The AIDS and Society Research Unit (ASRU) at the Centre for Social Science Research (CSSR) invites applications for a postdoctoral fellowship for a suitably qualified individual to join a research project on adolescent health in South Africa. For more information please visit www.mzantsiwakho.org.za).
AIDS and Society Research Unit
Elona Toska, CSSR Research Fellow, presented preliminary findings from the Mzantsi Wakho study (led by Dr. Rebecca Hodes at ASRU and Prof. Lucie Cluver at U. of Oxford) at the 20th International Workshop on HIV Observational Databases in Budapest, Hungary on April 7-9, 2016. IWHOD brings together junior and senior researchers from both developed and developing countries working on cohorts of patients with HIV, to present in an informal format their latest findings and work in progress, followed by open discussions on common issues of cohort methodology, techniques and statistics. Elona presented preliminary findings on linkages between social protection and unprotected sex in the Mzantsi Wakho adolescent health study, which is part of her doctoral research. These findings suggest that combinations of interventions are associated with greater reductions in unprotected sex. These effects were even stronger among adolescent girls.
Congratulations to Lesley Gittings for her first peer-reviewed article, which has recently been published in the Journal of Culture, Health and Sexuality. The article, entitled ‘”When you visit a man you should prepare yourself”: male community care worker approaches to working with men living with HIV in Cape Town, South Africa’ is based on her Masters Thesis and was first developed as a CSSR working paper. See: http://www.tandfonline.com/doi/full/10.1080/13691058.2016.1150513
Lesley Gittings has been awarded funding from the National Research Foundation (NRF) under their Innovation scheme (international non-SADC student category) for 2016. The Innovation Doctoral funding instrument is part of the Innovation Bursary Scheme (IBS) funded by the Department of Science and Technology (DST) and managed by the National Research Foundation (NRF). It aims to broaden the frontiers of knowledge in innovation areas and to build the PhD pipeline for a knowledge based economy. The competitive evaluation process is based on academic performance, leadership roles, potential research outputs and impact, and the feasibility and merit of the applicant’s research project proposal.
Rebecca Hodes has published an article in the Journal of Southern African Studies, 42, 1 (2016), pp. 79-93, as part of a special edition on 'South Africa in Transition'. The volume is edited by Jason Robinson, Jonny Steinberg and David Simon. Hodes's article is entitled 'The Culture of Illegal Abortion in South Africa'.
The article is available here, and the abstract is below:
Teenage pregnancy has attracted increasing public censure as a symptom of conspicious consumption and misspent youth. But is it in fact an example of post-apartheid disillusionment? ASRU Director Rebecca Hodes explores the contradictory attitudes held by society – and by the teens themselves. Read more ...
ASRU's director, Rebecca Hodes, has co-authored the first article on findings from the Mzantsi Wakho study, published in AIDS, the most highly-cited journal in HIV research. The Mzantsi Wakho study is a collaboration between the ASRU and Oxford University's Department of Social Policy and Intervention. The research team partners with UNICEF, Paediatric HIV Treatment for Africa, and the National Departments of Health, Basic Education and Social Development, to study how adolescents in the Eastern Cape use HIV treatment and sexual health services. The article presents findings from combined research methods, including longitudinal data, focus groups and direct observations in clinics and leisure spaces, to explore associations between HIV disclosure and adherence to antiretroviral treatment among teenagers in the Eastern Cape.
