Adolescent alcohol use in rural South African high schools

Objective: To examine psychosocial correlates of lifetime alcohol use among adolescents in rural South African high schools. Method: Questionnaires were administered to 1600 students from 20 randomly selected high schools in the Mankweng district within Limpopo province. Self-report data on alcohol use, demographic, environmental and psychosocial variables were collected. Results: About 22% of the students had ever used alcohol. Males were 2.4 times more likely to use alcohol than females. For students who attended religious services, the odds of ever having used alcohol were double those of students who did not attend religious services. The fitted logistic regression model shows that gender, age, ever having smoked a cigarette, ever damaged property, walking home alone at night, easy availability of alcohol, thinking alcohol use was wrong, attending religious services and number of friends who used alcohol are the best predictors of alcohol use among high school students in this setting. Conclusion: The results underline the importance of addressing personal, family, peer and school conduct factors as part of alcohol education initiatives. Efforts to prevent alcohol use among rural high school students should focus on changing drinking behaviour and on reducing risk factors for problem drinking

Sociocognitive Predictors of Condom Use and Intentions Among Adolescents in Three Sub-Saharan Sites

Many HIV intervention programs in sub-Saharan Africa have applied social cognitive theories such as the theory of planned behavior. However, a recent sub-Saharan African review was unable to show increased effectiveness for theory-based interventions. This study assessed whether the predictive value of attitudes, subjective norms, self-efficacy, and intention was similar to studies in Europe and the U.S., and whether there were differences between three sub-Saharan sites. Longitudinal multigroup structural equation modeling was used to assess whether attitudes, subjective norms, and self-efficacy predicted condom use intentions and condom use (after 6 months) among adolescents in three sites, namely Cape Town (South Africa; N = 625), Dar es Salaam (Tanzania; N = 271), and Mankweng (South Africa; N = 404). Condom use intentions were predicted by subjective norms and self-efficacy in all three sites. Attitudes were not related to intentions in Dar es Salaam and were moderately related to intentions in Cape Town and Mankweng. The proportions of explained variance in intentions and behavior were decent (37–52 and 9–19 %, respectively). Although significant differences in predictive value were found between sites and in comparison to European and U.S. studies, intentions could adequately be explained by attitudes, subjective norms, and self-efficacy. However, the limited proportions of variance in behavior explained by intentions could signify the importance of contextual and environmental factors. Future studies are recommended to use an integrative approach that takes into account both individual and contextual factors, as well as social and environmental differences

Promoting sexual and reproductive health among adolescents in southern and eastern Africa (PREPARE): project design and conceptual framework

Background: Young people in sub-Saharan Africa are affected by the HIV pandemic to a greater extent than young people elsewhere and effective HIV-preventive intervention programmes are urgently needed. The present article presents the rationale behind an EU-funded research project (PREPARE) examining effects of community-based (school delivered) interventions conducted in four sites in sub-Saharan Africa. One intervention focuses on changing beliefs and cognitions related to sexual practices (Mankweng, Limpopo, South Africa). Another promotes improved parent-offspring communication on sexuality (Kampala, Uganda). Two further interventions are more comprehensive aiming to promote healthy sexual practices. One of these (Western Cape, South Africa) also aims to reduce intimate partner violence while the other (Dar es Salaam, Tanzania) utilises school-based peer education. Methods/design: A modified Intervention Mapping approach is used to develop all programmes. Cluster randomised controlled trials of programmes delivered to school students aged 12–14 will be conducted in each study site. Schools will be randomly allocated (after matching or stratification) to intervention and delayed intervention arms. Baseline surveys at each site are followed by interventions and then by one (Kampala and Limpopo) or two (Western Cape and Dar es Salaam) post-intervention data collections. Questionnaires include questions common for all sites and are partly based on a set of social cognition models previously applied to the study of HIV-preventive behaviours. Data from all sites will be merged in order to compare prevalence and associations across sites on core variables. Power is set to .80 or higher and significance level to .05 or lower in order to detect intervention effects. Intraclass correlations will be estimated from previous surveys carried out at each site. Discussion: We expect PREPARE interventions to have an impact on hypothesized determinants of risky sexual behaviour and in Western Cape and Dar es Salaam to change sexual practices. Results from PREPARE will (i) identify modifiable cognitions and social processes related to risky sexual behaviour and (ii) identify promising intervention approaches among young adolescents in sub-Saharan cultures and contexts.publishedVersionPeer Reviewe

External quality assessment of SARS-CoV-2-sequencing: An ESGMD-SSM pilot trial across 15 European laboratories

