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The dynamics of HIV transmission in out of school young heterosexual men in South Africa: a systematic scoping review protocol.

ABSTRACT: In South Africa, gender inequality dominated by males and heterosexual HIV epidemic are associated with high HIV infection. Underlying epidemiological and social determinants driving HIV acquisition and transmission are critical to understand the extent and complexity of sexual networks as primary mechanisms through which HIV is likely to spread. The aim of the study is to provide an overview of empiric evidence that links the complex interaction of risk of HIV infection in men.We will conduct a systematic scoping review to identify, describe, and map literature on the dynamics of HIV infection in men, and we will determine the quality of the studies reporting on the dynamics of HIV infections in men. Primary research articles, published in peer-reviewed journals, review articles, and gray literature that address the research question, will be included. We will search PubMed, Web of Knowledge, Science Direct, EBSCOhost, Google Scholar, World Health Organization library, and UNAIDS database. Reference lists and existing networks such as government organizations and conferences will also be included to source relevant literature. Two independent reviewers will extract data in parallel from all relevant search engines, using specific inclusion and exclusion criteria. A thematic content analysis will be used to present the narrative account of the reviews, using NVivo version 10.We anticipate finding relevant literature on the dynamics of HIV transmission in South African men. Once summarized, data will be useful to guide future research.PROSPERO CRD42016039489.

SUBMITTER: Ntombela N

PROVIDER: S-EPMC5240355 | biostudies-other | 2017 Jan

REPOSITORIES: biostudies-other

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The dynamics of HIV transmission in out of school young heterosexual men in South Africa: a systematic scoping review protocol.

Ntombela Nonzwakazi N Mashamba-Thompson Tivani P TP Mtshali Andile A Voce Anna A Kharsany Ayesha B M AB

Systematic reviews 20170117 1

<h4>Background</h4>In South Africa, gender inequality dominated by males and heterosexual HIV epidemic are associated with high HIV infection. Underlying epidemiological and social determinants driving HIV acquisition and transmission are critical to understand the extent and complexity of sexual networks as primary mechanisms through which HIV is likely to spread. The aim of the study is to provide an overview of empiric evidence that links the complex interaction of risk of HIV infection in me ...[more]

PMID: 28095886

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Project description:BackgroundYoung people aged 10-24?years are a vulnerable group with poor health service access relative to other populations. Recent South African initiatives, the She Conquers campaign, the Integrated School Health Policy and the Adolescent & Youth Health Policy, include a focus on improving the breadth and quality of youth-friendly health service delivery. However, in some settings the provision and impact of scaled-up youth friendly health services has been limited indicating a gap between policy and implementation. In this study we reviewed existing sources of data on health service utilisation to answer the following question: 'What health conditions do young people present with and what services do they receive at public health clinics, mobile clinics and school health services?'MethodsWe conducted a retrospective register review in three purposively selected primary healthcare clinics (PHCC), one mobile clinic, and one school health team in Hlabisa and Mtubatuba sub-districts of uMkhanyakude District, KwaZulu-Natal, South Africa. The focus was service utilisation for any reason by 10-24?year olds. We also conducted descriptive analysis of pre-existing data on service utilisation by young people available from the District Health Information System for all 17 PHCC in the study sub-districts.ResultsThree quarters of 4121 recorded young person visits in the register review were by females, and 40% of all young person visits were by females aged 20-24?years. The most common presenting conditions were HIV-related, antenatal care, family planning, general non-specific complaints and respiratory problems (excluding TB). There were relatively few recorded consultations for other common conditions affecting young people such as mental health and nutritional problems. Antibiotics, antiretrovirals, contraceptives, vitamins/supplements, and analgesics were most commonly provided. Routine health registers recorded limited information, were often incomplete and/or inconsistent, and age was not routinely recorded.ConclusionsMeasuring morbidity and service provision are fundamental to informing policy and promoting responsive health systems. Efforts should be intensified to improve the quality and completeness of health registers, with attention to the documentation of important, and currently poorly documented, young people's health issues such as mental health and nutrition.

Project description:BackgroundSuicide is a serious public health problem in low- and middle-income countries. Understanding the context- and gender-specific risk factors for non-fatal suicidal behaviour is the cornerstone of evidence-based public health interventions to reduce suicide. Poverty and symptoms of depression are well established risk factors for suicidal behaviour. However, little is understood about how proximal economic factors (such as losing one's job, or food insecurity) may confound the effects of symptoms of depression to increase the risk of non-fatal suicidal behaviour in vulnerable populations, such as young men living under conditions of endemic poverty. The aim of this study was to explore the extent to which a wide range of poverty-related variables account for non-fatal suicidal behaviour independent of, or in addition to, symptoms of depression among young men living in low-resource communities in South Africa (SA).MethodsData were collected from a clustered sample of 647 young men living in low-resource communities in the Western Cape province of SA. Multivariate regressions were used to identify the associations between poverty-related measures, symptoms of depression, and past-month prevalence of non-fatal suicidal behaviour.ResultsNon-fatal suicidal behaviour in the last month was reported by 47 (6.13%) participants: suicidal ideation (n?=?43; 5.97%); suicide plan (n?=?5; 0.77%); suicide attempt (n?=?4; 0.62%), and deliberate self-harm without intent to die (n?=?4; 0.62%). Past-month prevalence of non-fatal suicidal behaviour was significantly associated with particular dimensions of poverty (living in a home without a toilet on the premises, having previously been fired, and food insecurity), but not with other dimensions of poverty (such as prolonged unemployment and low levels of income). However, symptoms of depression were a more significant predictor of non-fatal suicidal behaviour than any measure of poverty (aOR=1.093, 95% CI=1.058-1.129, p?<?.000).ConclusionsDepressive symptoms are more strongly associated with non-fatal suicidal behaviour than a range of proximal and distal economic factors among young men living under conditions of endemic poverty in South Africa. This has important public health implications and highlights the importance of increasing young men's access to psychiatric services and targeting depression as an integral component of suicide prevention in low resource communities.

Project description:The benefits of school feeding have been well documented. As such, school feeding programs have continuously gained popularity in developing countries. However, challenges and potential opportunities persist, calling for a review of school feeding for long-term sustainability. South Africa has an opportunity to improve their National School Nutrition Program (NSNP) by including an energy-dense snack that would increase the recommended dietary allowance (RDA) of school children to meet at least 25% of their energy requirements. The objective of this scoping review was to conduct a review and an appraisal of studies on snack food development for school feeding programs in Africa. Eligible studies had to report snack development for school feeding programs in Africa. We conducted an electronic search in National Research Foundation (NRF) NEXUS, Elton B. Stephens Company (EBSCO), International Food Information Service (IFIS), Nutrition and Food Sciences Center for Agriculture and Bioscience International (CABI.ORG), and Google Scholar. Of the 429 articles identified, nine studies were included in the final review-five from within South Africa and four from elsewhere in Africa. Data extracted included the study design, intervention, outcomes, relevant findings, and limitations. Results were presented in a narrative summary. The review findings showed that energy-rich staple foods and food fortification were commonly used in snack development. The popular snack products developed included porridges and biscuits. While most studies reported nutritional outcomes, few studies reported on sensory acceptability tests and only two studies conducted a cost analysis. This review of previous snack development initiatives for school feeding programs in Africa underscores the importance of establishing the sustainability of any food product developed. The findings of this review have the potential to inform future snack product development for school feeding programs.

Dataset Information

The dynamics of HIV transmission in out of school young heterosexual men in South Africa: a systematic scoping review protocol.

Publications

The dynamics of HIV transmission in out of school young heterosexual men in South Africa: a systematic scoping review protocol.

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