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1. Adults’ Perceptions of Adolescents’ Sexual and Reproductive Health: Qualitative Evidence from Uganda
2. Feel! Think! Act! A Guide to Interactive Drama for Sexual and Reproductive Health with Young People
3. The Future is in Our Hands: Tanzanian Youth, Reproductive Health and HIV
4. Identifying Sources of Adolescent Exclusion Due to Violence: Participatory Mapping in South Africa
5. Jamaican Youth Risk and Resiliency Behaviour Survey 2005: School-based Survey on Risk and Resiliency Behaviours of 10-15-year-olds
6. My Future Today – A Guide for Youth
7. Our Future – Preparing to Teach Sexuality and Life-skills: An Awareness Training Manual for Teachers and Community Workers
8. Prioritizing Second-Line Antiretroviral Drugs for Adults and Adolescents: A Public Health Approach: Report of a WHO Working Group Meeting
9. Putting Young People into National Poverty Reduction Strategies: A Guide to Statistics on Young People in Poverty
10. Sexuality and Life-skills: Participatory Activities on Sexual and Reproductive Health with Young People
1. Barriers to the community support of orphans and vulnerable youth in Rwanda
2. Correlates of premarital relationships among unmarried youth in Pune District, Maharashtra, India
3. HIV risk behaviours and situations as perceived by Thai adolescent daughters and their mothers in Bangkok, Thailand
4. HIV risks among gay- and non-gay-identified migrant money boys in Shanghai, China
5. The HIV testing experiences of adolescents in Ndola, Zambia: do families and friends matter?
6. Inconsistent reports of sexual intercourse among South African high school students
7. The Internet as a source of reproductive health information among adolescent girls in an urban city in Nigeria
8. Intervention to reduce adolescents sexual risk behaviors: a randomized controlled trial
9. Long-term effects of a community-based program on contraceptive use among sexually active unmarried youth in Shanghai, China
10. Low prevalence of HIV and other sexually transmitted infections in young women attending a youth counselling service in Maputo, Mozambique
11. Male sex work and HIV risk among young heroin users in Hanoi, Vietnam
12. Maternal versus paternal orphans and HIV/STI risk among adolescent girls in Zimbabwe
13. The sexual and reproductive health of young people in Latin America: evidence from WHO case studies
14. Sexual behaviour and contraceptive usage of secondary school adolescents in Ibadan, Nigeria
15. A systematic review of school-based sexual health interventions to prevent STI/HIV in sub-Saharan Africa
16. Traditional values of virginity and sexual behaviour in rural Ethiopian youth: results from a cross-sectional study
17. Transtheoretical model and risky sexual behaviour in HIV + youth in Thailand
18. "You must do the test to know your status": attitudes to HIV voluntary counseling and testing for adolescents among South African youth and parents?
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1. Adults’ Perceptions of Adolescents’ Sexual and Reproductive Health: Qualitative Evidence from Uganda (2008, 33 pages, 534 KB)
This report describes information gathered in 60 in-depth interviews with parents, community leaders, teachers, and health workers about their perceptions and attitudes about adolescent sexual and reproductive health issues (ASRH).
Organization: Guttmacher Institute
Contact: buyit@guttmacher.org
2. Feel! Think! Act! A Guide to Interactive Drama for Sexual and Reproductive Health with Young People (2008, 191 pages, 3.37 MB)
This toolkit contains drama and discussion activities that encourage young people to learn about sexual and reproductive health issues, and help adult facilitators gain skills in facilitating and using interactive drama tools and techniques.
Organization: International HIV/AIDS Alliance
Contact: mail@aidsalliance.org
3. The Future is in Our Hands: Tanzanian Youth, Reproductive Health and HIV (2007, 36 pages, 1.07 MB)
This report summarizes the latest information from the most recent Tanzania Demographic and Health Survey (2004-05) and the Tanzania HIV/AIDS Indicator Survey (2003-04). It provides exercises on how to use such data that is useful for other countries to consider as well.
Organization: Measure DHS, Tanzania National Bureau of Statistics
Contact: dg@nbs.go.tz
4. Identifying Sources of Adolescent Exclusion Due to Violence: Participatory Mapping in South Africa (2008, 4 pages, 299 KB)
This report examines the factors that shape adolescents' lives in South Africa. Researchers studied how economic literacy and life skills education affect young men and women who are economically and socially disenfranchised and at high risk of HIV infection.
