hiv prevention for south african youth which interventions work a systematic review of current evidence对南非的艾滋病预防青年干预工作系统回顾当前的证据.pdfVIP

Harrison et al. BMC Public Health 2010, 10:102 /1471-2458/10/102 RESEARCH ARTICLE Open Access HIV prevention for South African youth: which interventions work? A systematic review of current evidence Abigail Harrison1*, Marie-Louise Newell2,3, John Imrie2,4, Graeme Hoddinott2 Abstract Background: In South Africa, HIV prevalence among youth aged 15-24 is among the world’s highest. Given the urgent need to identify effective HIV prevention approaches, this review assesses the evidence base for youth HIV prevention in South Africa. Methods: Systematic, analytical review of HIV prevention interventions targeting youth in South Africa since 2000. Critical assessment of interventions in 4 domains: 1) study design and outcomes, 2) intervention design (content, curriculum, theory, adaptation process), 3) thematic focus and HIV causal pathways, 4) intervention delivery (duration, intensity, who, how, where). Results: Eight youth HIV prevention interventions were included; all were similar in HIV prevention content and objectives, but varied in thematic focus, hypothesised causal pathways, theoretical basis, delivery method, intensity and duration. Interventions were school- (5) or group-based (3), involving in- and out-of-school youth. Primary outcomes included HIV incidence (2), reported sexual risk behavior alone (4), or with alcohol use (2). Interventions led to reductions in STI incidence (1), and reported sexual or alcohol risk behaviours (5), although effect size varied. All but one targeted at least one structural factor associated with HIV infection: gender and sexual coercion (3), alcohol/substance use (2), or economic factors (2). Delivery methods and formats varied, and included teachers (5), peer educators (5), and older mentors (1). School-based interventions experienced frequent implementation challenges