Browsing by Subject "Youth"

Now showing 1 - 15 of 15
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    Alternative explanations about HIV and AIDS: re-examining distrust among young adults in Cape Town, South Africa
    (2014-07-31) Rubincam, Clara
    Alternative beliefs about HIV – such as the man-made origins of the virus or the existence of a cure – can undermine trust in and engagement with HIV prevention and treatment initiatives. It is therefore crucial to study the reasons why these beliefs are plausible to some individuals, and how we might better address them in future prevention and treatment campaigns. This study contributes to understanding these beliefs by examining the explanations provided by African respondents in Khayelitsha Township for the plausibility of alternative beliefs about HIV and AIDS. Drawn from a sub-selection of over 2900 respondents to the Cape Area Panel Study, ten focus group discussions (n=47) were held with African men and women from the township of Khayelitsha. Previous studies maintain that the experience of apartheid, of former President Mbeki’s AIDS denialism, and of the unsettling transformations of globalisation have negatively influenced the South African public’s trust in biomedical claims. This paper argues that in addition to these explanations, individuals express distrust about HIV science because certain aspects of these scientific explanations do not ‘add-up’, particularly when considered in light of their everyday observations and experiences. These disjunctures in information do not simply reflect a lack of HIV knowledge or rejection of scientific principles. Rather, in drawing on past and present experiences, individuals demonstrate their commitment to “street-level epistemologies of trust”, an informal manner of empirically engaging with science’s rationale. HIV prevention campaigns should draw on experiential aspects of HIV and AIDS to lend credibility to scientific claims and recognize that some doubts about science are a form of skeptical engagement rather than an outright rejection.
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    Association between breakfast frequency and physical activity and sedentary time: a cross-sectional study in children from 12 countries
    (BioMed Central, 2019-02-21) Zakrzewski-Fruer, Julia K; Gillison, Fiona B; Katzmarzyk, Peter T; Mire, Emily F; Broyles, Stephanie T; Champagne, Catherine M; Chaput, Jean-Philippe; Denstel, Kara D; Fogelholm, Mikael; Hu, Gang; Lambert, Estelle V; Maher, Carol; Maia, José; Olds, Tim; Onywera, Vincent; Sarmiento, Olga L; Tremblay, Mark S; Tudor-Locke, Catrine; Standage, Martyn
    Background Existing research has documented inconsistent findings for the associations among breakfast frequency, physical activity (PA), and sedentary time in children. The primary aim of this study was to examine the associations among breakfast frequency and objectively-measured PA and sedentary time in a sample of children from 12 countries representing a wide range of human development, economic development and inequality. The secondary aim was to examine interactions of these associations between study sites. Methods This multinational, cross-sectional study included 6228 children aged 9–11 years from the 12 International Study of Childhood Obesity, Lifestyle and the Environment sites. Multilevel statistical models were used to examine associations between self-reported habitual breakfast frequency defined using three categories (breakfast consumed 0 to 2 days/week [rare], 3 to 5 days/week [occasional] or 6 to 7 days/week [frequent]) or two categories (breakfast consumed less than daily or daily) and accelerometry-derived PA and sedentary time during the morning (wake time to 1200 h) and afternoon (1200 h to bed time) with study site included as an interaction term. Model covariates included age, sex, highest parental education, body mass index z-score, and accelerometer waking wear time. Results Participants averaged 60 (s.d. 25) min/day in moderate-to-vigorous PA (MVPA), 315 (s.d. 53) min/day in light PA and 513 (s.d. 69) min/day sedentary. Controlling for covariates, breakfast frequency was not significantly associated with total daily or afternoon PA and sedentary time. For the morning, frequent breakfast consumption was associated with a higher proportion of time in MVPA (0.3%), higher proportion of time in light PA (1.0%) and lower min/day and proportion of time sedentary (3.4 min/day and 1.3%) than rare breakfast consumption (all p ≤ 0.05). No significant associations were found when comparing occasional with rare or frequent breakfast consumption, or daily with less than daily breakfast consumption. Very few significant interactions with study site were found. Conclusions In this multinational sample of children, frequent breakfast consumption was associated with higher MVPA and light PA time and lower sedentary time in the morning when compared with rare breakfast consumption, although the small magnitude of the associations may lack clinical relevance. Trial registration The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) is registered at (Identifier NCT01722500 ).
