIDS: Second Stocktaking Report. Actions and Progress
4. Commitment to Practice: A Playbook for Practitioners in HIV, Youth and Sport
5. Education and HIV Advocacy Briefing Notes
6. Family Life Education: A Handbook for Adults Working with Youth from a Christian Perspective
7. HPV Vaccine Adoption in Developing Countries: Cost and Financing Issues
8. Improving the Education Response to HIV and AIDS
9. Involving Young People in Efforts to Combat HIV and AIDS in Africa: The Importance of Income-Generating Strategies
10. Our Future: Teaching Sexuality and Life-skills. A Guide for Teachers Using 'Our Future' Pupils' Books
11. PLACE in Zimbabwe: Identifying Gaps in HIV Prevention among Orphans and Young People in Hwange District, 2006
12. School-centred HIV and AIDS Care and Support in Southern Africa: Technical Consultation Report
13. Sexual Behavior and STI/HIV Status among Adolescents in Rural Malawi: An Evaluation of the Effect of Interview Mode on Reporting
14. Tell Me More: Children's Rights and Sexuality in the Context of HIV/AIDS in Africa
15. UNHCR Handbook for the Protection of Women and Girls
16. Young Men and HIV Prevention: A Toolkit for Action
II. RESEARCH SUMMARIES
1. Consistent condom use in South African youth's most recent sexual relationships
2. Cultural adaptation of the Focus on Kids program for college students in China
3. Effects of stigma on the mental health of adolescents orphaned by AIDS
4. Factors predisposing out-of-school youths to HIV/AIDS-related risky sexual behaviour in northwest Ethiopia
5. Health information seeking among Mbararan adolescents: results from the Uganda Media and You survey
6. Knowledge, attitudes to HIV/AIDS and sexual behaviour of students in a tertiary institution in south-western Nigeria
7. Knowledge of and perceptions about sexually transmitted diseases and pregnancy: a qualitative study among adolescent students in Uganda
8. Long-term effectiveness of highly active antiretroviral therapy on the survival of children and adolescents with HIV infection: a 10-year follow-up study
9. Personal involvement of young people in HIV prevention campaign messages: the role of message format, culture, and gender
10. The role of context: neighbourhood characteristics strongly influence HIV risk in young women in Ndola, Zambia
11. Sexually transmitted infections and sexual and substance use correlates among young adults in Chiang Mai, Thailand
*****************************************************
I. PROGRAM RESOURCES
1. Adolescent Reproductive Health Resources for Egypt (2007 and 2008)
FHI has produced a series of publications, some in Arabic, for providers working at youth-friendly health clinics. All the materials are culturally appropriate for use in the Middle East and North Africa. Included in the series are a VCT manual, a provider training manual about family planning and reproductive health, a peer training manual, a monitoring and evaluation guide, and qualitative and quantitative assessments of youth-friendly clinics.
Organization: FHI with UNFPA
Contact: publications@fhi.org
2. Asia-Pacific Operational Framework for Linking HIV/STI Services with Reproductive, Adolescent, Maternal, Newborn and Child Health Services (2008, PDF, 46 pages, 1.67 MB)
Distinct interventions are needed to improve reproductive health; adolescent reproductive health; and maternal, neonatal, and child health; and to prevent and manage HIV and other sexually transmitted infections. However, common underlying causes and shared solutions provide the basis for linkages that can strengthen all services and increase the reach of HIV prevention and testing. This operational framework provides information about how to create these linkages and what factors to take into account when doing so.
Organization: WHO Regional Office for the Western Pacific
Contact: publications@wpro.who.int
3. Children and AIDS: Second Stocktaking Report. Actions and Progress (2008, PDF, 52 pages, 2.15 MB)
This document reports on the progress that has been made in combating the spread of HIV/AIDS since UNICEF launched the Unite for Children, Unite against AIDS campaign in October 2005. In particular, it focuses on the campaign's "Four Ps": (1) preventing mother-to-child transmission of HIV, (2) providing pediatric treatment, (3) preventing infection among adolescents and young people, and (4) protecting and supporting children affected by HIV and AIDS.
