DB Click: HIV/AIDS, Young People, Research - February 2012

Below, to inform your work, are summaries of research and action that are based on research results relating to young people and HIV/AIDS. The focus is on very recent research, particularly, though not exclusively, work freely available in full-text format from professional journals and pertinent historical work done between 2009 and 2012.

NEW: The following links are from The CI's HIV/AIDS, Young People, Research Theme Site done in partnership with the Inter-Agency Task Team on HIV Prevention and Young People (IATT-YP). They are organised in research categories according to three priorities: Epidemiology, Services, and Structural Prevention.

EPIDEMIOLOGY
Including: young women and girls, young people who inject drugs, young men who have sex with men, and young people involved in sex work.

1.     Community-based Prevention Leads to an Increase in Condom Use and a Reduction in Sexually Transmitted Infections (STIs) among Men Who Have Sex with Men (MSM) and Female Sex Workers (FSW)
This article explores the International HIV/AIDS Alliance's Frontiers Prevention Project (FPP) in India, which was a community-based HIV prevention initiative designed to reduce risk-taking behaviours and sexually transmitted infection (STI) incidence, thereby resulting in a lower HIV incidence. It was geared towards female sex workers (FSW), men who have sex with men, injection drug users, and people with HIV, providing STI services, behaviour change communication, condom programmes, community mobilisation, and enabling and structural interventions. In addition, there was an emphasis on social capital building, network and support formation, empowerment, violence reduction, referrals for HIV testing, and basic AIDS care services. Among FSW, the FPP intervention was significantly correlated with increased condom use with regular partners and with lower probability of STI sero-positivity...

2.      Delaying Marriage for Girls in India: A Formative Research to Design Interventions for Changing Norms
This report examines the social norms surrounding child marriage, positive role models, community engagement, and government-led efforts to prevent the practice in the Indian states of Rajasthan and Bihar. The report makes recommendations toward the development of an integrated intervention strategy to delay marriage for girls by enhancing girls' access to education, empowerment, community mobilisation, partnership with media, and strengthening of law enforcement. "A key element of an effective communications and awareness generation strategy should be showcasing positive role models to highlight the reasons why they do not support early marriage, including the benefits they perceive from delaying marriage. In addition, educating, protecting and empowering young girls through life skills classes is an already proven strategy for effectively delaying the age of marriage, as demonstrated in previous studies..."

3.     Talking the Talk, Walking the Walk: Social Network Norms, Communication Patterns, and Condom Use among the Male Partners of Female Sex Workers in La Romana, Dominican Republic
The purpose of this study was to explore the relationship between social network norms and condom use among male partners of female sex workers in La Romana, Dominican Republic. The study sought to understand how the dynamics of social influence processes among men may abet or impede sexual risk reduction practices in order to develop more effective HIV prevention interventions. Results showed that men reported small, dense networks with high levels of communication about condoms and consistent condom use...

4.      Empowering Men Who Have Sex with Men to Live Healthy Lives in Colombia
This case study explores one effort to reach out to and include members of the lesbian, gay, bisexual, and transgender (LGBT) community in Colombia, who are often marginalised due to "pervasive stigma and discrimination". The case study examines the Lesbian, Gay, Bisexual, and Transgender Community Center's efforts to provide a social and educational base for its clients while also advocating for their rights. Recommendations include: draw on the strengths of various sectors to develop integrated services; assess community needs in advance of designing programmes; secure internal expertise and leadership to maintain the focus on HIV; combat HIV-related stigma, as well as stigma based on gender identity; involve appropriate and representative groups to represent LGBT populations; and undertake rigorous monitoring and evaluation...

5.     Impact Data - No Rubba, No Hubba Hubba
The New Zealand Ministry of Health funded the No Rubba, No Hubba Hubba communication campaign (summer of 2004/2005) to promote and increase safer sexual health practices. The health objective of the campaign was to reduce the incidence of STIs among this audience. The key goal for the campaign was for at least 80% of the priority audiences (15- to 19-year-old New Zealanders - with emphasis on Mâori rangatahi and Pacific youth) to be aware of the campaign. Almost half (49%) the respondents indicated the campaign had "definitely" or "probably" increased their likelihood of using condoms in the future. The proportion of respondents who said they would still have sex if no condom was available decreased significantly between the pre- and post-campaign (36%, down from 6%)...

