Determinants of HIV Testing Among Sexually Active Young People in Zambia

This study used data from the 2013 Zambia Demographic Health Survey (ZDHS) based on a nationally representative sample carried out by Central Statistical Office of Zambia. This paper analyzed a special module designed to collect information on the extent of the uptake of HIV testing by sexually active young people in Zambia. The analysis of this paper is based on 1879 young women aged 15-19 and 2747 aged 20-24 years respectively. Their male counterparts were 1675 aged 15-19 and 2005 aged 20-24 years. Overall 84% of females and 57% of males reported having tested for HIV. Regression analysis further showed that age, place of residence, work status, educational level, consistency of condom use and number of sex partners were significantly related to the uptake of HIV testing for both female and male participants. Young sexually active people should be availed affordable educational opportunities which in turn will hopefully accord them to viable economic opportunities. The media exposure to the young men and women should preach consistent condom use as well as a reduction in their sexual partners.Key Words: HIV testing; Sexually active; Condom use; Prevalenc

Domestic Violence and Sexual Health among Young Women in Zambia

This paper aims at describing the prevalence and correlates of domestic violence, and evaluating their associations with key health outcomes among Zambian young females aged 15–24 years.Data from the 2007 Zambia Demographic Health Survey was utilized. The survey was carried out by Central Statistical Office with the technical assistance from Macro International through MEASURE DHS programme. The 2007 ZDHS is based on a nationally representative sample of 7146 ever married women of 15-49 age group covering 320 Standard Enumeration Areas (clusters). In this paper, the data analysis was only restricted to young women aged 15-24.The results show that among the various forms of violence against women, 22% of the women faced sexual violence, followed by emotional violence (21%) and physical violence (16%). The results further revealed  that age, religion, educational level, working status, condom use during last sex and had any STDs in the last 12 months, had genital sores/ulcers in the last 12 months were the most prominent factors significantly explaining variation in the prevalence of physical, emotional and sexual violence. Domestic violence is a complex societal scourge which is unlikely to be attributed to one single determinant.Keywords: Domestic Violenc

Bride Price (Lobola) and Gender-based Violence among Married Women in Lusaka

Background: This study investigated the influence of lobola, a payment made for marriage, on gender-based violence among married women in Lusaka’s Kamanga compound. Specifically, the study sought to establish how married women and men perceived lobola in relation to gender-based violence in marriage. Method: The study used the qualitative research method. Participants in the study included eighteen married women and men. In addition, in-depth interviews using a semi-structured interview guide were conducted with five key informants. Results: The findings from the study suggest that paying lobola translated into buying a wife and as such, a wife became a husband’s property. Lobola gave the man or husband powers to treat his wife as he wished, including subjecting her to sexual and other forms of abuse. This seems to take away a wife’s rights to make decisions on matters that affected her own life such as being restricted in her movements, in choosing what to wear, and depriving her of a claim over her children among others. Conclusion: The study recommends that the Ministries of Justice and Gender and the Local Government should look deeply into the issue of paying lobola and correct the practice by deterring or reprimanding those who do adhere to its significance. Civil society should also lobby government to enact appropriate laws and policies to deal with patriarchy and help married women to enjoy their rights as human beings

Family Domestic Violence: Impact on Children in Lusaka, Zambia

Aim: To explore the experiences of children exposed to domestic violence in Lusaka District, Zambia. Study Design: A qualitative exploratory approach was adopted for this study. Place and Duration of the Study: The study took place in Lusaka district over a period of 8 months. The study population included domestic violence survivor children and their parents. The study sample consisted of fifty-two participants divided into thirty children (boys and girls), sixteen parents or guardians, and six key informants. Data was collected using detailed interviews with children and key informants, while focus group discussions were conducted with the parents or guardians. Results: The findings of the study revealed that children were exposed to different forms of domestic violence including physical abuse, emotional (verbal) abuse, and economic abuse. The children were both witnesses and victims of domestic violence. The study also revealed that exposure to violence had negative effects on the children such as physical injury, fear and anxiety, loss of confidence and self-esteem, academic under performance, guilt and shame, and poor relationships with peers and parents. Conclusion and Recommendations: Domestic violence is still prevalent in Lusaka District and has negative long-term effects on children who witness it and are victimised by it. Interventions are necessary to address the size, nature, and complexity of the problem. It is recommended that professionals who have regular contact with families and children, including teachers, child care workers, health and mental health care providers, law enforcement officers, child welfare workers, and court officials should receive ongoing training on domestic violence and its impact on children, and necessary interventions to combat it

