Health Risk Behaviour among Adolescents Living with HIV in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

Derrick Ssewanyana,Charles R Newton,Amina Abubakar,Patrick N Mwangala,Anneloes Van Baar

doi:10.1155/2018/7375831

Abstract

The burden of health risk behaviour (HRB) among adolescents living with HIV (ALWHIV) in sub-Saharan Africa (SSA) is currently unknown. A systematic search for publications on HRB among ALWHIV in SSA was conducted in PubMed, Embase, PsycINFO, and Applied Social Sciences Index and s databases. Results were summarized following PRISMA guidelines for systematic reviews and meta-analyses. Heterogeneity was assessed by the DerSimonian and Laird method and the pooled estimates were computed. Prevalence of current condom nonuse behaviour was at 59.8% (95% CI: 47.9–71.3%), risky sexual partnerships at 32.9% (95% CI: 15.4–53.2%), transactional sex at 20.1% (95% CI: 9.2–33.8%), and the experience of sexual violence at 21.4% (95% CI: 16.3–27.0%) among ALWHIV. From this meta-analysis, we did not find statistically significant differences in pooled estimates of HRB prevalence between ALWHIV and HIV uninfected adolescents. However, there was mixed evidence on the occurrence of alcohol and drug use behaviour. Overall, we found that research on HRB among ALWHIV tends to focus on behaviour specific to sexual risk. With such a high burden of HRB for the individuals as well as society, these findings highlight an unmet need for age-appropriate interventions to address the behavioural needs of these adolescents.

Highlights

Health risk behaviour (HRB) is a major concern in the prevention and management of HIV [1]
This review indicates that research on HRB among adolescents living with HIV in sub-Saharan Africa (SSA) is still scanty
Research on HRB among adolescents living with HIV in SSA is still limited and currently focuses on a few forms of HRB especially behaviour specific to sexual risk

Summary

Introduction

Health risk behaviour (HRB) is a major concern in the prevention and management of HIV [1]. Other studies have reported that adolescents living with HIV (ALWHIV) engage in various HRBs such as transactional sex, that is, sexual intercourse in exchange for material benefit or status [11, 12], alcohol abuse, and drug use [8, 13,14,15] This is problematic for persons living with HIV, because such behaviour underlies suboptimal health outcomes such as poor adherence to antiretroviral treatment [16,17,18], HIV coinfection [19, 20], injury, and mortality [21]. This behaviour adversely impacts the socioeconomic welfare of affected families [22]

Methods

Results

Discussion

Conclusion