Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa.
<h4>Background</h4>Evidence on sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa is urgently needed. This systematic review synthesizes the extant research on prevalence, factors associated with, and interventions to reduce sexual risk-taking among HIV-pos...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2017-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0178106 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850168997477089280 |
|---|---|
| author | Elona Toska Marija Pantelic Franziska Meinck Katharina Keck Roxanna Haghighat Lucie Cluver |
| author_facet | Elona Toska Marija Pantelic Franziska Meinck Katharina Keck Roxanna Haghighat Lucie Cluver |
| author_sort | Elona Toska |
| collection | DOAJ |
| description | <h4>Background</h4>Evidence on sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa is urgently needed. This systematic review synthesizes the extant research on prevalence, factors associated with, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa.<h4>Methods</h4>Studies were located through electronic databases, grey literature, reference harvesting, and contact with researchers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Quantitative studies that reported on HIV-positive participants (10-24 year olds), included data on at least one of eight outcomes (early sexual debut, inconsistent condom use, older partner, transactional sex, multiple sexual partners, sex while intoxicated, sexually transmitted infections, and pregnancy), and were conducted in sub-Saharan Africa were included. Two authors piloted all processes, screened studies, extracted data independently, and resolved any discrepancies. Due to variance in reported rates and factors associated with sexual risk-taking, meta-analyses were not conducted.<h4>Results</h4>610 potentially relevant titles/abstracts resulted in the full text review of 251 records. Forty-two records (n = 35 studies) reported one or multiple sexual practices for 13,536 HIV-positive adolescents/youth from 13 sub-Saharan African countries. Seventeen cross-sectional studies reported on individual, relationship, family, structural, and HIV-related factors associated with sexual risk-taking. However, the majority of the findings were inconsistent across studies, and most studies scored <50% in the quality checklist. Living with a partner, living alone, gender-based violence, food insecurity, and employment were correlated with increased sexual risk-taking, while knowledge of own HIV-positive status and accessing HIV support groups were associated with reduced sexual risk-taking. Of the four intervention studies (three RCTs), three evaluated group-based interventions, and one evaluated an individual-focused combination intervention. Three of the interventions were effective at reducing sexual risk-taking, with one reporting no difference between the intervention and control groups.<h4>Conclusion</h4>Sexual risk-taking among HIV-positive adolescents and youth is high, with inconclusive evidence on potential determinants. Few known studies test secondary HIV-prevention interventions for HIV-positive youth. Effective and feasible low-cost interventions to reduce risk are urgently needed for this group. |
| format | Article |
| id | doaj-art-aeacdf5abcbd46b99fa44ea254055273 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-aeacdf5abcbd46b99fa44ea2540552732025-08-20T02:20:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01126e017810610.1371/journal.pone.0178106Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa.Elona ToskaMarija PantelicFranziska MeinckKatharina KeckRoxanna HaghighatLucie Cluver<h4>Background</h4>Evidence on sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa is urgently needed. This systematic review synthesizes the extant research on prevalence, factors associated with, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa.<h4>Methods</h4>Studies were located through electronic databases, grey literature, reference harvesting, and contact with researchers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Quantitative studies that reported on HIV-positive participants (10-24 year olds), included data on at least one of eight outcomes (early sexual debut, inconsistent condom use, older partner, transactional sex, multiple sexual partners, sex while intoxicated, sexually transmitted infections, and pregnancy), and were conducted in sub-Saharan Africa were included. Two authors piloted all processes, screened studies, extracted data independently, and resolved any discrepancies. Due to variance in reported rates and factors associated with sexual risk-taking, meta-analyses were not conducted.<h4>Results</h4>610 potentially relevant titles/abstracts resulted in the full text review of 251 records. Forty-two records (n = 35 studies) reported one or multiple sexual practices for 13,536 HIV-positive adolescents/youth from 13 sub-Saharan African countries. Seventeen cross-sectional studies reported on individual, relationship, family, structural, and HIV-related factors associated with sexual risk-taking. However, the majority of the findings were inconsistent across studies, and most studies scored <50% in the quality checklist. Living with a partner, living alone, gender-based violence, food insecurity, and employment were correlated with increased sexual risk-taking, while knowledge of own HIV-positive status and accessing HIV support groups were associated with reduced sexual risk-taking. Of the four intervention studies (three RCTs), three evaluated group-based interventions, and one evaluated an individual-focused combination intervention. Three of the interventions were effective at reducing sexual risk-taking, with one reporting no difference between the intervention and control groups.<h4>Conclusion</h4>Sexual risk-taking among HIV-positive adolescents and youth is high, with inconclusive evidence on potential determinants. Few known studies test secondary HIV-prevention interventions for HIV-positive youth. Effective and feasible low-cost interventions to reduce risk are urgently needed for this group.https://doi.org/10.1371/journal.pone.0178106 |
| spellingShingle | Elona Toska Marija Pantelic Franziska Meinck Katharina Keck Roxanna Haghighat Lucie Cluver Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa. PLoS ONE |
| title | Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa. |
| title_full | Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa. |
| title_fullStr | Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa. |
| title_full_unstemmed | Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa. |
| title_short | Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa. |
| title_sort | sex in the shadow of hiv a systematic review of prevalence risk factors and interventions to reduce sexual risk taking among hiv positive adolescents and youth in sub saharan africa |
| url | https://doi.org/10.1371/journal.pone.0178106 |
| work_keys_str_mv | AT elonatoska sexintheshadowofhivasystematicreviewofprevalenceriskfactorsandinterventionstoreducesexualrisktakingamonghivpositiveadolescentsandyouthinsubsaharanafrica AT marijapantelic sexintheshadowofhivasystematicreviewofprevalenceriskfactorsandinterventionstoreducesexualrisktakingamonghivpositiveadolescentsandyouthinsubsaharanafrica AT franziskameinck sexintheshadowofhivasystematicreviewofprevalenceriskfactorsandinterventionstoreducesexualrisktakingamonghivpositiveadolescentsandyouthinsubsaharanafrica AT katharinakeck sexintheshadowofhivasystematicreviewofprevalenceriskfactorsandinterventionstoreducesexualrisktakingamonghivpositiveadolescentsandyouthinsubsaharanafrica AT roxannahaghighat sexintheshadowofhivasystematicreviewofprevalenceriskfactorsandinterventionstoreducesexualrisktakingamonghivpositiveadolescentsandyouthinsubsaharanafrica AT luciecluver sexintheshadowofhivasystematicreviewofprevalenceriskfactorsandinterventionstoreducesexualrisktakingamonghivpositiveadolescentsandyouthinsubsaharanafrica |