Medicine and Health Sciences Commons^™

Making Cities Mental Health Friendly For Adolescents And Young Adults, Pamela Y. Collins, Moitreyee Sinha, Tessa Concepcion, George Patton, Thaisa Way, Layla Mccay, Augustina Mensa-Kwao, Helen Herrman, Evelyne De Leeuw, Lukoye Atwoli

Brain and Mind Institute

Urban life shapes the mental health of city dwellers, and although cities provide access to health, education and economic gain, urban environments are often detrimental to mental health1,2. Increasing urbanization over the next three decades will be accompanied by a growing population of children and adolescents living in cities3. Shaping the aspects of urban life that influence youth mental health could have an enormous impact on adolescent well-being and adult trajectories4. We invited a multidisciplinary, global group of researchers, practitioners, advocates and young people to complete sequential surveys to identify and prioritize the characteristics of a mental health-friendly city for …

Comparison Of Physical Activity Levels Among School-Age Adolescents In The Rural And Urban Areas Of District Swat Kpk, Pakistan- An Analytical Cross-Sectional Study, Imran Uddin

Theses & Dissertations

Background: Obesity and overweight represent significant global public health concerns. Young adolescents are in particular increasingly experiencing obesity and overweight due to their sedentary lifestyles, excessive electronic media use, and lack of physical activity (PA). This trend is linked to the development of non-communicable diseases in later life. Moreover, data regarding the lack of PA is available in Pakistan, but a gap exists in the comparative analysis of physical activity levels between rural and urban adolescents. Rural and urban areas exhibit distinctions in both geographical settings and technological advancements, potentially influencing the PA levels of their respective inhabitants.
Purpose: The …

School-Based Study To Assess The Nutritional Status (Bmi Based) Of Adolescents Of Gojra City Of District Toba Tek Singh, Punjab, Pakistan, Shagufta Perveen, Rozina Karmaliani, Rubina Barolia, Rozina Mistry

School of Nursing & Midwifery

Adolescence is the make-or-break stage of life. Major physical, mental, and psychological growth takes place at this age. Adequate and balanced nutrition is a vital requirement to support this phase. Adolescents living in developing and low-income countries are more likely to face nutritional challenges. Poor nutritional status during adolescence is an important determinant of health outcomes.
Objective: To analyze the nutritional status (BMI based) of school-going adolescents in Gojra city, Punjab, Pakistan.
Methods: A school-based cross-sectional survey was carried out covering 635 (6-8 grade) school-going adolescents (boys and girls) from public schools in Gojra city. Data were collected through anthropometric …

Psychometric Properties Of The Sindhi Version Of The Mood And Feelings Questionnaire (Mfq) In A Sample Of Early Adolescents Living In Rural Pakistan, Janavi Shetty, Florence Perquier, Susan C. Campisi, Yaqub Wasan, Madison Aitken, Daphne J. Korczak, Suneeta Monga, Sajid Bashir Soofi, Peter Szatmari, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

There is a need for reliable and valid screening tools that assess depressive symptoms in adolescents in Pakistan. To address this need, the present study examined the psychometric properties and factor structure of a Sindhi-translated and adapted version of the child-report Mood and Feelings Questionnaire (MFQ-C) and the Short Mood and Feelings Questionnaire (SMFQ-C) in a community sample of adolescents living in Matiari, Pakistan. Questionnaires were translated into Sindhi and administered by study psychologists to 1350 participants (52.3% female) 9.0 to 15.9 years old. Measurement structure was examined using confirmatory factor analysis. Internal consistency was estimated, and convergent and divergent …

Adolescent Connectedness: A Scoping Review Of Available Measures And Their Psychometric Properties, Ezra Too, Esther Chongwo, Adam Mabrouk, Amina Abubakar

Institute for Human Development

Introduction: Adolescent connectedness, a key component of positive youth development, is associated with various positive health outcomes. Several measures have been developed to assess this construct. However, no study has summarized data on the existing measures of adolescent connectedness. We conducted this scoping review to fill this gap. We specifically aimed to: (i) identify the existing measures of adolescent connectedness, (ii) determine the most frequently used measures among the identified measures, and (iii) summarize the psychometric properties of these measures with a keen interest in highlighting their cross-cultural utility and validity.