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    Comparison of the EQ-5D-Y-5L, EQ-5D-Y-3L and PedsQL in children and adolescents
    (2022-06-16) Verstraete, Janine; Scott, Des
    Background There is an increased use of Patient-Reported Outcome Measures (PROMs) in children and adolescents. The aim of this study was to compare the feasibility, concurrent validity and known-group validity of the EQ-5D-Y-3L (Y-3L), EQ-5D-Y-5L (Y-5L) and PedsQL self-report PROMs. Methods Five hundred and fifty children and adolescents, aged 8–15-years, with acute and chronic health conditions and a general population sample were recruited from schools and hospitals in Cape Town South Africa. All respondents self-completed the Y-5L, PedsQL, Self-Rated Health Question and Y-3L. Feasibility of the measures was determined by comparing the number of missing responses. Convergent validity was assessed by Spearman’s and Intra-class correlations on the corresponding items and summary scores respectively. Known-groups validity across health conditions was assessed across the summary scores of the measures with analysis of variance (ANOVA). Results The Y-3L and Y-5L had a total of 1% and 3.5% missing responses compared to 19% on the PedsQL. Similar items on the PedsQL and Y-3L/Y-5L showed high correlations (> 0.5) and related items showed moderate correlations (0.3). PedsQL total score was moderately and significantly associated with Y-3L and Y-5L level sum and VAS scores. The Y-3L and Y-5L level sum and VAS scores showed significant differences between known health groups whereas the PedsQL only showed differences between those with acute and chronic illness. Conclusion The results of this study show that the Y-3L and Y-5L showed comparable psychometric validity to the PedsQL. When considering the choice between the PedsQL, Y-5L and Y-3L these study results indicate that the EQ-5D-Y instruments (Y-3L and Y-5L) are recommended for studies assessing known-group validity or where missing data should be minimised. The PedsQL generic measure may be preferable in future studies including the general population where a ceiling effect is anticipated. When considering the choice between the Y-5L and the Y-3L there was no systematic difference in the validity between these instruments or between the Y-3L or Y-5L and the PedsQL. Thus, the selection of EQ-5D-Y measures to include in future studies should be guided by the characteristics of the population to be tested.
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    Duration of unemployment in youth transitions from schooling to work in Cape Town
    (2017-06-06) Mlatsheni, Cecil; Leibbrandt, Murray
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    Factors affecting how the youth in the townships use internet to seek employment: case of a township in Cape Town
    (2019) Kunene, Khaya; Chigona, Wallace
    Problem Statement: South Africa is currently facing a challenge of youth unemployment. The hardest hit are those from low income communities, as they in addition have limited access to information. The Internet has proven to be one of the ways in which recruitment is done and failure to access reduces the opportunities. The purpose of the research: The main objective of this study was to understand how the youth living in the townships use the Internet to seek for employment. The purpose of this study is to assess how the Internet use affect the youth when searching for employment. Design/methodology/ approach: An interpretivist approach was employed to understand how the youth seek employment. This study used a qualitative approach to collect the data. Interviews were done using semi-structured questions. Alampay (2006) Capability Approach (CA) was used as a guide to conceptualise how the youth from low-income communities use the Internet to find employment. Borrowing from the four main constructs (conversion factors, freedom, capabilities and functionings) employed by Alampay (2006) in his model, this study operationalised the Alampay (2006) CA model by adding the ICT commodities as the fifth construct. The CA was chosen as an appropriate framework for this study because the framework focuses on what humans are able to do and achieve when presented with the available ICT resources. Findings: The findings demonstrate that the lack of resources, income, information and digital skills affected the individual capabilities to effectively use the Internet when seeking employment. The success rate in finding a job using the Internet was low among job seekers. Commodities, individual differences, social and environmental factors affected how the youth (18-34 years) from low-income communities use the Internet to find employment. In addition, crime, poor network coverage, expensive data bundles and limited access to ICT resources were among the key factors that contributed to limited use of the Internet among job seekers. Research Contribution: This study seeks to close the gap in limited knowledge available in developing countries with regards to the use of the Internet among job seekers. Therefore, based on the study findings, this thesis has contributed towards adding value to the body of knowledge within the field of Information Systems. In addition, the findings can contribute towards assisting policy makers in solving challenges faced by the unemployment youth in developing countries when using technology to find employment.
