RESUMO
Providing adolescents with evidence-based sexual risk reduction interventions is critical to addressing the HIV/AIDS epidemic among adolescents in sub-Saharan Africa. Project AIM (Adult Identity Mentoring) is an innovative, evidence-based, youth development intervention that is being evaluated for the first time in Botswana through a 3-year (2015-2017), 50-school cluster randomized controlled trial, including testing for herpes simplex virus type 2 as a sexual activity biomarker. Conducting a trial of this magnitude requires the support and collaboration of government and community stakeholders. All school staff, including teachers, must be well informed about the study; dedicated staff placed at each school can help to improve school and community familiarity with the study, improve the information flow, and relieve some of the burden study activities places on schools.
Assuntos
Participação da Comunidade/métodos , Infecções por HIV/prevenção & controle , Educação Sexual/organização & administração , Adolescente , Botsuana , Criança , Feminino , Herpesvirus Humano 2/isolamento & purificação , Humanos , Capacitação em Serviço/organização & administração , Masculino , Avaliação de Programas e Projetos de Saúde , Assunção de Riscos , Comportamento SexualRESUMO
OBJECTIVES: The past decade has seen changes in US HIV policy in sub-Saharan Africa in response to a new Administration and far-reaching technical, scientific and programmatic developments. These include: dramatically increased access to life-saving ART and related services; the roll-out of voluntary medical male circumcision; and growing sensitivity to gender-based violence, including child sexual abuse, and to its role in increasing vulnerability to HIV. The Families Matter! Program (FMP) is an intervention for parents and caregivers of 9-12 year-olds that promotes effective parent-child communication about sexuality and sexual risk reduction. FMP was adapted from a US evidence-based intervention in 2003-4 and is now implemented in eight African countries. In 2012-13, the FMP curriculum was updated and enhanced to respond to new US Government priorities. METHODS: Enhancements to the curriculum drew on the results of Violence Against Children surveys, on a review of existing literature, on feedback from the field on the existing curriculum, and on stories written by young people across Africa for scriptwriting competitions. RESULTS: We updated FMP with scientific content and stronger linkages to services. We also intensified our focus on structural determinants of risk. This contextualisation of sexual risk-taking within structural constraints led us to place greater emphasis on gendered vulnerability and the diverse pressures children face, and to intensify our situation-based pedagogical approach, drawing on the authentic youth-authored narratives. CONCLUSION: We describe these changes as an illustration of and source of insight into much-needed programmatic adaptation in response to evolving HIV policy.
RESUMO
A number of studies have examined the association between male involvement in sports and sexual violence (SV) perpetration, especially among college-age males. Less is known about the association between sports involvement and SV perpetration for adolescent males and females. To address this gap, the current study examined sports involvement in middle school (no sports, no/low contact, and high contact) among 1,561 students, who were then followed into high school and asked about the frequency of SV perpetration. Results from logistic regression models indicated that, even after controlling for mother's education, race/ethnicity, SV perpetration in middle school, and traditional beliefs about masculinity and substance use, middle school sports participation was significantly associated with risk of SV perpetration in high school. Compared with youth who reported no sports involvement in middle school, youth categorized as no/low contact sports involvement had greater odds of SV perpetration in high school. Sex differences emerged, revealing that no/low contact sports involvement was associated with SV perpetration for females and high contact sports involvement was associated with SV perpetration for males, compared with no sports involvement. These findings suggest potential opportunities to intervene in middle school to improve coaching practices, enhance respectful relationships, and modify athletes' norms, attitudes, and behaviors to reduce risk for SV perpetration in high school.