Objective: This first pilot on external quality assessment (EQA) of SARS-CoV-2 whole genome sequencing, initiated by the ESCMID Study Group for Genomic and Molecular Diagnostics (ESGMD) and Swiss Society for Microbiology (SSM), aims to build a framework between laboratories in order to improve pathogen surveillance sequencing.Methods: Ten samples with varying viral loads were sent out to 15 clinical laboratories who had free choice of sequencing methods and bioinformatic analyses. The key aspects on which the individual centres were compared on were identification of 1) SNPs and indels, 2) Pango lineages, and 3) clusters between samples.Results: The participating laboratories used a wide array of methods and analysis pipelines. Most were able to generate whole genomes for all samples. Genomes were sequenced to varying depth (up to 100-fold difference across centres). There was a very good consensus regarding the majority of reporting criteria, but there were a few discrepancies in lineage and cluster assignment. Additionally, there were inconsistencies in variant calling. The main reasons for discrepancies were missing data, bioinformatic choices, and interpretation of data.Conclusions: The pilot EQA was an overall success. It was able to show the high quality of participating labs and provide valuable feedback in cases where problems occurred, thereby improving the sequencing setup of laboratories. A larger follow-up EQA should, however, improve on defining the variables and format of the report. Additionally, contamination and/or minority variants should be a further aspect of assessment.</p

Building Competency for Health Promoting Schools Development in Resource-Limited Settings: Case Studies from South Africa

This chapter outlines the development of two health promoting schools (HPS) programs in resource-limited settings in South Africa, informed by work from two PhD tracks and a round table discussion on core health promotion competencies. The chapter focuses on the development, implementation, and evaluation of a training program for HPS among high school educators in the Limpopo Province guided by an assessment of priority needs; and factors influencing HPS implementation in three secondary schools in Cape Town. The first case study focuses on training program objectives, learning outcomes, and critical cross-field outcomes related to introducing the concept of HPS, empowerment of educators to initiate and evaluate HPS program design, and implementation. The second case study focuses on the role of external actors and stakeholders in designing and implementing HPS in resource-limited settings and the barriers and enablers related to HPS capacity building. The findings are discussed with reference to the national context and international literature and the competencies needed to guarantee successful HPS program implementation

Sociocognitive Predictors of Condom Use and Intentions Among Adolescents in Three Sub-Saharan Sites

Many HIV intervention programs in sub-Saharan Africa have applied social cognitive theories such as the theory of planned behavior. However, a recent sub-Saharan African review was unable to show increased effectiveness for theory-based interventions. This study assessed whether the predictive value of attitudes, subjective norms, self-efficacy, and intention was similar to studies in Europe and the U.S., and whether there were differences between three sub-Saharan sites. Longitudinal multigroup structural equation modeling was used to assess whether attitudes, subjective norms, and self-efficacy predicted condom use intentions and condom use (after 6 months) among adolescents in three sites, namely Cape Town (South Africa; N = 625), Dar es Salaam (Tanzania; N = 271), and Mankweng (South Africa; N = 404). Condom use intentions were predicted by subjective norms and self-efficacy in all three sites. Attitudes were not related to intentions in Dar es Salaam and were moderately related to intentions in Cape Town and Mankweng. The proportions of explained variance in intentions and behavior were decent (37–52 and 9–19 %, respectively). Although significant differences in predictive value were found between sites and in comparison to European and U.S. studies, intentions could adequately be explained by attitudes, subjective norms, and self-efficacy. However, the limited proportions of variance in behavior explained by intentions could signify the importance of contextual and environmental factors. Future studies are recommended to use an integrative approach that takes into account both individual and contextual factors, as well as social and environmental differences

Correlates of drug use in rural Africa: drug/substance use and sexual behaviour in Mankweng District, South Africa

The results of a study on drug/substance use and sexual behaviours are reported for 1 573 teenagers from a rural district of South Africa (males = 834; females = 692; mean age = 16.27 years and SD = 2.77 years). The teenagers reported on their drug/substance use, use of condoms, experience with anal sex and number of sexual partners. The analyses considered the prevalence of drug/substance use, condom use and anal sex within sexually-active cohorts and the prevalence of drug/substance use in a sexually-inactive cohort. Drug/substance use and non-use of condoms were more prevalent among the sexually-active than the sexually-inactive. Within the sexually-active cohort, those with multiple sexual partners were more likely to use drugs/substances or not to use condoms. Anal sex occurred in both males and females to a greater extent than could be attributed to chance.Keywords: prevalence, health-risk, partners, teenagers Journal of Psychology in Africa 2005, 15(1): 11–1

Fear Of Stigmatization As Barrier To Voluntary HIV Counselling And Testing In South Africa

Objective: The objective of this qualitative study was to identify psychosocial correlates of HIV voluntary counselling and testing (VCT), with an emphasis on the association between fear of AIDS-related stigma and willingness to have an HIV test. Methods: The study was executed in Limpopo Province at University of Limpopo, Polokwane, South Africa. Focus group interviews were held among 72 students, divided over 10 groups. Results: Results showed that participants had different levels of knowledge about HIV/AIDS and VCT, and that AIDS was still strongly associated with 'death'. Results further demonstrate that HIV/ AIDS related stigma is still a very serious problem in South Africa. Lack of HIV/ AIDS related knowledge, blaming persons with HIV/AIDS for their infection, and the life-threatening character of the disease were seen as the most important determinants of AIDS-related stigma. The main benefit to go for VCT was 'knowing your HIV status', whereas main barriers for testing were 'fear of being stigmatised' and ‘fear of knowing your HIV positive status'. Conclusion: Fear of stigmatization is an important barrier to HIV testing and has negative consequences for AIDS prevention and treatment. Interventions to reduce HIV-related stigma are needed in order to foster voluntary HIV counselling and testing in South Afric