Methods: We searched CINAHL, Embase, PsycInfo, PubMed, …

Nutritional Status And Dietary Intake Of School-Age Children And Early Adolescents: Systematic Review In A Developing Country And Lessons For The Global Perspective, Durray Shahwar Abid Khan, Jai K. Das, Shagufta Zareen, Zohra S. Lassi, Afsah Salman, Muhammad Raashid, Aftab A. Dero, Aijaz Khanzada, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: The prevalence of double burden of malnutrition (DBM) is high in low- and middle-income countries (LMICs). Data on malnutrition trends is present for children age, however the data for school-going children and adolescents aged 5-15 years is scarce.
Objective: This systematic review presents the pooled prevalence of nutritional status and dietary intake among school-going children and adolescents (5-15 years of age) in an LMIC of Pakistan and the perspective for broader global nutrition in this age group.
Methods: An electronic search of databases was run on Pubmed and Medline (via Ovid) along with gray literature and archives of local …

Risk Of Infection And Transmission Of Sars-Cov-2 Among Children And Adolescents In Households, Communities And Educational Settings: A Systematic Review And Meta-Analysis, Omar Irfan, Jiang Li, Kun Tang, Zhicheng Wang, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: There is uncertainty with respect to SARS-CoV-2 transmission in children (0-19 years) with controversy on effectiveness of school-closures in controlling the pandemic. It is of equal importance to evaluate the risk of transmission in children who are often asymptomatic or mildly symptomatic carriers that may incidentally transmit SARS-CoV-2 in different settings. We conducted this review to assess transmission and risks for SARS-CoV-2 in children (by age-groups or grades) in community and educational-settings compared to adults.
Methods: Data for the review were retrieved from PubMed, EMBASE, Cochrane Library, WHO COVID-19 Database, China National Knowledge Infrastructure (CNKI) Database, WanFang Database, Latin …

Longitudinal Association Between Parental-To-Child-Maltreatment And Self-Reported Generalized Anxiety Disorder Symptoms In Pakistani Adolescents, Maryam Pyar Ali Lakhdir, Ghazal Peerwani, Salman Muhammad Soomar, Apsara Ali, Salima Farooq, Naureen Akber Ali, Asif Khaliq, Muhammad Masood Kadir, Syed Iqbal Azam

Community Health Sciences

Background: Parent-to-child maltreatment is considered one of the risk factors for Generalized Anxiety Disorder (GAD) symptoms, but this hypothesis has not been adequately tested in Pakistani settings.
Aim: This study aimed to examine the association between parent-to-child maltreatment and the risk of developing GAD symptoms among adolescents.
Methods: The association of none to rare, occasionally, and frequently parent-to-child maltreatment with the incidence of GAD symptoms was investigated in a sample of 800 adolescents aged 11-17 years who were followed for two years. Parent-to-child maltreatment was assessed using ICAST-C (International child abuse screening tool). GAD Symptoms were determined by SCARED (Screen …

Inequalities In Early Marriage, Childbearing And Sexual Debut Among Adolescents In Sub-Saharan Africa, Dessalegn Y. Melesse, Réka M. Cane, Aveneni Mangombe, Macellina Y. Ijadunola, Adom Manu, Eniola Bamgboye, Abdu Mohiddin, Rornald M. Kananura, Elsie Akwara, Elsabé Du Plessis

Obstetrics and Gynaecology, East Africa

Background: Adolescent sexual and reproductive health (ASRH) is a major public health concern in sub-Saharan Africa (SSA). However, inequalities in ASRH have received less attention than many other public health priority areas, in part due to limited data. In this study, we examine inequalities in key ASRH indicators.

Methods: We analyzed national household surveys from 37 countries in SSA, conducted during 1990–2018, to exam- ine trends and inequalities in adolescent behaviors related to early marriage, childbearing and sexual debut among adolescents using data from respondents 15–24 years. Survival analyses were conducted on each survey to obtain estimates for …

Child Maltreatment And Neglect In The United Arab Emirates And Relationship With Low Self-Esteem And Symptoms Of Depression, Syed M. Shah, Gul Nowshad, Fatima Al Dhaheri, Mariam H. Al-Shamsi, Alfan M. Al-Ketbi, Alaa Galadari, Priyam Joshi, Heba Bendak, Michal Grivna, Danilo Arnone