Organization: Population Council
Contact: publications@popcouncil.org
5. Jamaican Youth Risk and Resiliency Behaviour Survey 2005: School-based Survey on Risk and Resiliency Behaviours of 10-15-year-olds (2007, 135 pages, 534 KB)
This document is based on a nationally representative sample of 3,003 in-school youth aged 10-15. The survey included questions on risk and resiliency to determine factors that provide protection from teen pregnancy, HIV/AIDS, violence, and obesity, in order to inform programs targeted at the early adolescent period.
Organization: Measure Evaluation
Contact: measure@unc.edu
6. My Future Today – A Guide for Youth (2007, 160 pages, 8.92 MB)
Young people leaving school face many challenges that they may not have faced while still under the care of their families. This comprehensive guide from Botswana gives advice and support to young people in all areas of life.
Organization: Ditshwanelo
Contact: legal.ditshwanelo@info.bw
7. Our Future – Preparing to Teach Sexuality and Life-skills: An Awareness Training Manual for Teachers and Community Workers (2008, 94 pages, 2.72 MB)
Before teachers can educate their pupils about adolescent sexual and reproductive health, they need to explore their own values, hopes and fears, knowledge, and skills related to this topic. This manual, developed in the Zambian context, equips teachers with a stronger understanding of sexuality, gender, sexual and reproductive health, and HIV and AIDS. The activities help teachers develop the self-awareness, values, and skills to play an effective role in HIV prevention, care, and mitigation in their schools and communities.
Organization: International HIV/AIDS Alliance
Contact: mail@aidsalliance.org
8. Prioritizing Second-Line Antiretroviral Drugs for Adults and Adolescents: A Public Health Approach: Report of a WHO Working Group Meeting (2008, 43 pages, 580 KB)
In an attempt to simplify the choice between second-line HIV treatment regimens, speed up drug approvals, and decrease prices, the World Health Organization has changed its second-line HIV treatment guidelines. WHO has narrowed the number of second-line medications it recommends in response to requests from governments for more direction about what to include in their countries' treatment programs.
Organization: World Health Organization
Contact: bookorders@who.int
9. Putting Young People into National Poverty Reduction Strategies: A Guide to Statistics on Young People in Poverty (2008)
Many national poverty reduction strategies overlook the needs of young people. Even where national strategies do have a youth focus, the analysis of their situation is limited because little or no reference is made to readily available data. The purpose of this step-by-step guide is to show how relevant statistics on young people in poverty can be easily sourced for use in developing national poverty reduction strategies. The guide shows how to use accessible databases on the Internet to provide individual countries with sophisticated statistical profiles of young people in poverty.
Organization: UNFPA
Contact: martinez@unfpa.org
10. Sexuality and Life-skills: Participatory Activities on Sexual and Reproductive Health with Young People (2008, 172 pages, 3.57 MB)
This toolkit provides participatory learning activities for young people to equip them with knowledge and positive attitudes about sexual and reproductive health and well-being. The toolkit offers factual information for youth, as well as activities that foster examination and clarification of values, self-esteem building, communication, problem-solving, and working as a group for collective action.
Organization: International HIV/AIDS Alliance
Contact: mail@aidsalliance.org
1. Barriers to the community support of orphans and vulnerable youth in Rwanda. Thurman TR, Snider LA, Boris NW, et al. Soc Sci Med 2008;66(7).
In this study, mixed methods are used to elucidate community-level barriers to care for orphans and vulnerable youth in Rwanda. Data are analyzed from a large survey of youth heads of household on their perceptions of marginalization from the community and the factors predicting that marginalization. Data were also collected from a survey of adults who volunteered to mentor these youth and focus groups with both community adults and youth heads of household. Results highlight how orphans' impoverished condition, cause of parents' death, and community perceptions play a role in the marginalization of orphaned youth in Rwanda. Evidence is also offered to show that targeting humanitarian assistance to vulnerable youth may inadvertently lessen the level of community support they receive and contribute to their marginalization. The implications of these data for community-based program approaches are discussed.
2. Correlates of premarital relationships among unmarried youth in Pune District, Maharashtra, India. Alexander M, Garda L, Kanade S, et al. Int Fam Plan Perspect 2007;33(4).
