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I. PROGRAM RESOURCES
1. 15 and Counting: Advocacy Materials
2. Child and Adolescent Health and Development Progress Report Highlights 2008
3. Introducing and Mainstreaming the Provision of Emergency Contraceptive Pills in Developing Countries
4. Meeting Young Women's Sexual and Reproductive Health Needs in Nigeria
5. More Positive Living: Strengthening the Health Sector Response to Young People Living with HIV
6. Moving Beyond Gender as Usual
7. Promoting and Protecting the Health of Orphans and Vulnerable Children in Monkey Bay, Malawi
8. Rapid Youth Assessment in the Eastern Caribbean
9. A Strategic Approach: HIV & AIDS and Education
10. Travelling Child-Sex Offenders in South East Asia: A Regional Review -- 2007/2008
11. A Turning Tide Among Teenagers? South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2008
II. RESEARCH SUMMARIES
1. Acceptability and reliability of an adolescent risk behavior questionnaire administered with audio and computer support
2. Asset ownership and health and mental health functioning among AIDS-orphaned adolescents: findings from a randomized clinical trial in rural Uganda
3. Characteristics and determinants of sexual behavior among adolescents of migrant workers in Shangai (China)
4. Effectiveness of peer education interventions for HIV prevention in developing countries: a systematic review and meta-analysis
5. Evaluation of HIV/AIDS secondary school peer education in rural Nigeria
6. Factors associated with sexual activity among high-school students in Nairobi, Kenya
7. HIV in adolescents in sub-Saharan Africa
8. Male homosexual identities, relationships, and practices among young men who have sex with men in Vietnam: implications for HIV prevention
9. Prevalence and predictors of HIV infection amongst Malian students
10. Preventive service needs of young people perinatally infected with HIV in Uganda
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I. PROGRAM RESOURCES
1. 15 and Counting: Advocacy Materials (2009, 11 pages, 3.3 MB)
This document describes how individuals and community groups can raise awareness about the 15 and Counting campaign. The campaign focuses on meeting the youth-related goals of the 1994 International Conference on Population and Development. While it specifically focuses on 15 and Counting, the document's principles could be applied to the process of developing an advocacy plan for many other youth projects. Click here to view additional resources.
Organization: 15 and Counting/International Planned Parenthood Federation
Contact: http://www.15andcounting.org/blog/?page_id=11
2. Child and Adolescent Health and Development Progress Report Highlights 2008 (2009, 32 pages, 819 KB)
This report presents highlights of work done in 2008 by the World Health Organization's Department of Child and Adolescent Health and Development. It provides an overview of key achievements in newborn, child, and adolescent health and development at the headquarters, regional, and country levels. It also includes a statistical annex covering key indicators for child health in a selection of countries with high under-five mortality rates, as well as adolescent health profiles for five countries.
Organization: WHO
Contact: cah@who.int
3. Introducing and Mainstreaming the Provision of Emergency Contraceptive Pills in Developing Countries (2009, 33 pages, 616 KB)
This handbook presents a step-by-step process that can help managers of integrated reproductive health programs, health care directors, and policy-makers introduce emergency contraceptive pills in local and national family planning programs. The process is based on research conducted in several developing countries. The handbook also discusses ways to address the needs of special groups, such as adolescents and rape survivors. A CD-ROM of the handbook is also available.
Organization: Population Council
Contact: frontiers@popcouncil.org
4. Meeting Young Women's Sexual and Reproductive Health Needs in Nigeria (2009, 24 pages, 362 KB)
This report assesses the current status of and recent trends in the sexual and reproductive behaviors and health needs of young women aged 15-19 in Nigeria. It also examines social and health policies and programs addressing these needs and highlights the gaps in policies and services.
Organization: Guttmacher Institute
Contact: http://www.guttmacher.org/about/contact.html
5. More Positive Living: Strengthening the Health Sector Response to Young People Living with HIV (2008, 16 pages, 941 KB)
This document is based on the outcome of a WHO/UNICEF consultation that brought together service providers, programmers, and young people living with HIV. The group highlighted the special needs of young people living with HIV and came to consensus about activities the health sector must undertake to meet these needs. The publication is intended for a wide audience, including policy-makers and program staff, and it provides an overview of the challenges confronting young people living with HIV and recommendations for ways to improve treatment, care, support, and prevention services for them.
Organization: WHO
Contact: cah@who.int
6. Moving Beyond Gender as Usual (2009, 94 pages, 1.9 MB)
This document argues that despite well-meaning global strategies and policies, the U.S. President's Emergency Plan for AIDS Relief; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and the World Bank's Africa Multi-Country AIDS Program have not yet been able to address gender inequality in HIV/AIDS programs. The authors urge donors, country governments, and relevant stakeholders to share knowledge and together support a comprehensive international gender analysis.
