Forced sexual experiences and sexual situation self-efficacy among South African youth

Nearly 20% of South African youth experience forced or coerced sexual intercourse. Understanding the factors associated with forced sex is important for informing prevention programs aimed at reducing sexual violence and HIV and AIDS. Multilevel regression models test the association between sexual situation self-efficacy and forced sex among 2,893 South African adolescents. Findings suggest that youth are more likely to experience forced sex after periods of time when their levels of self-efficacy are lower than their average levels of self-efficacy. Furthermore, youth who are lower on their self-efficacy compared to their peers are more likely to experience forced sex. Implications for prevention research are discussed.IS

Trends in cases, hospitalizations, and mortality related to the Omicron BA.4/BA.5 subvariants in South Africa

BACKGROUND : In this study, we compared admission incidence risk and the risk of mortality in the Omicron BA.4/BA.5 wave to previous waves. METHODS : Data from South Africa’s SARS-CoV-2 case linelist, national COVID-19 hospital surveillance system, and Electronic Vaccine Data System were linked and analyzed. Wave periods were defined when the country passed a weekly incidence of 30 cases/ 100 000 population. In-hospital case fatality ratios (CFRs) during the Delta, Omicron BA.1/BA.2, and Omicron BA.4/BA.5 waves were compared using post-imputation random effect multivariable logistic regression models. RESULTS : The CFR was 25.9% (N=37 538 of 144 778), 10.9% (N=6123 of 56 384), and 8.2% (N=1212 of 14 879) in the Delta, Omicron BA.1/BA.2, and Omicron BA.4/BA.5 waves, respectively. After adjusting for age, sex, race, comorbidities, health sector, and province, compared with the Omicron BA.4/BA.5 wave, patients had higher risk of mortality in the Omicron BA.1/BA.2 wave (adjusted odds ratio [aOR], 1.3; 95% confidence interval [CI]: 1.2–1.4) and Delta wave (aOR, 3.0; 95% CI: 2.8–3.2). Being partially vaccinated (aOR, 0.9; 95% CI: .9–.9), fully vaccinated (aOR, 0.6; 95% CI: .6–.7), and boosted (aOR, 0.4; 95% CI: .4–.5) and having prior laboratory-confirmed infection (aOR, 0.4; 95% CI: .3–.4) were associated with reduced risks of mortality. CONCLUSIONS : Overall, admission incidence risk and in-hospital mortality, which had increased progressively in South Africa’s first 3 waves, decreased in the fourth Omicron BA.1/BA.2 wave and declined even further in the fifth Omicron BA.4/BA.5 wave. Mortality risk was lower in those with natural infection and vaccination, declining further as the number of vaccine doses increased.https://academic.oup.com/cid/am2024Human NutritionSDG-03:Good heatlh and well-bein

Trends in COVID-19 admissions and deaths among people living with HIV in South Africa : analysis of national surveillance data