Data were drawn from a community-based study of 15- to 24-year-olds in urban slum and rural settings in Pune District, Maharashtra. Multivariate analyses were conducted to identify associations between youths' individual, peer, and family factors and their experience of romantic relationships and physical intimacy, including intercourse. Among young men, 17-24% had had a romantic relationship, 20-26% had engaged in some form of physical intimacy, and 16-18% had had sex. The proportions among young women were 5-8%, 4-6%, and 1-2%, respectively. Exposure to alcohol, drugs, or pornographic films and having more frequent interaction with peers were positively associated with romantic and sexual relationships for both young women and young men. Educational attainment was negatively associated with both types of relationships for young women, but only with sexual relationships for young men. Program interventions should (1) ensure that youth are fully informed and equipped to make safe choices and negotiate wanted outcomes, while positively influencing their peer networks; (2) encourage closer interaction between parents and children; and (3) be tailored to the different circumstances and experiences of young women and men.
3. HIV risk behaviours and situations as perceived by Thai adolescent daughters and their mothers in Bangkok, Thailand. Rasamimari A, Dancy B, Smith J. AIDS Care 2008;20(2).
A cross-sectional descriptive study identified the behaviors and situations that place Thai adolescent females at risk from HIV as perceived by the girls and their mothers. The girls were aged between 12 and 14 years and attended public middle schools in Bangkok, Thailand. Data were obtained from a demographic questionnaire and four different focus groups (n = 40); two focus groups with Thai adolescents (n = 20) and two focus groups with their mothers (n = 20). Content analysis suggested that the behaviors considered most likely to result in HIV infection of Thai adolescent females were having sex without protection and drug use, and the most likely situations placing them at HIV risk were pubs/bars and boyfriends' or friends' houses when there is no parental or adult supervision. The mothers and daughters reported that HIV/AIDS-prevention programs should provide education about the causes and dangers of sexually transmitted infections, including HIV/AIDS, and prevention strategies.
4. HIV risks among gay- and non-gay-identified migrant money boys in Shanghai, China. Wong FY, Huang ZJ, He N, et al. AIDS Care 2008;20(2).
This study aims to elucidate factors for preventing substance abuse and HIV among two types of money boys (i.e., those who engage in same-sex transactional sex for economic survival), “gay-identified” and “non-gay-identified,” living in the Shanghai metropolitan area. Results reveal gay and non-gay money boys were not significantly different in age, income, marriage status, and education. Both groups shared similar patterns of substance use. Both groups had high self-reported depressive symptoms and low HIV knowledge. However, sexual orientation differentially predicted HIV testing, with gay money boys more likely to be tested for HIV. Non-gay money boys showed fewer sexual risks. HIV prevention targeting MSM (including money boys) within rapidly changing China is discussed, as are methodologies and outreach strategies most effective for particular subgroups of MSM.
5. The HIV testing experiences of adolescents in Ndola, Zambia: do families and friends matter? Denison JA, McCauley AP, Dunnett-Dagg WA, et al. AIDS Care 2008;20(1).
This study explored how adolescents involve their families, friends, and sex partners when making decisions about seeking HIV voluntary counseling and testing (VCT) and disclosing their HIV status. The study is based on 40 qualitative in-depth interviews with 16- to 19-year-olds who knew their HIV status in Ndola, Zambia. The findings show that a) almost half of the youth turned to family members for advice or approval prior to seeking VCT; b) a disapproving reaction from family members or friends often discouraged youth from attending VCT until they found someone supportive; c) informants often attended VCT alone or with a friend, but rarely with a family member; and d) disclosure was common to family and friends, infrequent to sex partners, and not linked to accessing care and support services. Family members need access to information on VCT so they can support young peoples' decisions to test for HIV and to disclose their HIV status. These results reinforce the need to provide confidential VCT services for adolescents and the need to develop and test innovative strategies to reach adolescents, their families, and sex partners with VCT information and services.
6. Inconsistent reports of sexual intercourse among South African high school students. Palen L-A, Smith EA, Caldwell LL, et al. J Adolesc Health 2008;42(3).
Consistency of reported lifetime sexual intercourse was assessed using five semiannual waves of data. Odds ratios related inconsistent reporting to demographic variables and potential indicators of general and risk-behavior-specific reliability problems. Of the sexually active participants in the sample, nearly 40% reported being virgins after sexual activity had been reported at an earlier assessment. Inconsistent reporting could not be predicted by gender or race or by general indicators of poor reliability (inconsistent reporting of gender and birth year). However individuals with inconsistent reports of sexual intercourse were more likely to be inconsistent reporters of substance use. These results suggest that researchers need to undertake efforts to deal specifically with inconsistent risk behavior data. These efforts may include modification of data collection procedures and use of statistical methodologies that can account for response inconsistencies.