Organization: Center for Global Development
Contact: http://www.cgdev.org/section/feedback
7. Promoting and Protecting the Health of Orphans and Vulnerable Children in Monkey Bay, Malawi (2009, 33 pages, 555 KB)
This report presents results from participatory reflection and action (PRA) research that focused on coordinating support from service providers and community organizations working to improve the sexual and reproductive health of orphans and vulnerable children in Monkey Bay, Malawi.
Organization: Country Minders for Peoples Development (CMPD), Network for Equity in Health in Southern Africa (EQUINET)
Contact: admin@equinetafrica.org, countryminders@yahoo.com
8. Rapid Youth Assessment in the Eastern Caribbean (2008, 84 pages, 1.28 MB)
The Education Development Center conducted a rapid youth assessment to glean information and strategic ideas from a diverse range of stakeholders about the lives of 15- to 20-year-olds in Antigua, Grenada, St. Kitts, and St. Lucia in July 2008. Across the four islands, researchers interviewed 211 key informants from the private sector, government, nongovernmental organizations, community colleges, and international donor organizations. This report describes regional and country-specific youth programs, and it organizes the assessment's findings into three major sections: (1) a multisectoral analysis of key issues surrounding young people; (2) a supply (youth assets) and demand (key industries and emerging markets) analysis across the four countries; and (3) recommendations for youth strategy development.
Organization: Education Development Center
Contact: http://www.equip123.net/webarticles/anmviewer.asp?a=16&z=47
9. A Strategic Approach: HIV & AIDS and Education (2009, 53 pages, 2.4 MB)
French (55 pages, 2.3 MB)
Spanish (55 pages, 2.3 MB)
This publication provides a strategic vision of the role that education must play in addressing HIV and AIDS. It targets decision-makers and practitioners in the education sector, as well as colleagues who work on HIV and AIDS responses in other sectors. It can be used as an advocacy tool to build commitment to the role of education in the HIV and AIDS response and to generate multisectoral partnerships for implementation.
Organization: UNAIDS Inter-Agency Task Team (IATT) on Education
Contact: info-iatt@unesco.org
10. Travelling Child-Sex Offenders in South East Asia: A Regional Review -- 2007/2008 (2009, 39 pages, 455 KB)
This is the third edition of this compendium of information about the sexual exploitation of children in tourism destinations throughout South East Asia. The report provides a regional overview of child sex tourism in South East Asia along with national reports from all 10 countries in the region. It also provides an update on the successful ASEAN Regional Education Campaign and a brief summary of the key findings from a situational analysis of hotline reporting numbers in the region.
Organization: Child Wise
Contact: office@childwise.net
11. A Turning Tide Among Teenagers? South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2008 (2009, 120 pages, 652 KB)
This report is the third in a series of population-based HIV seroprevalence surveys that started in 2002 and were repeated in 2005 and again in 2008. The survey found that South Africa's HIV epidemic has leveled off at a prevalence of 10.9 percent for people aged two years and older, with 5.2 million people estimated to be living with HIV in 2008. HIV prevalence has also declined among children aged 2-14, from 5.6 percent in 2002 to 2.5 percent in 2008, and a decline in new infections has also been noted among teenagers aged 15-19. But the survey warns that the overall situation remains "dire" since South Africa has the world's largest HIV-positive population.
Organization: Human Sciences Research Council (HSRC)
Contact: http://www.hsrcpress.ac.za/help.php?section=contactus&mode=update
II. RESEARCH SUMMARIES
1. Acceptability and reliability of an adolescent risk behavior questionnaire administered with audio and computer support. Gutierrez JP, Torres-Pereda P. Rev Panam Salud Publica 2009;25(5):418-22.
Answers to sensitive behavior-related questions were obtained using ACASI systems and compared with answers to the same questions obtained through face-to-face interviews (FFIs) among adolescents in Mexico. Focus groups were conducted to explore ACASI's acceptability among adolescents and ACASI's potential for obtaining better self-reported data on sensitive behaviors. ACASI was adolescents' preferred method for reporting risk behaviors, particularly sexual behavior. Also, more risk behaviors were reported through ACASI than FFIs. The authors conclude that using ACASI systems in disadvantaged households to obtain data on adolescent risk behavior is not only feasible but may also improve data quality in the case of complex questionnaires, compared with FFIs.