Department of Family Medicine

Objectives: To our knowledge, this study is the first in the United Arab Emirates (UAE) to investigate the prevalence of child maltreatment in relation to depressive symptoms and self-esteem.
Study design: Exposure to physical maltreatment, emotional abuse and neglect was evaluated in 518 adolescents (86% response rate) randomly selected from schools in Al Ain in the Emirate of Abu Dhabi. The Rosenberg self-esteem scale and the Beck Depression Inventory were used to measure self-esteem and depressive symptoms by using multivariate logistic regression analyses.
Results: The mean age of study participants was 14.3 years. Emotional abuse was the most frequent form …

Mental Health Of Children And Adolescents Amidst Covid-19 And Past Pandemics: A Rapid Systematic Review, Salima Meherali, Neelam Punjani, Samantha Louie-Poon, Komal Abdul Rahim, Jai K. Das, Rehana A. Salam, Zohra S. Lassi

School of Nursing & Midwifery

Background: The COVID‑19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID‑19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children's and adolescent's mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children's and adolescents' mental health.
Methodology: We conducted …

Non-Communicable Diseases Among Adolescents: Current Status, Determinants, Interventions And Policies, N Akseer, S Mehta, J Wigle, R Chera, Z J. Brickman, S Al-Gashm, B Sorichetti, A Vandermorris, D B. Hipgrave, N Schwalbe, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Addressing non-communicable disease (NCDs) is a global priority in the Sustainable Development Goals, especially for adolescents. However, existing literature on NCD burden, risk factors and determinants, and effective interventions and policies for targeting these diseases in adolescents, is limited. This study develops an evidence-based conceptual framework, and highlights pathways between risk factors and interventions to NCD development during adolescence (ages 10-19 years) and continuing into adulthood. Additionally, the epidemiologic profile of key NCD risk factors and outcomes among adolescents and preventative NCD policies/laws/legislations are examined, and a multivariable analysis is conducted to explore the determinants of NCDs among adolescents …

Reliability And Validity Of The Rs14 In Orphaned And Separated Adolescents And Youths In Western Kenya, Sarah C. Sutherland, Harry S. Shannon, David Ayuku, David L. Streiner, Olli Saarela, Lukoye Atwoli, Paula Braitstein

Internal Medicine, East Africa

Purpose: The 14-item Resilience Scale (RS14) is a tool designed to measure psychological resilience. It has been used effectively in diverse populations. However, its applicability is largely unknown for Sub-Saharan adolescent populations and completely unknown for orphaned and separated adolescents and youths (OSAY), a highly vulnerable population for whom resilience may be critical. This study assesses the RS14's psychometric properties for OSAY in Uasin Gishu County, Kenya.

Methods: Survey responses from a representative sample of 1016 OSAY (51.3% female) aged 10-25 (mean = 16; SD = 3.5) living in institutional and home-based environments in Uasin Gishu County were analyzed. The …

Sleep And Its Relation With Academic Performance Among Adolescents: An Analytical Cross Sectional Study In Gulshan Town, Karachi, Zainab Mohammad Anjarwala, Niloufer Sultan Ali, Kashmira Nanji, Anum Arshad Beg, Veena Kumari Karmani

Department of Family Medicine

Objective: To determine the prevalence of sleep patterns and their relationship with academic performance among adolescents.
Methods: The analytical cross-sectional study was conducted from March to August 2015 in Gulshan Town of Karachi and comprised students in grades 6 to 8 who were selected from six government and private schools. Data was collected regarding their sleeping time, wake-up time, sleep latency and total sleep duration. Paediatric Daytime Sleepiness Scale was administered to calculate daytime sleepiness. Academic performance of students was taken from school academic records. Data was analysed using SPSS 22.
Results: Of the 440 subjects, 234 (53.2%) were boys …

The Epidemiological Burden Of Obesity In Childhood: A Worldwide Epidemic Requiring Urgent Action, Mariachiara Di Cesare, Maroje Sorić, Pascal Bovet, J Jaime Miranda, Zulfiqar Ahmed Bhutta, Gretchen A. Stevens, Avula Laxmaiah, Andre-Pascal Kengne, James Bentham