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    HIV/AIDS risk perceptions and first sexual intercourse among youth in Cape Town, South Africa
    (2007) Anderson, Kermyt G; Beutel, Ann M; Brendan, Maughan-Brown
    HIV prevalence is high among South African youth. Health behavior models posit that perceived risk of HIV/AIDS is associated with HIV/AIDS risk behaviors, but research in sub-Saharan Africa that has considered the predictors of HIV/AIDS risk perceptions and behaviors or the relationship between them has been limited. Longitudinal data collected in 2002 and 2005 from 3,025 black, coloured, and white youth aged 14-22 (in 2002) in Cape Town, South Africa were analyzed using multivariate regression to examine correlates of perceived HIV/AIDS risk and one HIV/AIDS risk behavior, transition to first sex. Independent variables taken from the 2002 survey were used to predict dependent variables taken from the 2005 survey. Results indicate that most respondents viewed themselves at no risk or small risk of HIV infection. Perceived risk of HIV/AIDS was positively associated with having had sex and knowing somebody with HIV/AIDS. Among those who were virgins in 2002, perceived HIV/AIDS risk and knowing somebody with HIV/AIDS predicted entry into first sex by 2005 for females only. The effects of race on risk perceptions also varied by gender. In conclusion, HIV/AIDS education and prevention programs should consider more carefully how gender and race may intersect to influence risk perceptions and risk behaviors. The reciprocal relationship between risk perceptions and risk behaviors should also be considered in education and intervention programs.
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    Linking poverty and income shocks to risky sexual behaviour: evidence from a panel study of young adults in Cape Town
    (2008) Dinkelman, Taryn; Lam, David; Leibbrandt, Murray
    Is there a link between household income and income stress, and risky sexual behaviour of young people? Anecdotal and qualitative evidence suggests this may be the case, but there is little quantitative research measuring this relationship. We use two waves of new data from the Cape Area Panel Study to investigate this link for 2,993 African and coloured youths aged 14 to 22 in 2002. In the process, we discuss one type of research design that could allow for a causal interpretation of the effect of income poverty on HIV risk. This design plausibly separates out the effect of income stress from the effect of living in a poor household by comparing behaviours across households with and without negative economic shocks, conditional on baseline income. Our results indicate that females in poorer households are more likely to be sexually active in 2002 and more likely to sexually debut by 2005. In addition, girls in households experiencing negative economic shocks are more likely to reduce condom use between 2002 and 2005. However, they are less likely to have multiple partners in 2002 or have transitioned to multiple partners by 2005. Males who experienced a negative shock are more likely to have multiple partners. Despite the tight research design for assessing shocks, the findings on the impacts of shocks do not generate clear recommendations for policy. There appears to be no systematic difference in condom use at last sex by household income levels or income shocks.
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    Measurement properties and responsiveness of the EQ-5D-Y-5L compared to the EQ-5D-Y-3L in children and adolescents receiving acute orthopaedic care
    (2022-02-17) Verstraete, Janine; Marthinus, Zara; Dix-Peek, Stewart; Scott, Des
    Objective The aim of this study is a head-to-head comparison of the instrument performance and responsiveness of the EQ-5D-Y-3L and the expanded English version of the EQ-5D-Y-5L in children/adolescents receiving acute orthopaedic management in South Africa. Methods Children/adolescents aged 8–15 years completed the EQ-5D-Y-5L, EQ-5D-Y-3L, self-rated health (SRH) question and PedsQL at baseline. The EQ-5D-Y-5L, EQ-5D-Y-3L and SRH question were repeated after 24 and 48 h. Performance of the EQ-5D-Y-5L and EQ-5D-Y-3L was determined by comparing feasibility (missing responses), redistribution of dimensions responses, discriminatory power, concurrent validity, and responsiveness. Results Eighty-three children/adolescents completed baseline measures and seventy-one at all three time-points. Reporting of 11111 decreased by 20% from the EQ-5D-Y-3L to the EQ-5D-Y-5L. Informativity of dimensions improved on average by 0.267 on the EQ-5D-Y-5L with similar evenness. There was a range of 11–27% inconsistent responses when moving from the EQ-5D-Y-3L to the EQ-5D-Y-5L. There was a low to moderate and significant association on the EQ-5D-Y-3L and EQ-5D-Y-5L to similar items on the PedsQL and SRH scores. Percentage change over time was greater for the EQ-5D-Y-5L (range 0–182%) than EQ-5D-Y-3L (range 0–100%) with the largest reduction for both measures between 0 and 48 h. For those who respondents who showed an improved SRH the EQ-5D-Y-5L and EQ-5D-Y-3L showed significant paired differences. Conclusion The English version of the EQ-5D-Y-5L appears to be a valid and responsive extension of the EQ-5D-Y-3L for children receiving acute orthopaedic management. The expanded levels notably reduce the ceiling effect and has greater discriminatory power. Concurrent validity of the EQ-5D-Y-3L and EQ-5D-Y-5L was low to moderate with similar PedsQL items and SRH. The EQ-5D-Y-5L generally showed greater change than the EQ-5D-Y-3L across all dimensions with the greatest change observed for 0–48 h. Responsiveness was comparable across the EQ-5D-Y-3L and EQ-5D-Y-5L for those with improved SRH. Greater sensitivity to change may be observed on comparison of utility scores, once preference-based value sets are available for the EQ-5D-Y-5L.
