young people

Promising Practices in Integrating HIV and SRH Services for Adolescents and Young People Living with HIV

Evidence shows that adolescents and young people access to comprehensive SRH information and services leads to improved health outcomes. Currently many existing SRH services are not comprehensive and do not meet the unique needs of adolescents and young people. This promising practice brief highlights successful facility- level models that respond to the unique SRH service needs of AYPLHIV.

This document draws on data from six surveys submitted from PATA network members and partners through a call for promising models of practice in comprehensive HIV and SRH services.

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Promising Practices in Peer Support for Adolescents and Young People Living with HIV

The principles of peer engagement are increasingly being applied to support populations of adolescents and young people living with HIV (AYPLHIV). As a critical key population of people living with, and at risk of HIV in sub-Saharan Africa, a focus on peer support is timely. This promising practice brief highlights the importance of peer-to-peer dialogue and engagement as both a significant challenge and a powerful opportunity.

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Exposure to violence predicts poor educational outcomes in young children in South Africa and Malawi

Research by: L. Sherr, I.S. Hensels, S. Skeen, M. Tomlinson, K.J. Roberts, and A. Macedo. 

Methods: This study assessed child violence experiences (harsh punishment and exposure to domestic or community violence) and school enrolment, progress and attendance in children attending community-based organisations in South Africa and Malawi (n=989) at baseline and at 15 months’ follow-up, examining differential experience of HIV positive, HIV affected and HIV unaffected children.

Discussion: This data revealed some important findings.

First, there are high rates of violence exposure in this population. A report on the use of corporal punishment in LMICs found that corporal punishment was very prevalent in several sub-Saharan African countries, with more than 80% of children in the region reporting being beaten at home. In both Malawi and South Africa there are also high rates of community and domestic violence. In South Africa, rates of perpetration of physical violence against a partner are as high as 40%, while in Malawi 28.5% of women report being exposed to abuse by their partners. Children in these countries are also witnesses to violence; in South Africa, 45% of children have witnessed their mother being beaten.

Second, this research found that this exposure to violence has an impact on education outcomes. Specifically, we found an impact of harsh punishment on school enrolment and performance. Research into children being out of school in South Africa has identified costs of transport, child labour in the home or elsewhere, illness, disability and poor school performance as drivers of dropout. In Malawi, reasons for non-enrolment include long distances to school and poor quality of available schooling and infrastructure. And violence againt girls was also noted as having a negative impact on girls attending and perfoming well in school. 

Finally, the findings also highlight that children who are HIV positive in particular appear to be most at risk of poor educational outcomes in the context of high exposure to violence. This is likely to be due to a range of inter-related risk factors that affect educational outcomes. We know that many of the risk factors for violence against children are prevalent in families and communities affected by HIV/AIDS. Children who are HIV positive have been shown to perform more poorly than their peers on a range of cognitive tests and are also more likely to have mental health problems. Further, other factors such as parental death, shifting care arrangements, change in school, illness-induced poverty and increased caregiving responsibilities might affect a child’s ability to access schooling and perform well in the context of HIV.

Conclusion: Violence experiences were associated with a number of educational outcomes, which may have long-term consequences. Community-based organisations may be well placed to address such violence, with a particular emphasis on the challenges faced by children who are HIV positive

Abstract  Full-text [free] access 

Interventions targeting sexual and reproductive health and rights outcomes of young people living with HIV: a comprehensive review of current interventions from sub-Saharan Africa

A study by Leandri Pretorius*, Andrew Gibbs, Tamaryn Crankshaw and Samantha Willan, sought to understand the scope and impact of interventions targeting young people (ages 10- 24) living with HIV (YPLWH) to improve SRH-related outcomes in sub-Saharan Africa (SSA)

This study found that there have been a limited number of interventions to improve SRHR outcomes of YPLWH in the region.
In addition, the findings reflect that more detailed information regarding description of interventions, such as session content, sex and age, and delivery method, need
to be provided so that others can more easily understand embedded theories of change and how interventions work. There also exists a need for broader, more inclusive interventions aimed at YPLWH that address structural and contextual issues, specifically gender equality and livelihoods strengthening, recognising how these are major determinants of realising SRHR for young people. More widely, understandings of SRHR remain narrow with limited engagement around sexuality and sexual identity. Only through articulating a comprehensive approach to improving SRHR that recognises the multiple underlying determinants, is it likely that the SRHR of YPLWH in SSA can be improved.

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