Batswana Adolescents' Attitudes Toward Sex With Older Adults: Psychometric Properties of the Attitudes Toward Transactional Sex Scale.

A programmatic series of studies developed and evaluated the Attitudes toward Transactional Sex Scale (ATTS) to measure adolescents' attitudes toward engaging in a sexual encounter initiated by an older adult offering desired objects such as cell phone, clothes, cash, or car rides in exchange for sex. Qualitative interviews informed the initial item generation followed by a series of studies assessing the psychometric properties of the measure. Study 1 evaluated the ATTS in a sample of 186 Batswana adolescents and assessed the factor structure, item-to-whole correlations, internal consistency, and convergent validity. In Study 2, the ATTS was administered to a cross-validation sample (N = 387). Confirmatory factor analysis, convergent validity, and internal consistency were consistent with the findings from the original sample. Discriminant validity was also assessed in Study 2. A subset of the sample (N = 119) completed the measure on two occasions and yielded satisfactory test-retest reliability. The resulting instrument appears to have sound psychometric properties and can be used to measure adolescents' attitudes toward accepting such adult sexual initiation that are implicated in the disproportionate burden of HIV among adolescents and young adults in sub-Saharan Africa. No existing measure with known psychometric properties has previously been available.

Perceptions of key participants about Botswana adolescents' risks of unplanned pregnancy, sexually transmitted diseases, and HIV: Qualitative findings.

AIM: The qualitative research findings are reported on the perceptions of key participants in Botswana about adolescent sexuality problems and the feasibility (with suggestions) of an adolescent prevention intervention. METHODS: Twenty adult key participants who were selected through purposive sampling from schools and youth centers responded to open-ended questions during face-to-face individual in-depth interviews that were conducted between December, 2011 and January, 2012 in Gaborone, Botswana. RESULTS: The data were analyzed by using an inductive content analysis. Five major themes and 12 subthemes emerged from the interviews. The key participants discussed situations that exposed adolescents to HIV, sexually transmitted infections, and pregnancy. They also discussed unsafe sexual practices, the consequences of unprotected sex, poor parent-adolescent communication on sexuality, and the need for a sexuality education program. CONCLUSION: Policy changes are needed to improve collaboration between adolescents, parents, teachers, and youth officers in order to address adolescent sexuality problems. Further research is needed to explore the ways in which to improve sexuality communication between these groups. The results of the study provide valuable information on the sexuality risks that expose adolescents to HIV, pregnancy, and sexually transmitted infections and the strategies for the prevention of these risks, thus informing targeted interventions for risk reduction for adolescents.

Development and Psychometric Evaluation of Health Protective Sexual Communication Content Discussed Scale for Young Women in Gaborone, Botswana.

Health protective sexual communication can reduce HIV transmission, but women in Botswana find it difficult because of cultural barriers, suggesting the need for relevant measures. A Health Protective Sexual Communication Content Discussed Scale was developed and tested among young women aged 21-35 years in Gaborone, Botswana, to guide HIV prevention interventions. The project was conducted from June 2006 to August 2007. Literature review, expert advice, and a qualitative pilot guided the process. The scale had 22 items. The content validity index was 97%. Cronbach's alpha was .69. Eight extracted factors included risky sexual behaviors and relationships, sexually transmitted infections, substance abuse, genital health concerns, and safer sex practices. The scale was valid and reliable and therefore useful in future research and interventions.

Motivating HIV positive women to adhere to antiretroviral therapy and risk reduction behavior: the KHARMA Project.

Women comprise the fastest growing group of persons with AIDS. They are often diagnosed later in the disease, when antiretroviral therapy (ART) is strongly indicated. Antiretroviral therapy has transformed the course of HIV/AIDS to a treatable, chronic illness. This article provides a profile of women with HIV/AIDS and describes ART. Selected research related to adherence and motivation is summarized. Psychosocial and economic concerns specific to women, ART, adherence, and motivation are presented. The article reviews challenges for risk reduction behaviors for HIV+ women, such as sexual activity and substance abuse. The authors discuss the Keeping Health and Active with Risk reduction and Medication Adherence (KHARMA) Project, a research project in progress that was designed to promote adherence to both ART and risk reduction behaviors in HIV+ women. The study includes two groups: a motivational group intervention based on motivational interviewing and a health promotion program control group tailored to the needs of HIV+ women. A description of the tailored intervention and project update is included.