Department of Paediatrics and Child Health

Background: In recent decades, the prevalence of obesity in children has increased dramatically. This worldwide epidemic has important consequences, including psychiatric, psychological and psychosocial disorders in childhood and increased risk of developing non-communicable diseases (NCDs) later in life. Treatment of obesity is difficult and children with excess weight are likely to become adults with obesity. These trends have led member states of the World Health Organization (WHO) to endorse a target of no increase in obesity in childhood by 2025.
Main body: Estimates of overweight in children aged under 5 years are available jointly from the United Nations Children's Fund …

Nash-Wo-Numa (Childhood Growth & Development) Study Protocol: Factors That Impact Linear Growth In Children 9 To 15 Years Of Age In Matiari, Pakistan, Susan C. Campisi, Yaqub Wasan, Sajid Bashir Soofi, Suneeta Monga, Daphne J. Korczak, Wendy Lou, Olle Soder, Ashley Vandermorris, Khadija N Humayun, Ayesha Mian, Peter Szatmari, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Introduction: Adolescence is a time of significant physical and emotional change, and there is emerging concern that adolescents living in low- and middle-income countries (LMIC) may face substantial challenges in relation to linear growth and mental health. Data on the global burden of stunting after 5 years of age are limited, but estimates suggest up to 50 per cent of all adolescents in some LMIC are stunted. Additionally, many LMIC lack robust mental health care delivery systems. Pakistan has one of the world's largest populations of adolescents (10 to 19 years) at approximately 40 million. The Nash-wo-Numa study's primary objective …

Ethical Considerations For Conducting Sexual And Reproductive Health Research With Female Adolescents Engaged In High-Risk Behaviours In China, Xu-Dong Zhang, Sabrina Ching Yuen Luk, Yue-Hong Han, Gui-Rong Chen, Bao-Sheng Zhu, Stanley Luchters

Population Health, East Africa

Background: Chinese female adolescents engaged in sex trade and substance use are often criminalized and stigmatized. As a result of these cultural, legal and political constraints, ethical concerns can discourage investigators from engaging these adolescents in research. This paper aims to address the ethical tensions between protection and inclusion in conducting sexual and reproductive health (SRH) research with adolescents engaged in high-risk behaviours. Processes of moral reasoning, and examples and practical mechanisms in managing such ethical challenges were presented in the hope of advancing the research ethics policies and practice with adolescents.

Methods: We extracted ethical issues from three previously …

Factors Associated With Substance Use Among Adolescents Living With Hiv In Kenya, Wambui Kagucia

Theses & Dissertations

Background: Substance use is rife in our society and adolescents (10-19 years) do face this problem during this vulnerable period of growth and development. Use of substances is known to be associated with poor health choices and risky sexual behaviour. Since the advent of antiretroviral therapy (ART), significant progress has been made with reduced rates of mother to child transmission (MTCT) and a general downward global trend in acquired immunodeficiency disease (AIDS) related mortalities. However, human immunodeficiency virus (HIV)/AIDS is still a leading cause of mortality in adolescents living in Sub Saharan Africa, with an upward trend in new HIV …

Lessons Learnt From The Cerca Project, A Multicomponent Intervention To Promote Adolescent Sexual And Reproductive Health In Three Latin America Countries: A Qualitative Post-Hoc Evaluation., Olena Ivanova, Kathya Cordova Pozo, Zoyla Esmeralda Segura, Bernardo Vega, Venkatraman Chandra-Mouli, Michelle J. Hindin, Marleen Temmerman, Peter Decat, Sara De Meyer, Kristien Michielsen

Obstetrics and Gynaecology, East Africa

The Community-Embedded Reproductive Health Care for Adolescents (CERCA) Project was implemented in Bolivia, Ecuador and Nicaragua (2011–2014) to test the effectiveness of interventions preventing teenage pregnancies. As the outcome evaluation showed limited impact, a post-hoc process evaluation was carried out to determine if and how CERCA’s design, implementation, monitoring and evaluation affected the results. We did a document analysis and conducted 18 in-depth interviews and 21 focus group discussions with stakeholders and beneficiaries. Transcripts were analyzed using directed content analysis.

Data showed that CERCA sensitized stakeholders and encouraged the discussion on this sensitive issue. In terms of design, a strong …

The Global Strategy For Women's, Children's And Adolescents' Health (2016-2030): A Roadmap Based On Evidence And Country Experience., Shyama Kuruvilla, Flavia Bustreo, Taona Kuo, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

The Global strategy for women’s, children’s and adolescents’ health (2016–2030) provides a roadmap for ending preventable deaths of women, children and adolescents by 2030 and helping them achieve their potential for and rights to health and well-being in all settings.1 The global strategy has three objectives: survive (end preventable deaths); thrive (ensure health and well-being); and transform (expand enabling environments). These objectives are aligned with 17 targets within nine of the sustainable development goals (SDGs),2 including SDG 3 on health and other SDGs related to the political, social, economic and environmental determinants of health and sustainable development.