2. Asset ownership and health and mental health functioning among AIDS-orphaned adolescents: findings from a randomized clinical trial in rural Uganda. Ssewamala FM, Han C-K, Neilands TB. Soc Sci Med 2009;69(2):191-8.
This study evaluated an economic empowerment intervention designed to promote life options, good health, and good mental health among AIDS-orphaned adolescents in rural Uganda. The study used an experimental design in which adolescents (N = 267) were randomly assigned to receive an economic empowerment intervention or usual care for orphaned children. The study measured mental health functioning using 20 items of the Tennessee Self-Concept Scale (TSCS: 2) -- a standardized measure for self-esteem -- and measured overall health using a self-rated health measure. Data obtained at a 10-month follow-up revealed significant positive effects of the economic empowerment intervention on adolescents' self-rated health and mental health functioning. Additionally, health and mental health functioning were found to be positively associated with each other.
3. Characteristics and determinants of sexual behavior among adolescents of migrant workers in Shangai (China). Li S, Huang H, Cai Y, et al. BMC Public Health 2009;9(Article No.195):10 p.
This study assessed the prevalence of sexual behaviors and correlates among the adolescents of migrant workers in China. The authors conducted a cross-sectional study in 10 junior high schools from April to June 2008. A total of 2,821 adolescents aged 14.06 0.93 years participated in the survey (8.9% were children of migrant workers; 91.1% were children of general residents). A self-administrated questionnaire was used to collect information on knowledge, attitude, and behaviors associated with increased risk for HIV/STIs. The percentage of adolescents who ever had sexual intercourse or had sexual intercourse in past three months was 7.2% and 4.3% in adolescents of migrant workers, respectively. In contrast, 4.5% of the children of general residents had ever had sexual intercourse and 1.8% had sexual intercourse in the past three months. Approximately 47% of adolescents of migrant workers and 34% of adolescents of general residents reported no condom use in sexual intercourse during last three months. Multivariate logistic regression analyses found that migration was an independent risk factor for sexual intercourse in last three months in the sampled adolescents. In adolescents of migrant workers, factors such as lower family income, younger age at first sexual intercourse, lower knowledge about HIV/AIDS, and less communication about HIV/AIDS were related to sexual intercourse in last three months. The authors conclude that it is necessary to target adolescents of migrant workers given their higher level of sexual experience, lower socioeconomic status, restricted reproductive health information, and vulnerability to HIV and other STIs.
Click here (10 pages, 246 KB) to access the full text of the article.
4. Effectiveness of peer education interventions for HIV prevention in developing countries: a systematic review and meta-analysis. Medley A, Kennedy C, O'Reilly K, et al. AIDS Educ Prev 2009;21(3):181-206.
The authors conducted a systematic review and meta-analysis of peer education interventions in developing countries published between January 1990 and November 2006. Standardized methods of searching and data abstraction were used. Merged effect sizes were calculated with random effects models. Thirty studies were identified. In meta-analysis, peer education interventions were significantly associated with increased HIV knowledge (odds ratio [OR]: 2.28; 95%, confidence interval [CI]:1.88, 2.75), reduced equipment sharing among injection drug users (OR: 0.37; 95% CI: 0.20, 0.67), and increased condom use (OR: 1.92; 95% CI: 1.59, 2.33). Peer education programs had a nonsignificant effect on sexually transmitted infections (OR: 1.22; 95% CI: 0.88, 1.71). Meta-analysis indicates that peer education programs in developing countries are moderately effective at improving behavioral outcomes but show no significant impact on biological outcomes.
5. Evaluation of HIV/AIDS secondary school peer education in rural Nigeria. van der Maas F, Otte WM. Health Educ Res 2009;24(4):547-57.
The authors assessed whether peer education is an effective method of HIV/AIDS awareness -- in terms of knowledge, misconceptions, and behavior -- among adolescents in rural Nigeria. A comparative case series (n = 250), cross-sectional structured survey (n = 135), and focus group discussions (n = 80) were undertaken among adolescents. In both the case series and structured survey, a questionnaire was used that addressed the following issues: sociodemography, knowledge on transmission and prevention of HIV/AIDS, accessibility to different sources of HIV/AIDS information, stigmatization, and sexual behavior. Binary logistic regression was applied to compare responses from the peer-educated and not peer-educated populations. The model was adjusted for confounders. The authors demonstrated increased knowledge and decreased misconceptions and sexual risk behavior in adolescents receiving peer education as compared to adolescents not receiving peer education. These differences are apparent both over time (2005-2007) and cross-sectionally (2007). In conclusion, peer education in rural areas can be effective in HIV/AIDS prevention. Knowledge and behavior can be influenced positively.