Gender Differentials in Consistent Condom Use among Young People in Zambia

The aim of this paper is to determine socio-economic and demographic factors that influence gender differentials in consistent use of condoms among young people in Zambia. Data for this paper were collected from a household questionnaire that was administered to sexually active youth (N=3554) between the ages of 15-24 during the 2013 Demographic Health survey. Cross tabulation and chi-square results revealed a relationship between age, gender, place of location, socio-economic background, employment status, level of education media exposure, alcohol consumption and perceived risk of contracting HIV with the consistent use of condoms. For females, regression analyses revealed that wealth status, work status, educational level and drinking alcohol were positively associated with reporting consistent use of condoms. For males, age, work status, educational level, perceived risk of contracting HIV and drinking alcohol are associated with increased likelihood of reporting consistent condom use within the last 6 months.Key Words: Gender Differentials, Condom use, Youth, Zambi

Dating Violence Experienced by Students at the University of Zambia

Dating violence is a complex problem determined by multiple factors. Poverty, cultural and social environmental factors are a major contributor to the gender based violence. The aim of this study was to examine the nature and extent of dating violence experienced by students at the University of Zambia. Eighteen students (nine males and nine females) aged fifteen to thirty years were recruited from the University of Zambia hostels. In-depth interviews with semi-structured interviews were used for data collection. This study has found that various forms of dating violence exists at the University of Zambia. The study further found risk factors that were associated with dating violence such as consumption of alcohol and/or use of entertaining substances, as well as being involved in aggressive activities such as fighting or insulting; other factors included; poverty, experiencing of inter-parental violence and prior experience with violence. The psychological and emotional implications were that some students became depressed and stressed, insecure, ideated suicide, feared sex, distrusted people and were worried and uneasy. Under physiological and health outcomes, some students contracted STDs and HIV, body injuries, became pregnant, and others lost or terminated their pregnancy. Furthermore, social implications were that some students became aggressive, went into self-isolation, and began living recklessly. Physical abuse, verbal abuse, sexual abuse and psychological or emotional abuse where the most common types of dating abuse found at the University of Zambia. Conclusively, In addition to awareness against gender based violence, youth friendly corners should be considered during the treatment of gender based violence in universities

Types of episodic disability among people living with HIV in Zambia.

HIV is increasingly recognized as a chronic illness which may result in episodic disability related to the effects of the virus, side effects of medication, co-morbidities and consequences of aging. Little is known about the episodic disability experiences of people living long-term with HIV in resource-limited countries, which is best understood by following people over time. This qualitative longitudinal study examined the episodic disability experiences and the applicability of four types of episodic disability among people living with HIV and on anti-retroviral therapy in Zambia. We interviewed 31 men and women living with HIV on 3 occasions at 6-month intervals (total of 93 interviews) examining the processes of change over time. We used disability models to inform the interviews exploring impairments/symptoms, activity limitations and participation restrictions. Longitudinal analyses of transcribed interviews confirmed the applicability of four types over time: stable, increasing disability, decreasing disability and significant fluctuations. Analyses highlighted the extent to which determinants of health contributed to the disability experienced. The use of disability models revealed the importance of environmental and social influences on disability and quality of life. The indicators of the type of episodic disability could be used clinically to help understand the nature and potential triggers of the episodes

Written Advice Given by African American Smokers to Their Peers: Qualitative Study of Motivational Messages

BACKGROUND: Although African Americans have the lowest rates of smoking onset and progression to daily smoking, they are less likely to achieve long-term cessation. Interventions tailored to promote use of cessation resources in African American individuals who smoke are needed. In our past work, we demonstrated the effectiveness of a technology-assisted peer-written message intervention for increasing smoking cessation in non-Hispanic White smokers. In this formative study, we have adapted this intervention to be specific for African American smokers. OBJECTIVE: We aimed to report on the qualitative analysis of messages written by African American current and former smokers for their peers in response to hypothetical scenarios of smokers facing cessation challenges. METHODS: We recruited African American adult current and former smokers (n=41) via ResearchMatch between April 2017 and November 2017. We asked participants to write motivational messages for their peers in response to smoking-related hypothetical scenarios. We also collected data on sociodemographic factors and smoking characteristics. Thematic analysis was conducted to identify cessation strategies suggested by the study participants. RESULTS: Among the study participants, 60% (25/41) were female. Additionally, more than half (23/41, 56%) were thinking about quitting, 29% (12/41) had set a quit date, and 27% (11/41) had used electronic cigarettes in the past 30 days. Themes derived from the qualitative analysis of peer-written messages were (1) behavioral strategies, (2) seeking help, (3) improvements in quality of life, (4) attitudes and expectations, and (5) mindfulness/religious or spiritual practices. Under the behavioral strategies theme, distraction strategies were the most frequently suggested strategies (referenced 84 times in the 318 messages), followed by use of evidence-based treatments/cessation strategies. Within the seeking help theme, subthemes included seeking help or support from family/friends or close social networks (referenced 56 times) and health care professionals (referenced 22 times). The most frequent subthemes that emerged from improvements in the quality of life theme included improving one\u27s health (referenced 22 times) and quality of life (referenced 21 times). Subthemes that emerged from the attitude and expectations theme included practicing positive self-talk (referenced 27 times), autonomy/independence from the smoking habit (referenced six times), and financial cost of smoking (referenced five times). The two subthemes that emerged from the mindfulness/religious or spiritual practices theme were use of self-awareness techniques (referenced 36 times) and religious or spiritual practices to cope (referenced 13 times). CONCLUSIONS: Our approach to adapt a prior peer-message intervention to African American smokers yielded a set of evidence-based messages that may be suitable for smokers at all phases of motivation to quit (ready to quit or not ready to quit). In future research, we plan to assess the impact of texting these messages to African American smokers in a smoking cessation trial. H Williams, Dalton Mourao, Oluwabunmi M Emidio, Maryann Davis, Lori Pbert, Sarah L Cutrona, Thomas K Houston, Rajani S Sadasivam. Originally published in JMIR Formative Research (https://formative.jmir.org), 30.04.2021