Like the SDGs, …

Towards A New Global Strategy For Women’S, Children’S And Adolescents’ Health, Marleen Temmerman, Rajat Khosla, Zulfiqar Ahmed Bhutta, Flavia Bustreo

Obstetrics and Gynaecology, East Africa

The year 2015 marks a defining moment for the health of women, children, and adolescents. It is the end point of the United Nations’ millennium development goals, and their transition to the sustainable development goals, and also the 20th anniversary of the International Conference on Population and Development’s plan of action and the Beijing Declaration and platform of action.

This is a moment of reflection as well as celebration. Although great strides have been made in reducing maternal and child mortality, showing that change is possible, many countries are lagging behind in reaching millennium development goal 4 (to reduce the …

Abuse Among School Going Adolescents In Three Major Cities Of Pakistan: Is It Associated With School Performances And Mood Disorders?, Saleem Khawaja, Adeel Khoja, Komal Motwani

Department of Medicine

Objective: To assess the proportion of various types of abuses and their association with school performances and psychological stress among adolescents from three major cities of Pakistan.

Methods: The cross-sectional school survey was conducted from March to September 2009, comprising adolescent students at six schools in Karachi, Lahore and Quetta. Data was collected using a self-administered and pre-tested questionnaire by trained medical students. SPSS 16 was used for statistical analysis..

Results: Of the 414 subjects in the study, there were 223(54%) boys and 191(46%) girls with an overall mean age of 14.36 ±1.08 years. In all, 140(33.7%) participants were physically …

Women’S Health Priorities And Interventions, Marleen Temmerman, Rajat Khosla, Laura Laski, Zoe Mathews, Lale Say

Obstetrics and Gynaecology, East Africa

Over the past decades, governments have taken steps towards improving women’s health in line with commitments made in key international summits. Progress has been made in reducing maternal mortality,1 which accelerated with the launch of the United Nations secretary general’s Global Strategy for Women’s and Children’s Health in 2010. Use of maternal healthcare and family planning has increased in some countries.2 Progress has also been seen on two determinants of women’s health—school enrolment rates for girls and political participation of women—but not for others such as gender based violence.3

However, societies are still failing women in relation to health, especially …

Sexual Onset And Contraceptive Use Among Adolescents From Poor Neighbourhoods In Managua, Nicaragua, Peter Decat, Sara De Meyer, Lina Jaruseviciene, Miguel Orozco, Marcia Ibarra, Zoyla Segura, Bernardo Vega, Kristien Michielsen, Marleen Temmerman, Olivier Degomme

Obstetrics and Gynaecology, East Africa

Background and objectives: The prevalence of teenage pregnancies in Nicaragua is the highest in Latin-America. This study aimed to gain insight into factors which determine the sexual behaviours concerned.

Methods: From July until August 2011, a door-to-door survey was conducted among adolescents living in randomly selected poor neighbourhoods of Managua. Logistic regression was used to analyse factors related to sexual onset and contraceptive use.

Results: Data from 2803 adolescents were analysed. Of the 475 and 299 sexually active boys and girls, 43% and 54%, respectively, reported contraceptive use. Sexual onset was positively related to increasing age, male sex, alcohol consumption …

Twenty Years After International Conference On Population And Development: Where Are We With Adolescent Sexual And Reproductive Health And Rights?, Venkatraman Chandra-Mouli, Joar Svanemyr, Avni Amin, Helga Fogstad, Lale Say, Françoise Girard, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

The International Conference on Population and Development in Cairo in 1994 laid out a bold, clear, and comprehensive definition of reproductive health and called for nations to meet the educational and service needs of adolescents to enable them to deal in a positive and responsible way with their sexuality. In the context of the ongoing review of the International Conference on Population and Development Programme of Action and the considerations for a post-2015 development agenda, this article summarizes the findings of the articles presented in this volume and identifies key challenges and critical answers that need to be tackled in …

Primary Healthcare Providers’ Views On Improving Sexual And Reproductive Healthcare For Adolescents In Bolivia, Ecuador, And Nicaragua, Lina Jaruseviciene, Miguel Orozco, Marcia Ibarra, Freddy Cordova Ossio, Bernardo Vega, Nancy Auquilla, Joel Medina, Anna C. Gorter, Peter Decat, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Objectives: To elicit the views of primary healthcare providers from Bolivia, Ecuador, and Nicaragua on how adolescent sexual and reproductive health (ASRH) care in their communities can be improved.