7. The Internet as a source of reproductive health information among adolescent girls in an urban city in Nigeria. Nwagwu WE. BMC Public Health 2007;7(Article No. 354).
A questionnaire was used to collect data from 1,011 adolescent girls in selected secondary schools in Owerri, Nigeria, and also from 134 out-of-school girls selected from the same communities. More than 73% of the girls reported having ever used the Internet; more than 74% and 68% of them being in-school and out-of-school respectively. The in-school girls (43.9%) reported having home access more than the out-of-school (5.6%) although the out-of-school have used the Internet for finding reproductive and related information more than the in-school. While parents (66.2%) and teachers (56.2%) are the two most used sources of information to the in-school girls, friends (63.2%) and the Internet (55.2%) were reported by the out-of-school youth as the two most used sources of information. The authors conclude that the Internet is not a first choice of source of reproductive health information for either the in-school or out-of-school adolescent girls in Owerri, Nigeria. The source is, however, more commonly used by the out-of-school than the in-school, but the in-school girls have a more favorable assessment of the quality of information they obtain from the Internet. The full text (PDF, 13 pages, 290 KB) of the article is available online.
8. Intervention to reduce adolescents sexual risk behaviors: a randomized controlled trial. Gallegos EC, Villarruel AM, Loveland-Cherry C, et al. Salud Publica Mex 2008;50(1).
In a randomized controlled trial with four follow-ups, 832 adolescents aged 14-17 were recruited from Monterrey, Mexico high schools and randomly assigned to the experimental or control group. The six-hour intervention used active learning strategies and was delivered in two sessions on two consecutive Saturdays. The study was carried out between 2002 and 2005. GEE analysis indicated no differences in sexual relationship intentions between the two groups; however, the experimental group had higher intentions to use condoms and contraceptives (mean differences 0.15 and 0.16, CI 95%) in the next three months, as compared with the control group. Theoretical variables, such as control beliefs, were significant mediators of the intervention. The authors conclude that the behavioral intervention represents an important effort in promoting safe sexual behaviors among Mexican adolescents. The full text (Spanish, PDF, 8 pages, 190 KB) of the article is available online.
9. Long-term effects of a community-based program on contraceptive use among sexually active unmarried youth in Shanghai, China. Tu X, Lou C, Gao E, et al. J Adolesc Health 2008;42(3).
This study evaluated the long-term (48-month) sustainable effect of a set of community-based interventions to promote contraceptive use among sexually active unmarried youth in suburban Shanghai, China. A nonrandomized community trial with one intervention and one control group was conducted in two comparable towns of a suburban area of Shanghai. The intervention program was developed and implemented to increase knowledge and access to sexual and reproductive health services among unmarried youth aged 15-24 years. Baseline surveys were conducted in both sites before implementation of the intervention, and similar surveys were conducted in both sites 20 months after the launch of the intervention and 28 months after the end of the intervention. Statistically significant differences between the respondents surveyed at baseline in 2000 and at the long-term follow up in 2004 were observed in some age categories and in some educational groups. In the post-project period, there was a major improvement in all indicators in the control group. Among the sub-set of respondents interviewed both in 2000 and 2004 who were exposed to the intervention program, the interventions were associated with a significant increase in the frequency of contraceptive use among participants initiating sexual relations over the period of the intervention (odds ratio [OR] = 6.91), as well as with significant reduction in use ever of the withdrawal method of contraception among all sexually active respondents (OR = .37) compared with the control group during long-term follow-up period. No long-term effects on contraceptive practice were observed among new respondents who were not exposed to the intervention program. Comprehensive community-based interventions appear to have limited long-term effects on contraceptive use among unmarried youth in suburban Shanghai.
10. Low prevalence of HIV and other sexually transmitted infections in young women attending a youth counselling service in Maputo, Mozambique. Melo J, Folgosa E, Manjate D, et al. Trop Med Int Health 2008;13(1).
A total of 445 women attending the Adolescent and Youth Friendly Service, in Maputo, Mozambique voluntarily participated in the study and filled in a self-administered questionnaire on knowledge, practices, and attitudes. All but ten of the women also underwent a laboratory examination for vaginosis, candidiasis, trichomoniasis, gonorrhoea, chlamydiosis, syphilis, and HIV infection. Women had a high level of awareness and knowledge of STIs and HIV. Candidiasis was the most prevalent reproductive tract infection (36%), followed by vaginosis (13%) and trichomoniasis (7.6%). HIV seroprevalence was 4%; 42% were negative in all tests. The low prevalence of STIs and HIV may be related in part to the high level of awareness registered in the group.