Organization: The United Nations Children's Fund (UNICEF), UNAIDS and WHO
Contact: pubdoc@unicef.org
4. Commitment to Practice: A Playbook for Practitioners in HIV, Youth and Sport (2008, PDF, 34 pages, 2.96 MB)
Within the HIV/AIDS sector, there is growing recognition that sport-for-development (SfD) approaches can achieve significant HIV prevention goals. This paper encourages practitioners to develop "plus sport" programs that have non-sport, HIV/AIDS-related outcomes as their primary objectives. Examples are provided from programs in Liberia and Southern Sudan.
Organization: Mercy Corps
Contact: http://www.mercycorps.org/contact.php
5. Education and HIV Advocacy Briefing Notes (2008)
These documents, developed by the UNAIDS Inter-Agency Task Team (IATT) on Education, aim to help education professionals advocate for issues related to the education sector's responses to HIV.
Organization: UNAIDS IATT
Contact: info-iatt@unesco.org
6. Family Life Education: A Handbook for Adults Working with Youth from a Christian Perspective (2008, PDF, 41 pages, 1.52 MB)
This handbook is designed to help adults talk to youth about sexuality, reproductive health, and HIV in the context of faith communities. It provides accurate public health information on sensitive issues in the context of faith values and does not promote religion. This handbook was adapted from a 188-page training manual that includes six day-long workshops.
Organization: FHI/Interagency Youth Working Group
Contact: youthwg@fhi.org
7. HPV Vaccine Adoption in Developing Countries: Cost and Financing Issues (2007, PDF, 40 pages, 372 KB)
This paper analyzes the cost, cost-effectiveness, and affordability of the new human papillomavirus (HPV) vaccines as well as financing options. These are critical issues that developing-country policy-makers, manufacturers, and international donors will have to address in the next few years if the vaccine is to be made widely available to adolescent girls and women.
Organization: IAVI, PATH
Contact: pubs@iavi.org
8. Improving the Education Response to HIV and AIDS (2008, PDF, 77 pages, 792 KB)
This report synthesizes case study exercises undertaken to examine the quality, effectiveness, and coordination of the education sector's response to the HIV epidemic in Jamaica, Kenya, Thailand, and Zambia. Stakeholders assessed critical achievements and gaps in the education sector's response to HIV and AIDS; the evolution and effectiveness of coordination mechanisms and structures; information sharing on HIV and AIDS and education; key resources for the response; and monitoring and evaluation.
Organization: UNAIDS Inter-Agency Task team on Education
Contact: info-iatt@unesco.org
9. Involving Young People in Efforts to Combat HIV and AIDS in Africa: The Importance of Income-Generating Strategies (2007, PDF, 58 pages, 939 KB)
This paper examines the importance of strategies that support young people in gaining important skills and earning income to reduce their own poverty as one way of combating HIV/AIDS. The strategies also help foster a sense of hope and purpose in young people as they contribute to addressing this social problem.
Organization: Education Development Center
Contact: info@hhd.org
10. Our Future: Teaching Sexuality and Life-skills. A Guide for Teachers Using Our Future Pupils' Books (2008, PDF, 84 pages, 1 MB)
This guide equips teachers and others with the knowledge, attitudes, and skills needed to plan and lead effective lessons on sexuality and life-skills. It encourages teachers to take some responsibility for their learners' sexual and reproductive wellbeing and to create caring schools that promote health within their communities.
Organization: International HIV/AIDS Alliance
Contact: mail@aidsalliance.org
11. PLACE in Zimbabwe: Identifying Gaps in HIV Prevention among Orphans and Young People in Hwange District, 2006 (2008, PDF, 152 pages, 1.98 MB)
The Priorities for Local AIDS Control Efforts (PLACE) method is a tool used to identify areas where HIV transmission is most likely to occur, and, within these areas, to identify gaps in prevention programs. In Zimbabwe, the PLACE method was used to understand what factors are putting adolescent girls (orphans and non-orphans) and young women 18-24 years of age at risk of acquiring HIV. Programmatic recommendations are offered.