Implementing internet-based cognitive behavioural therapy (moodgym) for African students with symptoms of low mood during the COVID-19 pandemic: a qualitative feasibilty study

Background: Online therapies have been shown to be effective in improving students’ mental health. They are cost-effective and therefore have particular advantages in low-income countries like Zambia where mental health resources are limited. This study aimed to explore the perceived impact of the COVID-19 pandemic and the feasibility of implementing an Internet-Based Cognitive Behavioural Therapy (iCBT) intervention (‘moodgym’) to improve resilience in vulnerable Zambian students. Methods: The study was a qualitative interview study. Participants identifying as having symptoms of low mood and completing a baseline, online survey (n = 620) had the option to volunteer for a semi-structured interview to explore views about their experience of the pandemic and the acceptability and perceived benefits and limitations of using moodgym. Results: A total of 50 students (n = 24 female, n = 26 male) participated in the study. One theme with 4 sub-themes, captured the severe emotional and social impact of the COVID-19 pandemic. A second, very strong theme, with 5 sub-themes, reflected the considerable negative effects of the pandemic on the students’ educational experience. This included the challenges of online learning. The third theme, with three subthemes, captured the benefits and acceptability of moodgym, particularly in terms of understanding the relationship between thoughts and feelings and improving academic performance. The fourth theme described the technical difficulties experienced by students in attempting to use moodgym. Conclusion: COVID-19 caused fear and impacted wellbeing in vulnerable students and severely impaired the quality of students’ educational experience. The findings suggest that moodgym might be a valuable support to students in a low-income country

Factors influencing COVID-19 health protective behaviours in Zambian university students with symptoms of low mood

BackgroundHealth protective behaviours are crucial in the prevention of the spread of COVID-19, particularly in university students who typically live and study in large groups. Depression and anxiety are common in students and can impact young people’s motivations to follow health advice. The study aims to assess the relationship between mental health and COVID-19 health-protective behaviours in Zambian university students with symptoms of low mood.MethodsThe study was a cross-sectional, online survey of Zambian university students. Participants were also invited to take part in a semi-structured interview to explore views about COVID-19 vaccination. Invitation emails were sent explaining the study aims and directed students who self-identified as having low mood in the past two weeks to an online survey. Measures included COVID-19 preventive behaviours, COVID-19-related self-efficacy, and Hospital and Anxiety Depression scale.ResultsA total of 620 students (n=308 female, n=306 male) participated in the study, with a mean participant age of 22.47±3.29 years (range 18–51). Students reported a mean protective behaviour score of 74.09/105 and 74% scored above the threshold for possible anxiety disorder. Three-way ANOVA showed lower COVID-19 protective behaviours in students with possible anxiety disorder (p=.024) and those with low self-efficacy (p<0.001). Only 168 (27%) said they would accept vaccination against COVID-19, with male students being twice as likely to be willing to accept COVID-19 vaccination (p<0.001). Of 50 students interviewed. 30 (60%) expressed fears about the vaccination and 16 (32%) were concerned about a lack of information. Only 8 (16%) participants expressed doubts about effectiveness.ConclusionStudents who self-identify as having symptoms of depression have high levels of anxiety. The results suggest that interventions to reduce anxiety and promote self-efficacy might enhance students’ COVID-19 protective behaviours. Qualitative data provided insight into the high rates of vaccine hesitancy in this population