6.    Striving for Transformation through Empowered People (STEP)
Implemented in Vietnam's southwestern province, the 4-year STEP programme (2008-2012) addresses gender and its effects on the behaviour and life choices of both men and women. Recommendations from STEP's experiences include: tailor the gender-based violence (GBV) component to the level of community understanding, focus training on strengthening critical thinking about gender norms and their effects, support equitable business and job opportunities, consider providing basic education, increase the level of loan support for women, and strengthen monitoring and evaluation...

SERVICES
Including: condoms, HIV testing and counselling, information/communication, sexuality education and lifeskills, harm reduction, male circumcision, treatment for adolescents and young people living with HIV

7.    Assessment: Life-Skills Based Curriculum Project in Lao PDR
This assessment from the United Nations Children's Fund (UNICEF) Asia-Pacific Shared Services Center (APSSC) and East Asia and Pacific Regional Office (EAPRO) investigates the knowledge, attitudes, and behaviours of students in Laos PDR regarding reproductive health, HIV and AIDS, STIs, and drugs. It describes what young people know and makes specific recommendations to the Ministry of Education to support the national response on HIV/AIDS and STIs. Recommendations focus on integrating life-skills education into national core curricula and ensuring that teachers and schools are empowered to deliver measurable results...

8.     Promoting HIV Prevention Behaviors in Malawi through the BRIDGE Project
This report presents findings from the outcome evaluations pertaining to BRIDGE, a behaviour change initiative that aimed to encourage Malawians, youth in particular, to adopt behaviours that prevent HIV transmission. Six communication projects were evaluated, including Agogo Training. Assessments of the Agogo (grandmothers) training showed that grandmothers could be used as effective conduits of influence to impart information about HIV prevention behaviours and sexuality to young girls...

9.      HIV-Related Knowledge, Attitudes, Behaviors, and Practices of Young People in Cross River State and Kogi State, Nigeria
C-Change/Nigeria assessed and reported on the HIV-related knowledge, attitudes, beliefs, and practices (KAPB) of more than 1,200 youth ages 10-24 in Cross River State and Kogi State. Results of focus group discussions and in-depth interviews included: In addition to lack of engaging in HIV counselling and testing, youth rely on established media (radio, television, and newspapers) for health information. They were found to have good recall of overall health and HIV prevention and intervention programmes, but expressed concern about lack of youth perspectives in the design and implementation of these programmes...

10.      Addressing Gender Dynamics and Engaging Men in HIV Programs: Lessons Learned from Horizons Research
This article highlights findings from more than 10 studies in Asia, Africa, and Latin America - conducted from 1997 through 2007 as part of the Horizons programme - "that have contributed to understanding the relationship between gender and men's behaviors, developing useful measurement tools for gender norms, and designing and evaluating the impact of gender-focused program strategies. Studies showed significant associations between support for inequitable norms and risk, such as more partner violence and less condom use. Programmatic lessons learned ranged from insights into appropriate media messages, to strategies to engage men in critically reflecting upon gender inequality, to the qualities of successful program facilitators. The portfolio of work reveals the potential and importance of directly addressing gender dynamics in HIV- and violence-prevention programs for both men and women..."

11.      Presenting the Evidence for HIV Communication
From Johns Hopkins Health and Education in South Africa, this report makes the case that social and behavioural prevention in South Africa is contributing to the uptake of HIV prevention behaviours, averting and/or delaying new HIV infections, and saving the country in future treatment costs. "There is ample evidence that health communication programmes are having an impact and that South Africans are heeding the messages and taking action to avert new HIV infections. This is saving the country billions in future treatment-related costs. Communication programming has reached over 90% of the population of South Africa, leading to a significant improvement in HIV-related knowledge, attitudes and beliefs. It has also had a direct impact on a number of behaviours, including partner reduction, HIV testing and counselling and condom-use..."