Organization: MEASURE Evaluation
Contact: leah.gordon@unc.edu
12. School-centred HIV and AIDS Care and Support in Southern Africa: Technical Consultation Report (2008, PDF, 42 pages, 2.63 MB)
This report provides a synthesis of discussions held at a UNESCO technical consultation on school-centered care and support held in May 2007 in Gaborone, Botswana.
Organization: UNESCO
Contact: aids@unesco.org
13. Sexual Behavior and STI/HIV Status among Adolescents in Rural Malawi: An Evaluation of the Effect of Interview Mode on Reporting (2008, PDF, 34 pages, 750 KB)
This paper summarizes the results from an experiment conducted with unmarried young women aged 15-21 in rural southern Malawi, during which respondents were randomly assigned to either an audio computer-assisted self-interview or a conventional face-to-face interview. In addition, biomarkers were collected for HIV and three STIs: gonorrhea, chlamydia, and trichomoniasis. Before collecting the biomarkers, nurses conducted a brief face-to-face interview with participants in which they repeated questions about sexual behavior asked earlier.
Organization: Population Council
Contact: publications@popcouncil.org
14. Tell Me More: Children's Rights and Sexuality in the Context of HIV/AIDS in Africa (2008, PDF, 64 pages, 601 KB)
This report presents children's views on how they can prevent becoming infected with HIV. Save the Children and the Swedish Association for Sexuality conducted a literature review and analysis of studies with children (7-18 years old) within the last ten years in nine countries in Sub-Saharan Africa in order to collect information about what children think about HIV/AIDS, sexuality education, and health services and how to improve them to better cater to children.
Organization: Save the Children Sweden and the Swedish Association for Sexuality (RFSU)
Contact: info@rb.se
15. UNHCR Handbook for the Protection of Women and Girls (2008; the document can be downloaded by chapter, or whole [PDF, 4.71 MB])
This handbook describes some of the protection challenges faced by women and girls of concern to the Office of the United Nations High Commissioner for Refugees (UNHCR) and outlines various strategies to tackle these challenges.
Organization: UNHCR Division of International Protection Services (DIPS)
Contact: http://www.unhcr.org/cgi-bin/texis/vtx/contact?hq=y
16. Young Men and HIV Prevention: A Toolkit for Action (2008, PDF, 150 pages, 6.4 MB)
This toolkit serves to reinforce the benefits of working with young men and provides conceptual and practical information on how to design, implement, and evaluate HIV/AIDS prevention activities that incorporate a gender perspective and engage young men and relevant stakeholders. The toolkit can be downloaded in English, Portuguese, and Spanish.
Organization: Promundo and UNFPA
Contact: promundo@promundo.org.br
II. RESEARCH SUMMARIES
1. Consistent condom use in South African youth's most recent sexual relationships. Moyo W, Levandowski BA, Macphail C, et al. AIDS Behav 2008;12(3):431-40.
The authors examined correlates of consistent condom use with most recent sex partners among a nationally representative sample of youth 15-24 years old who reported having had sex in the previous 12 months (n = 6,649). Among men and women, having talked to a partner about using condoms was the most significant predictor of consistent condom use. However, youth who reported being in their most recent relationship for more than one year and who reported having had sex one or more times in the last month were more likely to report inconsistent condom use. HIV interventions should empower youth to talk about using condoms with their partners, encourage periodic testing for HIV, and reinforce condom use according to HIV status in long-term relationships.
2. Cultural adaptation of the Focus on Kids program for college students in China. Li X, Stanton B, Wang B, et al. AIDS Educ Prev 2008;20(1):1-14.
This pilot study was designed to evaluate the efficacy of cultural adaptation of an HIV risk-reduction program based on social cognitive theory and delivered among college students in China. Three hundred eighty students from four universities in Nanjing, China, were assigned by classroom to either an intervention group receiving the culturally adapted HIV risk-reduction curriculum or a control group. Data were collected at baseline and 6 months postintervention. Outcome measures included HIV-related knowledge and perceptions, intention of risk behaviors, and self-reported risk behaviors. Participation in the intervention was significantly associated with increased HIV-related knowledge (including knowledge of condom use) and protective perceptions (e.g., self-efficacy), and associated with decreased intention of engaging in sexual intercourse in the next 6 months. There was no intervention effect on sexual behaviors because of the relatively low rates of sexual activities. The results suggest that an HIV risk-reduction program based on social cognitive theory can be effective in changing HIV-related perceptions and intentions among young adults in China.