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    Measuring multidimensional poverty among youth in South Africa at the sub-national level
    (2017-06-06) Frame, Emily; De Lannoy, Ariane; Leibbrandt, Murray
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    Missed opportunities for NCD multimorbidity prevention in adolescents and youth living with HIV in urban South Africa
    (2020-06-01) Kamkuemah, Monika; Gausi, Blessings; Oni, Tolu
    Abstract Background Epidemiological transition in high HIV-burden settings is resulting in a rise in HIV/NCD multimorbidity. The majority of NCD risk behaviours start during adolescence, making this an important target group for NCD prevention and multimorbidity prevention in adolescents with a chronic condition such as HIV. However, there is data paucity on NCD risk and prevention in adolescents with HIV in high HIV-burden settings. The aim of this study was to investigate the extent to which NCD comorbidity (prevention, diagnosis, and management) is incorporated within existing adolescent HIV primary healthcare services in Cape Town, South Africa. Methods We reviewed medical records of 491 adolescents and youth living with HIV (AYLHIV) aged 10–24 years across nine primary care facilities in Cape Town from November 2018–March 2019. Folders were systematically sampled from a master list of all AYLHIV per facility and information on HIV management and care, NCDs, NCD risk and NCD-related health promotion extracted. Results The median age was 20 years (IQR: 14–23); median age at ART initiation 18 years (IQR: 6–21) and median duration on ART 3 years (IQR: 1.1–8.9). Fifty five percent of participants had a documented comorbidity, of which 11% had an NCD diagnosis with chronic respiratory diseases (60%) and mental disorders (37%) most common. Of those with documented anthropometrics (62%), 48% were overweight or obese. Fifty nine percent of participants had a documented blood pressure, of which 27% were abnormal. Twenty-six percent had a documented health promoting intervention, 42% of which were NCD-related; ranging from alcohol or substance abuse (13%); smoking (9%); healthy weight or diet (9%) and mental health counselling (10%). Conclusions Our study demonstrates limited NCD screening and health promotion in AYLHIV accessing healthcare services. Where documented, our data demonstrates existing NCD comorbidity and NCD risk factors highlighting a missed opportunity for multimorbidity prevention through NCD screening and health promotion. Addressing this missed opportunity requires an integrated health system and intersectoral action on upstream NCD determinants to turn the tide on the rising NCD and multimorbidity epidemic.
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    Sexual health in relation to religious beliefs: perceptions of young women living in Khayelitsha
    (2019) Perera, Shehani; Swartz, Alison
    South Africa continues to have the highest HIV-prevalence in the world, in addition to other sexual health-related issues. A vast majority of its population is also religiously affiliated with Christianity. This study sought to understand how young women living in Khayelitsha experience the relationship between sexual health and religion within the context of uncertainty and socio-economic deprivation. How their sexual health-decision making unfolds given the tensions that arise between religious expectations and socio-economic realities and how they perceive the partnership between religious organisations and public health facilities offering sexual health services was also explored. Data collection consisted of ethnographic field notes, 11 semistructured interviews and 3 focus group discussions with 6 people in each group. Data were then analysed using a thematic analysis approach. The findings reveal that young women experience the tension between religious expectations and their socio-economic realities through the “moral dichotomisation of right and wrong” and that this, in addition to the ‘dynamics of hypervulnerability’ consisting of gender inequalities and economic vulnerability, leads to a sense of lacking control over sexual health decision-making. The call for church involvement in sexual health-related matters reveals a deeper desire for various forms of support as they transition to adulthood in the context of uncertainty and socio-economic marginalisation. The article argues that young people navigating uncertainty and dealing with the complexities of transitioning to adulthood may perceive religion and the church to play the role of a custodian in sexual health issues, however, expectations of the church are difficult to live up to and sit in tension with socio- economic realities. Thus, a division of duties between religious organisations and public health facilities should be established to strengthen sexual health promotion and prevention efforts.