Methods: Overall, 126 healthcare providers (46 from Bolivia, 39 from Ecuador, and 41 from Nicaragua) took part in this qualitative study. During a series of moderated discussions, they provided written opinions about the accessibility and appropriateness of ASRH services and suggestions for its improvement. The data were analyzed by employing a content analysis methodology.

Results: Study participants emphasized managerial issues such as the prioritization of adolescents as a patient group and …

Self-Perceived Health Among School Going Adolescents In Pakistan: Influence Of Individual, Parental And Life Style Factors?, Asad Ali Khan Afridi, Komal Motwani, Saleem Khawaja, Adeel Khoja, Zafar Fatmi, Iqbal Azam Syed, Muhammad Masood Kadir

Department of Medicine

BACKGROUND: Adolescents are at substantial risk of acquiring behaviors which might influence their health status. This study was aimed to assess the proportion of school going adolescents (both males and females) with poor self-perceived health and its associated factors.

METHODOLOGY: A cross-sectional study was conducted in three major cities of Pakistan i.e. Karachi, Lahore and Quetta. From each city, six (6) secondary schools were randomly selected (3 public and 3 private). Pre-tested, self-administered questionnaire was distributed to students. Binary logistic regression analysis was conducted to determine independent factors associated with poor self-perceived health.

RESULTS: Approximately 29% adolescents (119/414) reported poor …

Preventable Lifestyle Risk Factors For Non-Communicable Diseases In The Pakistan Adolescents Schools Study 1 (Pass-1)., Ali Khan Khuwaja, Saleem Khawaja, Komal Motwani, Adeel Khoja, Iqbal Azam Syed, Zafar Fatmi, Badar Sabir Ali, Muhammad Masood Kadir

Department of Medicine

Objectives: The rising burden of preventable risk factors for non-communicable diseases (NCDs) among adolescents is a major public health challenge worldwide. We identified the preventable risk factors for NCDs in adolescents.

Methods: In a school-based study, pre-tested structured questionnaires were completed by 414 adolescents (14 to 17 years) at six schools in three cities in Pakistan. The chi-squared test and adjusted odds ratio (aOR) with 95% confidence interval (CI) were calculated in a multinomial logistic regression analysis.

Results: Over 80% of the adolescents had unhealthy diets, and 54% were physically inactive. Most adolescents were exposed to passive smoking, and 14% …

The Prevalence And Factors Associated With Nonadherence With Arv Treatment And Cotrimoxazole Preventive Therapy Among Hiv Infected Adolescents Attending Out-Patient Hiv Clinics In Kenya, Reson Marima

Theses & Dissertations

Background: There is an increase in the burden of HIV infected adolescents, both those perinatally infected as well as those acquiring HIV during adolescence. Female adolescents continue to be at the highest risk for acquiring HIV; in many Southern African countries, they have a three fold risk of acquiring HIV compared to their male counterparts. Adherence to treatment among adolescents has been shown to range between 30-70%, which is unacceptably low for antiretroviral therapy (ART). Psychosocial wellbeing and social support have been shown to be possible contributing factors to adherence to ART. This relationship has not been previously evaluated …

Reducing Hiv/Aids In Young People In Sub-Sahara Africa: Gaps In Research And The Role Of Theory, Kristien Michielsen, Marleen Bosmans, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

This paper discusses the role of education in preventing HIV in children and young people in sub-Sahara Africa and presents the results of policy advisory research conducted on behalf of the Belgian Development Cooperation. The research consisted of a literature review and a field study in Rwanda. Relative to the high number of HIV prevention activities in sub-Sahara Africa, there is a limited number of scientific data on HIV risk reduction interventions for young people in this region. Longitudinal studies are especially scarce. Preliminary results show that many interventions have only a marginal impact on reducing sexual risk behaviour. Factors …