3. Effects of stigma on the mental health of adolescents orphaned by AIDS. Cluver LD, Gardner F, Operario D. J Adolesc Health 2008;42(4):410-7.
The authors assessed the associations of four risk factors that can potentially be addressed at a community level (bullying, stigma, community violence, and lack of positive activities) with psychological problems and orphanhood status. One thousand twenty-five participants aged 10-19 were recruited from deprived urban settlements in South Africa. The sample included adolescents orphaned by AIDS (n = 425), adolescents orphaned by non-AIDS causes (n = 241), and non-orphaned adolescents (n = 278). Participants were interviewed using standardized psychological measures of depression, anxiety, posttraumatic stress, peer problems, delinquency, and conduct problems. Information on risk factors and demographic characteristics were also assessed. AIDS-orphaned adolescents reported higher levels of stigma and fewer positive activities than other groups. There were no reported differences on bullying or community violence. All community-level risk factors were associated with poorer psychological outcomes. Multivariate analyses controlling for age and gender showed that experience of stigma significantly mediated associations between AIDS orphanhood and poor psychological outcomes. Reduction of AIDS-related stigma could potentially reduce adverse psychological outcomes among AIDS-orphaned adolescents.
4. Factors predisposing out-of-school youths to HIV/AIDS-related risky sexual behaviour in northwest Ethiopia. Alemu H, Mariam DH, Belay KA, et al. J Health Popul Nutr 2007;25(3):344-50.
This paper presents results of a cross-sectional descriptive study conducted in Bahir Dar town, northwest Ethiopia, to assess factors that predispose out-of-school youths to HIV/AIDS-related risk behaviors. For quantitative data collection, a household interview survey was conducted among 628 out-of-school youths, aged 15-24 years, within the 17 kebeles (villages) of the town. Qualitative data were collected by conducting five focus-group discussions with 46 participants and in-depth interviews with 10 participants. Of the 628 study subjects, 64.8% had experienced sexual intercourse at the time of the survey. The mean age at first sex was 17.7 years. Of those who were sexually active, 33% had sexual intercourse with non-regular partners. Of these, 40.6% were male and 24.7% were female, suggesting that males tended to be about two times more likely to have sex with non-regular sexual partners than females (odds ratio = 1.78, with 95% confidence interval 1.16-2.73). Furthermore, consistent condom use among those who had sex in exchange for money was low (36%). Alcohol intake, chewing of khat (a green leaf), low educational background, and being male were significantly associated with having sex with either a commercial or a non-regular sexual partner. The authors conclude that efforts need to be made to address the identified predisposing factors as well as the problems of idleness, lack of jobs, and hopelessness.
5. Health information seeking among Mbararan adolescents: results from the Uganda Media and You survey. Ybarra ML, Emenyonu N, Nansera D, et al. Health Educ Res 2008;23(2): 249-58.
To improve the efficiency and impact of disease prevention and health promotion efforts in resource-limited settings, the authors examine sources of health information cited by adolescents in Mbarara, Uganda. Participants in the Uganda Media and You survey were students aged 12-18 (n = 500) randomly identified in five secondary schools. Ninety-three percent of eligible and invited youth completed the cross-sectional survey. Four in five adolescents (81%) indicated they turned to parents, teachers, and other adults, whereas around half read a book/went to the library (56%) or turned to siblings and friends (50%) for information about health and disease. More than one in three (38%) indicated that they used the computer and Internet to search for health information. Older respondents tended to rely upon siblings and friends for all types of health questions. On the other hand, younger youth were significantly more likely to turn to parents, teachers, and other adults for their questions about sexual health. Adults may be an important component of effective disease prevention and health promotion campaigns. Multiple delivery methods may be especially effective for reaching older adolescents. Technology also may be an important health promotion tool in resource-limited settings.