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    South Africa’s youth and political participation, 1994-2014
    (2014-07-09) Mattes, Robert; Richmond, Samantha
    South Africans hold – often simultaneously – contradictory beliefs about young people and politics. On one hand, driven largely by a romanticized memory of Soweto and the street battles of the 1980s, many people see the youth as the primary catalyst of activism and political change. On the other hand, driven by continuing media depictions of youth unemployment, township protests and the antics of the ANC Youth League, a wide range of commentators routinely experience “moral panics” about the apparent “crisis” of the youth and their corrosive effect on the country’s political culture. In this report, we review a wide range of longitudinal survey data spanning the first two decades of democracy and find that there are indeed a series of real problems with South Africa’s political culture, particularly in the area of citizenship. At the same time, these data clearly show that these problems are largely not peculiar to young people. Across a range of different indicators, we find consistently that there are no, or relatively minor, age profiles to most dimensions of South African political culture.
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    The CombinADO study to assess the impact of a combination intervention strategy on viral suppression, antiretroviral therapy adherence, and retention in HIV care among adolescents and young people living with HIV: protocol for a cluster-randomized controlled trial
    (BioMed Central, 2021-12-27) Mogoba, Phepo; Lesosky, Maia; Zerbe, Allison; Falcao, Joana; Mellins, Claude A; Desmond, Christopher; Arnaldo, Carlos; Kapogiannis, Bill; Myer, Landon; Abrams, Elaine J
    Background Adolescents and youth living with HIV (AYAHIV) have worse HIV outcomes than other age groups, particularly in sub-Saharan Africa (SSA). AYAHIV in SSA face formidable health system, interpersonal- and individual-level barriers to retention in HIV care, uptake of ART, and achievement of viral suppression (VS), underscoring an urgent need for multi-component interventions to address these challenges. This cluster-randomized control trial (cRCT) aims to evaluate the effectiveness and monitor implementation of a community-informed multi-component intervention (“CombinADO strategy”) addressing individual-, facility-, and community-level factors to improve health outcomes for AYAHIV. Methods This trial will be conducted in 12 clinics in Nampula Province, Northern Mozambique. All clinics will implement an optimized standard of care (control) including (1) billboards/posters and radio shows, (2) healthcare worker (HCW) training, (3) one-stop adolescent and youth-friendly services, (4) information/motivation walls, (5) pill containers, and (6) tools to be used by HCW during clinical visits. The CombinADO strategy (intervention) will be superadded to control conditions at 6 randomly selected clinics. It will include five additional components: (1) peer support, (2) informational/motivational video, (3) support groups for AYAHIV caregivers, (4) AYAHIV support groups, and (5) mental health screening and linkage to adolescent-focused mental health support. The study conditions will be in place for 12 months; all AYAHIV (ages 10–24 years, on ART) seeking care in the participating sites will be exposed to either the control or intervention condition based on the clinic they attend. The primary outcome is VS (viral load < 50 copies/mL) at 12 months among AYAHIV attending participating clinics. Secondary outcomes include ART adherence (self-reported and TDF levels) and retention in care (engagement in the preceding 90 days). Uptake, feasibility, acceptability, and fidelity of the CombinADO strategy during implementation will be measured. Trial outcomes will be assessed in AYAHIV, caregivers, healthcare workers, and key informants. Statistical analyses will be conducted and reported in line with CONSORT guidelines for cRCTs. Discussion The CombinADO study will provide evidence on effectiveness and inform implementation of a novel community-informed multi-component intervention to improve retention, adherence, and VS among AYAHIV. If found effective, results will strengthen the rationale for scale up in SSA. Trial registration ClinicalTrials.gov NCT04930367 . Registered on 18 June 2021