12.    Community-Based Intervention to Increase HIV Testing and Case Detection in People Aged 16-32 Years in Tanzania, Zimbabwe, and Thailand
This study from The Lancet aimed to assess whether HIV testing could be increased by combination of community mobilisation, mobile community-based voluntary counselling and testing (VCT), and support after testing. In this interim analysis, researchers examined community-based VCT (CBVCT) and standard clinic-based VCT (SVCT). The proportion of clients receiving their first HIV test during the study was higher in CBVCT communities than in SVCT communities in Tanzania, Zimbabwe, and Thailand...
 

STRUCTURAL PREVENTION
Including: incentives for change (e.g. cash transfers, microfinance, economic empowerment), laws and policies, and gender-based violence.

13.   Comparing the Cost-Effectiveness of HIV Prevention Interventions
This study sought to provide evidence in response to the need of communities to identify cost-effective interventions for HIV prevention as a means to optimise limited resources. The study, conducted in the United States, included estimates of the relative cost-effectiveness for 26 HIV prevention interventions, which included biomedical interventions, structural interventions, and individual behaviour change interventions. The authors state that the study can provide strong evidence for the use of certain interventions in HIV prevention. In addition to the use of mass media, another intervention with great potential, they argue, is the increase of alcohol prices as a way to prevent high-risk behaviour for HIV...
 

14.      Triple Jeopardy: Female Adolescence, Sexual Violence, and HIV/AIDS
This advocacy fact sheet describes the linkages between female adolescence, sexual violence, and HIV/AIDS, termed the "Triple Jeopardy", and describes possible policy and programme responses. It is published by the International Women's Health Coalition (IWHC) from among their fact sheets on young adolescents' sexual and reproductive health and rights. IWHC's series on young adolescents uses evidence on the sexual and reproductive knowledge and behaviours of 10- to 14-year-olds to argue for more responsive policies and programmes regionally and globally. Of 7 policy and programme response, two are: make health services attractive to young people and create safe places for girls inside schools and in the community...

15.       The Role of Traditional Leadership Preventing Violence Against Women
This fact sheet, published by the Southern Africa HIV and AIDS Information Dissemination Services (SAfAIDS), outlines how traditional leaders and traditional institutions can facilitate positive change in local communities working to address HIV and violence against women. The fact sheet concludes that there is ample evidence supporting the effectiveness of partnering with traditional leaders to support HIV prevention efforts by ending violence against women...

16.    Securing the Future Today: Synthesis of Strategic Information on HIV and Young People
This synthesis document was written after the Joint United Nations Programme on HIV/AIDS (UNAIDS) Report on the Global AIDS Epidemic 2010 in order to focus specifically on young people. It presents an in-depth review and analysis of 2010 country reports on United Nations General Assembly Special Session (UNGASS) indicators and strategic information. The report focuses on prevention but also assesses the availability of strategic information on HIV treatment, care, and support for young people...

17.    National Teacher Training HIV End Line Survey Malawi 2009
This report shares findings from an external evaluation of the first year of Theatre for a Change (TfaC)'s work with trainee teachers in Malawi to reduce HIV/AIDS. The goal of TfaC's Teacher Training College (TTC) programme is to reduce this high risk of HIV infection among teachers and, in turn, their future pupils. TfaC offers teachers an after-school workshop programme that uses participatory learning techniques. For example, at the endline, 76% of women and 79% of men demonstrated in a workshop observation that they would assert a child's right not to be sexually abused and report an incident of sexual abuse to the authorities. The evaluation also found that both participants' agency in claiming rights and their teaching methods showed improvement. Women and men demonstrated an improvement in knowledge of and their ability to advocate for their sexual and gender rights...

18.    Intervenciones con padres de familia para modificar el comportamiento sexual en adolescentes - Interventions Involving Parents in Order to Impact Adolescent Sexual Behaviour
This Spanish language article was prepared by Salud Pública México (Public Health Mexico) and published in its March-April 2011 journal. The objective of this study was to examine how educational interventions that incorporate parent participation actually affect and modify adolescent sexual behaviour. Salud Pública evaluated educational interventions involving parents and found a significant increase in adolescents' intentions to postpone sexual intercourse and use contraceptives, a reduction in self-reported sexual relations, and an increase in condom use...

DB Click: HIV/AIDS, Young People, Research is one of two special issues which complement DB Click: HIV/AIDS and The Drum Beat through a specific focus on HIV/AIDS, Youth, and development.

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