6. Knowledge, attitudes to HIV/AIDS and sexual behaviour of students in a tertiary institution in south-western Nigeria. Odu OO, Asekun-Olarinmoye EO, Bamidele JO, et al. Eur J Contracept Reprod Health Care 2008;13(1):90-6.
The authors conducted a descriptive cross-sectional survey between January and March 2005. Information was collected from 368 students in Ede, Osun State, Nigeria. Participants were selected by a multi-stage sampling method and data obtained using a semi-structured pre-tested questionnaire. Most (89.4%) respondents were aware of the existence of HIV/AIDS, and knew the etiology, routes of transmission, signs and symptoms, and preventive measures against the disease. While a little over half (59.8%) of the respondents revealed that they could hug people with HIV/AIDS, one out of four (27.2%) stated that these persons should be isolated from the community. Less than a quarter (22.3%) of the respondents believed that they were vulnerable to HIV/AIDS. More than half (58.2%) had ever had sex; the mean age at their first sexual exposure (for all respondents) was 16.7 plus or minus 4.4 years. Almost half (48.2%) of the 191 currently sexually active respondents had multiple sexual partners. Of the sexually active respondents, 75.9% claimed to have ever used condoms; among these, male respondents were more likely to have ever used condoms than their female counterparts (p < 0.05). The study revealed a gap in the knowledge of HIV/AIDS and an inappropriate sexual behavior among respondents.
7. Knowledge of and perceptions about sexually transmitted diseases and pregnancy: a qualitative study among adolescent students in Uganda. Chacko S, Kipp W, Laing Let al. Health Popul Nutr 2007;25(3):319-27.
The authors conducted eight focus-group discussions with 38 female and 32 male secondary students from four different schools to learn about their knowledge of and perceptions about HIV/AIDS and pregnancy and how both relate to one another. Widespread misinformation and misconceptions about contraceptives exist. There was a serious gap in knowledge and understanding of dual protection against sexually transmitted infections, including HIV/AIDS, and against pregnancy. Fertility was very highly valued, and many girls stated that they would want a child even if they were HIV-positive. Responses of girls showed that they were quite assertive in making decisions to use contraceptives. The reasons for students not being able to understand the interconnectedness of sexually transmitted infections and pregnancy may lie in the fragmented fashion in which relevant health education is delivered through two separate programs.
8. Long-term effectiveness of highly active antiretroviral therapy on the survival of children and adolescents with HIV infection: a 10-year follow-up study. Patel K, Hernan MA, Williams PL, et al. Clin Infect Dis 2008;46(4):507-15.
Previous observational studies found highly active antiretroviral therapy (HAART) to be associated with improved survival among HIV-infected children and adolescents. However, these studies had limited follow-up of HIV-infected children undergoing HAART. Given that HIV infection is chronic and that exposure to HAART is likely to be life-long, there is a need to evaluate the long-term effect of HAART on survival in this population. The study included 1,236 children and adolescents who were perinatally infected with HIV, who were on study or enrolled after January 1996 in a United States-based multicenter prospective cohort study (Pediatric AIDS Clinical Trials Group 219/219C), and who were not receiving HAART at baseline; subjects were observed for a maximum of 10 years through June 2006. A weighted Cox regression model was used to estimate the effect of HAART on survival, appropriately adjusted for time-varying confounding by severity. At the end of the 10-year follow-up period (median duration of follow-up, 6.3 years; interquartile range, 4.3-9.8 years), 70% of participants had initiated HAART. Lower CD4 cell percentages, total lymphocyte counts, and albumin levels were associated with an increased probability of initiating HAART. Eighty-five deaths were observed, and the mortality hazard ratio associated with HAART, compared with non-HAART regimens, was 0.24 after adjusting for measured confounding by severity (95% confidence interval, 0.11-0.51). The use of HAART was highly effective in reducing mortality during the period 1996-2006 among children and adolescents infected with HIV. With improved long-term survival, continued follow-up is necessary to evaluate the effects of prolonged use of HAART on potential adverse events, immune function, growth, sexual maturation, and quality of life in this population.