6. Factors associated with sexual activity among high-school students in Nairobi, Kenya. Kabiru CW, Orpinas P. J Adolesc 2009;32(4):1023-39.
This study examined sociodemographic, behavioral, and psychosocial factors associated with heterosexual activity among a sample of 3,556 male and female high school students in Nairobi, Kenya. Approximately 50% of the males and 11% of females reported having had sexual intercourse at least once in their lifetime with a significant proportion reporting multiple sexual partnerships. Sexual activity was associated with various factors including religiosity, perceived parental attitudes towards sex, living arrangements, and school characteristics. However, the pattern of association differed for males and females. Results suggest that adolescents may benefit from sex education programs addressing multiple factors that may predispose adolescents to sexual activity, and that take into account gender differences.
7. HIV in adolescents in sub-Saharan Africa. Cowan F, Pettifor A. Curr Opin HIV AIDS 2009;4(4):288-93.
The authors summarize existing evidence on the effectiveness of different intervention approaches to HIV prevention in adolescents. They focus on studies that are either from or are relevant to sub-Saharan Africa. In addition, they include a brief review of other issues relevant to HIV prevention research in adolescents. Although numerous adolescent behavioral HIV prevention interventions have been evaluated, few have assessed their impact on HIV endpoints or been undertaken in Africa. In the three trials from Africa, which had HIV endpoints, none of the interventions had an impact on HIV, although all affected some knowledge and attitudes and reported behaviors. In one of these trials, there was a borderline effect on herpes simplex virus-2 incidence. Adolescents have typically been excluded from trials of biological interventions, although they are likely to benefit from these interventions if found to be effective. Despite the regulatory difficulties, they must be considered for inclusion in these trials as an important target population.
8. Male homosexual identities, relationships, and practices among young men who have sex with men in Vietnam: implications for HIV prevention. Ngo DA, Ross MW, Phan H, et al. AIDS Educ Prev 2009;21(3):251-65.
This qualitative study examines local identities, relationships, and sexual practices among young men who have sex with men (MSM) aged 15-24 in the cities of Hanoi and Ho Chi Minh City. The analyses were based on 26 in-depth interviews and 10 focus group discussions with young MSM recruited through public place intercepts and cruising areas. Data document the linguistic classification, sexual relationships and behaviors, identity and process of homosexual identification, and the potential linkage between sexual identity and sexual behaviors of MSM in Vietnam.
9. Prevalence and predictors of HIV infection amongst Malian students. White HL, Kristensen S, Coulibaly DM, et al. AIDS Care 2009;21(6):701-7.
The objectives of this cross-sectional study were to assess the prevalence and identify predictors of HIV-1 and HIV-2 infection among students in three cities of Mali. Between January and June 2005, the authors assessed HIV knowledge, attitudes, and associated sexual behaviors and tested HIV serostatus among 950 high school and university students in Sikasso, Bamako, and Koulikoro cities. The authors used a combination of enzyme-linked immunosorbent assay (ELISA) and Western blot testing. Univariate and logistic regression analyses were used to determine predictors of infection among students. Mean HIV prevalence was 3.1%, ranging from 1.8% in Sikasso to 3.6% in Bamako. The results showed the presence of all three HIV subtypes in Bamako, though HIV-1 predominated in all cities. Infection rates were slightly higher among males (3.6%) than among females (2.8%), but the difference was not significant. The single significant predictor of HIV infection was knowledge of HIV routes of transmission (p = 0.01). HIV prevalence rates observed in this population were higher than general adult prevalence rates previously reported for Mali.
10. Preventive service needs of young people perinatally infected with HIV in Uganda. Birungi H, Obare F, Mugisha JF, et al. AIDS Care 2009;21(6):725-31.
This study examines the sexual expressions and experiences as well as the preventive practices of 732 adolescent boys and girls aged 15-19 years who were born with HIV. The data come from a project on the sexuality of young people perinatally infected with HIV conducted in 2007 in four districts of Uganda. The analysis involves both quantitative and qualitative approaches. The quantitative approach entails cross-tabulations with chi-square tests as well as significance tests of proportions. The qualitative approach involves an analysis of individual case stories, in-depth probes, and focus group discussions for content. The findings show disconnect between: (1) the information service providers give to young people and young people's actual needs and desires; (2) adolescents' fears and their actual preventive practices; and (3) the high level of reported condom use and the frequency of use. Programs need to recognize that young people perinatally infected with HIV are sexually active or anticipate being so in future.