DATA SHARING : Aggregated data are available on request to the South African National Institute for Communicable Diseases. The data dictionary is available on request to the corresponding author, [email protected] : In 2021, the HIV prevalence among South African adults was 18% and more than 2 million people had uncontrolled HIV and, therefore, had increased risk of poor outcomes with SARS-CoV-2 infection. We investigated trends in COVID-19 admissions and factors associated with in-hospital COVID-19 mortality among people living with HIV and people without HIV. METHODS : In this analysis of national surveillance data, we linked and analysed data collected between March 5, 2020, and May 28, 2022, from the DATCOV South African national COVID-19 hospital surveillance system, the SARS-CoV-2 case line list, and the Electronic Vaccination Data System. All analyses included patients hospitalised with SARS-CoV-2 with known in-hospital outcomes (ie, who were discharged alive or had died) at the time of data extraction. We used descriptive statistics for admissions and mortality trends. Using post-imputation random-effect multivariable logistic regression models, we compared characteristics and the case fatality ratio of people with HIV and people without HIV. Using modified Poisson regression models, we compared factors associated with mortality among all people with COVID-19 admitted to hospital and factors associated with mortality among people with HIV. FINDINGS : Among 397 082 people with COVID-19 admitted to hospital, 301 407 (75·9%) were discharged alive, 89 565 (22·6%) died, and 6110 (1·5%) had no recorded outcome. 270 737 (68·2%) people with COVID-19 had documented HIV status (22 858 with HIV and 247 879 without). Comparing characteristics of people without HIV and people with HIV in each COVID-19 wave, people with HIV had increased odds of mortality in the D614G (adjusted odds ratio 1·19, 95% CI 1·09–1·29), beta (1·08, 1·01–1·16), delta (1·10, 1·03–1·18), omicron BA.1 and BA.2 (1·71, 1·54–1·90), and omicron BA.4 and BA.5 (1·81, 1·41–2·33) waves. Among all COVID-19 admissions, mortality was lower among people with previous SARS-CoV-2 infection (adjusted incident rate ratio 0·32, 95% CI 0·29–0·34) and with partial (0·93, 0·90–0·96), full (0·70, 0·67–0·73), or boosted (0·50, 0·41–0·62) COVID-19 vaccination. Compared with people without HIV who were unvaccinated, people without HIV who were vaccinated had lower risk of mortality (0·68, 0·65–0·71) but people with HIV who were vaccinated did not have any difference in mortality risk (1·08, 0·96–1·23). In-hospital mortality was higher for people with HIV with CD4 counts less than 200 cells per μL, irrespective of viral load and vaccination status. INTERPRETATION : HIV and immunosuppression might be important risk factors for mortality as COVID-19 becomes endemic.South African National Institute for Communicable Diseases, the South African National Government, and the United States Agency for International Development.http://www.thelancet.com/hiv2025-02-01hj2024Human NutritionSDG-03:Good heatlh and well-bein

“We have our own special language.” Language, sexuality and HIV / AIDS: a case study of youth in an urban township in South Africa

Background: Despite the fact that most South African youth know about HIV/AIDS and how it can be prevented, there is a high prevalence of HIV/AIDS amongst youth in South Africa. Generally youth do not practice safe sex, and youth sexuality is characterised by multiple sexual partners, not using condoms and transactional sex. Objectives: To minimize the risk of HIV infection, it is necessary to understand youth sexuality. In this paper I explore youth sexuality with a specific focus on how language influences sexuality. Methods: I use discourse analysis and qualitative research techniques. Purposive sampling, a form of non-probability sampling was used. I interviewed seventy youth individually or in groups and used in-depth semi-structured interviews. Results: The use of language influences youth sexuality. Youth have developed a specialised language to talk about sex and sexuality and this language has become part of the daily discourse, so that unsafe sexual practices become norms and are justified. Conclusions: The realm of language can be a creative way for peer and HIV/AIDS educators to work with youth towards creating a healthier sexuality. However, as language always occurs in a material context, it is also necessary to work towards changing the material environment, such as poverty. This environment not only facilitates the development of a particular language but it also encourages unsafe sexual practices such as transactional sex. African Health Sciences Vol.4(2) 2004: 102-10

ReviewMedia messaging: a synthesis of lessons from the literature to inform HIV

Based on a review of literature, we provide a number of challenges and lessons to inform HIV-prevention media messaging initiatives for the youth. When designing initiatives, it is imperative that the unique needs of the youth are taken into account, although the youth should not be seen as a homogenous group. The evaluation of initiatives is also important and external evaluators and implementers should work together and draw on methodological pluralism to produce the most useful evaluations. For media initiatives to be successful, all stakeholders need to support the intervention. A key challenge is working with communities who may be divided over approaches to HIV prevention. Young people should not only be the ‘target' of messaging initiatives but should play a central role in their design and implementation. Exposure to media messaging is not a proxy for behaviour change. Initiatives should be based on explicit theories of the complex relationship between messaging and behaviour change. It is important for media messaging to engage with how structures constrain sexual choices. Messaging is most successful when it uses a multi-media approach and when it is combined with interpersonal communication. This type of pedagogy is dialogical and allows for engagement with the youth, challenging the view of the youth as passive recipients of messages.Journal of Child and Adolescent Mental Health 2006, 18(2): 61–7