9. Personal involvement of young people in HIV prevention campaign messages: the role of message format, culture, and gender. Geary CW, Burke HM, Johnson L, et al. Health Educ Behav 2008;35(2):190-206.
To examine young people's reactions to and understanding of HIV prevention messages developed for MTV's global HIV-prevention campaign, "Staying Alive," videotaped campaign materials were shown to focus group discussion (FGD) participants living in urban areas of Brazil, Kenya, Nepal, and Senegal. Responses related to "personal involvement" with the message were identified in the data from these FGDs and were examined in relationship to the emerging message themes, the message format (public service announcement [PSA] vs. documentary), cultural context (site), and participant gender. Across groups, greater personal involvement (measured by personal connections, emotional reactions, and lessons learned) was found in responses about the documentary format compared to the PSA format. Exceptions were found for specific PSAs that were considered more relevant within specific gender or cultural contexts. Implications of findings for global campaigns were considered.
10. The role of context: neighbourhood characteristics strongly influence HIV risk in young women in Ndola, Zambia. Gabrysch S, Edwards T, Glynn JR. Trop Med Int Health 2008;13(2):162-70.
The authors re-analyzed a cross-sectional, population-based sero-survey conducted in 1997/1998 to examine the effect of neighborhood socioeconomic factors on HIV prevalence in young women (aged 15-24 years) in Ndola, Zambia. Neighborhood-level socioeconomic status (SES) was defined using the availability of running water and electricity in addition to educational, employment, and occupational characteristics of adults older than 24 years. Neighborhood-level and individual-level risk factors were analyzed with a multivariate, multilevel logistic regression model using a hierarchical conceptual framework. Young women living in neighborhoods of lower or middle SES had higher HIV prevalence than those from higher SES neighborhoods [lower SES: adjusted odds ratio (OR) 2.4, 95% confidence interval (CI) 1.3-4.5, middle SES: adjusted OR 2.4, 95% CI 1.3-4.7]. Young women living near a market were at increased risk of HIV infection (OR 2.9, 95% CI 1.4-5.9), while proximity to a health center seemed protective (OR 0.4, 95% CI 0.2-1.0). When controlling for neighborhood factors, better education was a risk factor for HIV infection (OR 1.5, 95% CI 1.0-2.1), although it was not significant in individual-level analysis. Community-level factors are as important as individual-level factors in determining HIV infection in young women. Confining analyses to individual-level factors ignores the underlying causes and the modifying effect of context on individual behavior and may even lead to different conclusions about the role of individual-level factors.
11. Sexually transmitted infections and sexual and substance use correlates among young adults in Chiang Mai, Thailand. Celentano DD, Sirirojn B, Sutcliffe CG, et al. Sex Transm Dis 2008;35(4):400-5.
The authors conducted a cross-sectional study in Chiang Mai, Thailand in 2005-2006 among 658 sexually active participants aged 18 to 25 years, the majority of whom had history of recent methamphetamine (MA) use. Data were collected by interview, and STIs were detected using standard laboratory assays. Overall, 38% of participants had at least one STI. Herpes simplex virus and chlamydia were significantly more common among women, whereas hepatitis B virus was significantly more common among men. Men reported a greater number of sexual partners than women, and condom use at last sex was infrequent. Most participants reported using MA at least weekly, with men more frequent users than women and more often reporting frequent drunkenness and arrests. In multivariate analysis, women > 20 years of age, with > 2 heterosexual partners in the past year and a younger age at sexual debut were significantly more likely to have a prevalent STI. Men > 20 years of age, with > 2 heterosexual partners in the past year and who enrolled both sex and drug network members were significantly more likely to have a prevalent STI, whereas men who used a condom at last sex were significantly less likely to have a prevalent STI. Substance abuse was associated with behavioral risks but not with prevalent STI. The authors conclude that sexual risks and substance abuse are substantially elevated among young Thai MA users, but only sexual risks are associated with prevalent STI.