HIV-positive adolescents who engage in unsafe sex are at heightened risk for transmitting or re-acquiring HIV. Disclosure of HIV-status to sexual partners may impact on condom use, but no large-scale, mixed methods studies have explored the effects of adolescent knowledge of one’s HIV status, knowledge of partner status, and disclosure to partners on safer sex. This study aimed to identify whether knowledge of HIV-status by HIV-positive adolescents and partners was associated with safer sex. 684 HIV-positive adolescents who had ever initiated ART in 39 health facilities in the Eastern Cape, South Africa, were interviewed using standardised questionnaires. Quantitative analyses used multivariate logistic regressions, controlling for confounders. Qualitative research included interviews, focus group discussions and observations with 43 HIV-positive teenagers, and their caregivers and healthcare workers. Knowledge of HIV-status among HIV-positive adolescents was associated with safer sexual practices, but knowing partner’s status and disclosure of HIV-positive status to sexual partners were not. These findings challenge assumptions that disclosure is automatically protective in sexual and romantic relationships for HIV-positive adolescents.
Early adolescents (13-15 years) are an ideal target for preventive interventions targeting healthy sexual and mental behaviors. Engaging families in adolescent prevention is developmentally appropriate for early adolescents (13-15 years). However, few family-based adolescent HIV interventions have been empirically tested in South Africa and few HIV interventions take an integrated HIV-mental health approach.
We describe a set of preliminary studies in South Africa and the existing literature documented the intersections between poor mental health and HIV risk. We then describe preliminary qualitative work conducted to inform the design of a resilience-focused family preventive intervention targeting prevention of adolescent HIV risk and depression. This intervention is derived from the integration and adaptation of two existing best-evidence models for HIV risk reduction and prevention of depression. Adaptation needs were assessed utilizing k=8 focus groups with Xhosa-speaking mixed gender adolescents and parents or guardians and n=25 interviews with HIV and mental health experts. Qualitative data were recorded, transcribed verbatim, translated from Xhosa to English, and analyzed in NVivo using a thematic analysis. Respondents identified social and contextual challenges for HIV prevention including age disparate sexual relationships driven by economic needs, adolescent gang violence, and sexual violence. Respondents described aspects of family interactions that presented both challenges and opportunities for family-based adolescent HIV prevention. Parent-child communication on mental health and sexual topics were taboo, with these conversations perceived as an invitation for children to engage in HIV risk behavior. Parents experienced social sanctions for discussing sex and animosity towards children who asked about sex. However, respondents also identified unique cultural conceptions of family resilience that could be leveraged to increase intervention engagement, including family meetings and communal parenting. Qualitative findings guided alteration of existing intervention content, and the addition of new content, topics, and delivery modalities for South Africa. This included a strengthened emphasis on family resilience; how mental health affects sexual decision making; parental monitoring, positive parenting; and building efficacy around parent-adolescent communication on the topics of sex and mental health are important target foci for a family-based intervention. The adapted family intervention will be tested in a randomized pilot trial in 2015-2016.
Dr Rebecca Hodes is the new Director of the AIDS and Society Research Unit (ASRU), which is one of four research units within the CSSR. Rebecca is the author of Broadcasting the Pandemic: A History of HIV on South African Television HSRC Press, 2014), based on her doctoral thesis (from Oxford), as well as journal articles and book chapters in the field of public health and the history of medicine with a focus on sexual and reproductive rights and the AIDS epidemic. After completing her doctorate she worked for the Treatment Action Campaign (TAC) as manager of the policy, communications and research department, before coming to UCT as a post-doctoral fellow, first in ASRU and then in the Institute for Humanities in Africa (HUMA). In 2013, Rebecca was awarded a grant by the International AIDS Society, as a part of the Collaborative Initiative for Pediatric HIV Education and Research (CIPHER), and she returned to ASRU.
Body maps: 2002&2012
Prevalence of drug-resistant TB is increasing. Treatment regimens have to be taken, typically, for two years and have poor outcomes. Most second-line TB medicines have poor evidence to support their use and are associated with terrible side effects. In 2010, no new class of TB drug had been approved in several decades. Based on the historical examples of campaigns for HIV medicines in the 1980s and 1990s in Europe and the US, the Global TB Community Advisory Board, TAC and other organisations began campaigning for pre-regulatory approval access to an experimental drug called bedaquiline. I will discuss the complex scientific and ethical challenges brought to the fore by this campaign