11. Male sex work and HIV risk among young heroin users in Hanoi, Vietnam. Clatts MC, Giang le M, Goldsamt LA, et al. Sex Health 2007;4(4).
This study describes complex drug and sexual risk in a group of male sex workers (n = 79) who were recruited in the context of a larger study of young heroin users in Hanoi, Vietnam (n = 1,270). Male sex workers were significantly more likely than male non-sex workers to be migrants (P < 0.001); to have unstable housing (P < 0.001); and to have lifetime exposure to marijuana (P < 0.001), methylenedioxy methamphetamine (MDMA, ecstasy) (P < 0.01), amphetamines (P < 0.05), cocaine (P < 0.01) and morphine (P < 0.001). Male sex workers are more likely to currently use MDMA (P < 0.05), amphetamines (P < 0.001), morphine (P < 0.05), and to “smoke” as their most frequent mode of heroin administration (P < 0.01). Male sex workers are more likely to have both male and female concurrent sex partners (P < 0.001), to have a history of sexual victimization (P < 0.001), to have had more than three different sex partners in the past 30 days (P < 0.001), and to have had partners who injected drugs before sex (P < 0.001) or who used drugs during sex (P < 0.01). In their last sexual encounter with a client partner, approximately one-third (31.1%) reported having had receptive anal sex. In nearly three-quarters of these exchanges (71.4%), no condom was used. Similarly, in their last sexual encounter with a client partner, 42.2% reported having had insertive anal sex and in nearly half (47.4%) of these encounters no condom was used. Consistent with recent data from elsewhere in the region, there is an urgent need for additional research on male sex work in South-east Asia in order to properly situate behavioral interventions for male sex workers in this region.
12. Maternal versus paternal orphans and HIV/STI risk among adolescent girls in Zimbabwe. Kang M, Dunbar M, Laver S, et al. AIDS Care 2008;20(2).
The authors recruited a convenience sample of 200 girls in a peri-urban area of Zimbabwe to examine the impact of orphan status (compared to non-orphans) on household composition, education, risk behavior, pregnancy, and prevalent HIV and HSV-2 infection. Maternal orphans were more likely to be in households headed by themselves or a sibling, to be sexually active, to have had an STI, to have been pregnant, and to be infected with HIV. Paternal orphans were more likely to have ever been homeless and to be out of school. Findings suggest that maternal care and support is important for HIV prevention. This finding corroborates previous research in Zimbabwe and has implications for intervention strategies among orphan girls.
13. The sexual and reproductive health of young people in Latin America: evidence from WHO case studies. Kostrzewa K. Salud Publica Mex 2008;50(1).
This article explains the importance of studies that address the sexual and reproductive health of young people in developing countries. It provides an overview of sexual and reproductive health issues in Latin America and a discussion of these issues in three study countries. The full text (PDF, 7 pages, 181 KB, or HTML) of the article is available online.
14. Sexual behaviour and contraceptive usage of secondary school adolescents in Ibadan, Nigeria. Oladokun A, Morhason-Bello IO, Enakpene CA, et al. J Reprod Contracept 2007;18(4).
A descriptive cross-sectional study was conducted among selected senior secondary school students in Ibadan, following a stratified multistage random sampling technique. There were 695 respondents out of which females constituted 51% and males 49%. Less than one third (28.3%) of the respondents had previous sexual exposure at the time of the study. The median age of sexual debut among the sexually exposed was 15 years in both males and females. Bivariate analysis of sociodemographic characteristics of respondents with previous sexual exposure showed that sex, religion, father's and mother's educational background, and level of class were statistically significant(P < 0.001). Further analysis using logistic regression model revealed that male respondents were three times more likely than females (95% CI 1.92 -4.56) to have had sexual experience, while those whose mother had tertiary educational background were less likely to have had previous sexual experience compared with those with secondary and lower educational back-ground (OR = 1.76, 95% CI 1.11-2.77). Less than half of the sexually active males (44.2%) were using various methods of contraception, while 54.4% of the sexually active females were using different types of modern methods. The authors conclude that risky sexual behaviors are in practice among the secondary school students studied and by extension in the country.
15. A systematic review of school-based sexual health interventions to prevent STI/HIV in sub-Saharan Africa. Paul-Ebhohimhen VA, Poobalan A, van Teijlingen ER. BMC Public Health 2008;8(Article No. 4).
