Human immunodeficiency virus testing and treatment intervention strategies for sub-Saharan African female youth: A systematic review

Merissa V Hawkins, Purdue University

Abstract

Introduction: HIV/AIDS disproportionally impacts adolescent and young adult females in sub-Saharan Africa with roughly 2.8 million individuals living with HIV in this region in 2014. HIV testing is acknowledged by the WHO and UNAIDS as a primary preventative behavior that should be routinely practiced. However, female sub-Saharan youth lack regular access to HIV testing and treatment and encounter barriers to care. The purpose of this systematic review was to examine and summarize strategies to address HIV testing and treatment interventions for adolescent (10-19 years old) and young adult (20-24 years old) females in Sub-Saharan Africa to provide recommendations for future studies and interventions. Method: A systematic review was conducted. In addition, the Theory of Triadic Influence (TTI) was used as a guiding theoretical framework to categorize intervention strategies into each of the three streams of influence: personal, social, and environmental. Further, existing intervention strategies were examined to determine their theoretical foundation. Results: Twelve studies met inclusion criteria. Successful HIV testing interventions worked within all three TTI streams of Influence and included all of the following elements; education, availability of free HIV tests, and youth friendly services through a mobile or established clinic. The presence of theory reported was minimal and present in only half of the interventions (n=6). Social Learning Theory was the most common due to its focus on peer education. Discussion: Interventions needed to properly address multiple TTI streams when designing and implementing their project, specifically in regards to providing free HIV testing in a confidential setting. Testing outcomes also varied between mobile and established clinics, with more female youth taking advantage of home-based mobile clinic tests. Too much focus appeared to be given to the education and self-efficacy aspect of HIV testing, and not so much the actual access to youth-friendly HIV services. In studies where researchers did not specify a theory that was used in intervention implementation, it does not necessarily mean that the intervention did not have any theoretical guidance. Researchers should consider explicitly reporting their use of theory or their reasoning on why theory was not used to guide intervention design and implementation.

Degree

M.P.H.

Advisors

Snyder, Purdue University.

Subject Area

Behavioral psychology|Public health|Sub Saharan Africa Studies|Health education

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