Adapting an evidence-based family intervention program for adolescent HIV prevention in South Africa
Methods: The study took place in Khayelitsha, South Africa during 2013. Adaptation needs were assessed during 8 focus groups (5-9 participants per group) with Xhosa-speaking mixed gender adolescents (13-15 years) and parents or guardians (18+ years) and 19 interviews with HIV experts (ongoing, target n=30). Brown and Cape Town Universities provided ethical approvals. Focus groups and interviews were recorded, transcribed verbatim, translated from Xhosa to English, and analyzed in NVivo using a thematic analysis.
Results: Findings identify cultural factors that necessitate adaptations to increase intervention acceptability. Beliefs regarding foreign origins of HIV, that anal sex or menstruation carry no risk for transmission, and traditional cures affected risk perceptions and behaviors. Parent-child communication regarding sex was taboo, with sexual communication viewed as an invitation to engage in HIV risk behavior, social sanctions for parents who discussed sex, and animosity towards children who asked about sex. Respondents identified culturally appropriate modalities to increase intervention engagement including family meetings and communal parenting.
Conclusions: An existing family-based intervention will be adapted to include new content, topics, and delivery modalities for South Africa. The adapted family HIV intervention will be tested in a randomized pilot trial in 2014-2015.
Learning Areas:Implementation of health education strategies, interventions and programs
Public health or related research
Social and behavioral sciences
Describe the process of adapting evidence-based interventions to international populations and settings. Identify cultural and contextual adaptations needed to increase family engagement in HIV prevention in South Africa.
Keyword(s): HIV Interventions, Family Involvement
Qualified on the content I am responsible for because: I have been the principal or co-principal investigator of several federally or internationally funded grants focusing on the health outcomes of HIV affected populations. My research interests include the epidemiology of mental health among HIV affected populations, and developing and testing psychosocial and behavioral HIV interventions for vulnerable populations in HIV endemic settings.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.