The authors conducted a focused, systematic review of school-based sexual health interventions in sub-Saharan Africa that were aimed at preventing HIV/AIDS and sexually transmitted infections (STI) among adolescents. Searches were conducted in Medline, Embase, Cinahl, and PsychINFO according to agreed a priori criteria for studies published between 1986 and 2006. Further searches were conducted on the UNAIDS and World Health Organization Web sites, and on the Google search engine. Relevant journals were hand-searched, and references cited in identified articles were followed up. Data extraction and quality assessment was carried out on studies selected for full text appraisal, and results were analyzed and presented in narrative format. Some 1,020 possible titles and abstracts were found, 23 full text articles were critically appraised, and 12 articles (10 studies) reviewed, reflecting the paucity of published studies conducted relative to the magnitude of the HIV epidemic in sub-Saharan Africa. Knowledge and attitude-related outcomes were the most associated with statistically significant change. Behavioral intentions were more difficult to change and actual behavior change was least likely to occur. Behavior change in favor of abstinence and condom use appeared to be greatly influenced by pre-intervention sexual history. The authors conclude that there is a great need in sub-Saharan Africa for well-evaluated and effective school-based sexual health interventions. The full text (PDF, 13 pages, 353 KB) of the article is available online.
16. Traditional values of virginity and sexual behaviour in rural Ethiopian youth: results from a cross-sectional study. Molla M, Berhane Y, Lindtjorn B. BMC Public Health 2008;8(Article No. 9).
This study examined the effect of virginity norm on having sex before marriage and sexual behavior after marriage among rural Ethiopian youth. The authors did a cross-sectional survey in 9 rural areas and 1 urban area using a probabilistic sample of 3,743 youth, 15-24 years of age. Univariate analysis was used to assess associations between virginity norm and gender stratified by area, and between sexual behavior and marital status. They applied Kaplan-Meier and Cox regression analysis to estimate age at sexual debut and assessed the predictors of premarital sex among the never-married using SPSS. The authors found that maintaining virginity is still a way of securing marriage for girls, especially in rural areas; the odds of marrying and intention to marry a virgin among boys were three to four times higher among rural young males. As age increased, the likelihood of remaining a virgin decreased. There was no significant difference between married and unmarried young people in terms of number of partners and visiting commercial sex workers. Although virginity norms help delay age at sexual debut among rural Ethiopian youth, and thus reduce vulnerability to sexually transmitted infections and HIV infection, vulnerability among females may increase after marriage due to unprotected multiple risky sexual behaviors by spouses. The use of preventive services, such as VCT before marriage and condom use in marriage should be part of the HIV/AIDS prevention and control strategies. The full text (PDF, 10 pages, 336 KB) of the article is available online.
17. Transtheoretical model and risky sexual behaviour in HIV + youth in Thailand. Naar-King S, Rongkavilit C, Wang B, Wright K, et al. AIDS Care 2008;20(2).
Questionnaires and interviews about sexual behavior, readiness to change, self-efficacy, substance use, emotional distress, and social support were obtained from 70 HIV+ Thai youth (ages 17 to 25). Path analysis suggested the model was an excellent fit with the data. Readiness to change but not self-efficacy was directly related to unprotected intercourse acts. This differed from HIV+ youth in the U.S., where self-efficacy fully mediated the relationship between readiness to change and condom use. In the Thai sample, social support and self-efficacy were indirectly related to unprotected intercourse through stage of change. Substance use was unrelated to unprotected intercourse, but rates of use were low. Potential cultural differences in the construct of self-efficacy and its relationship to risky behaviors in Thailand require further study. However, results highlight the potential of prevention interventions that increase readiness to change through boosting self-efficacy and social support specific to practicing safer sex while addressing mental health concerns.
18. "You must do the test to know your status": attitudes to HIV voluntary counseling and testing for adolescents among South African youth and parents. MacPhail CL, Pettifor A, Coates T, et al. Health Educ Behav 2008;35(1).
Focus group discussions were held with adolescents and parents in two South African townships to establish the perceptions of and needs for voluntary counseling and testing (VCT) among young people. Ecological theory informed the analysis. Adolescents had limited experience of VCT, were afraid of knowing their HIV status, and felt that testing was only for symptomatic individuals. Youth felt that they would disclose their HIV status to family members who they felt would be most supportive. Youth were afraid of stigma and discrimination, rarely referring to the community as a source of support. Discussions highlighted the inappropriateness of clinical facilities for youth VCT. The authors conclude with recommendations for youth-friendly VCT services.
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