Youth Friendly Research Articles

Examining functional sexual and reproductive health and right-based friendly services: perspectives from exit adolescents, caregivers, and health workers at health services delivery points in Tanzania

BackgroundThe lack of adequate access to and use of sexual and reproductive health care by youth and adolescent, n low- and middle-income countries persists despite international accords on their rights, which exposes them to violence against children; early and unintended pregnancies; and sexually transmitted infections. This study examined functional sexual and reproductive health and right-based friendly services as perceived by exit male and female adolescents, caregivers, and health workers at the Tanzanian health services delivery points as they were the ones who would share their opinions to establish a diversified and representative reality about the matter based on sex.MethodsThis was a multicentric study among 205 randomly selected participants in eleven selected health facilities within the three regions of Tanzania including Dar es Salaam, Dodoma, and Kigoma regions using a one-time descriptive cross-sectional design with a quantitative research approach from 01 to 30 November 2022. Triangulation technique of data collection activities using structured questionnaires and observation checklist adopted from the Tanzanian Ministry of Health was used to collect data. IBM Statistical Package for Social Sciences version 26 data entry templates (Sa PSS – 26) were used to analyze data descriptively to establish frequencies and percentages.ResultsResults indicated that 205 participants were assessed in this study with a response rate of 100%. Exit adolescents (46%); health workers in dispensaries (60%), and community members (42%) were more likely to confirm the availability of functional SRH right-based adolescent and youth-friendly services at the health services delivery points. The SRH displays (50%); adolescent rights (6%) and confidentiality (5%) were the least reported functional SRH aspects by the study participants. It was noted that the 11 health services delivery points in their totality did not fully implement the National standards in providing the services to adolescents and youth of which standards III (54.0%) and VIII (46.1%) scored the lowest.ConclusionThe results of this study have uncovered that there is disperities in the availability and accessibility of functional SRH right-based adolescent and youth-friendly services across the levels of health facilities; among adolescents and community members. Hospitals were more likely to confirm the availability of Functional Right Based Youth Friendly Services than at health centers and dispensaries with female adolescents, youth, and community members being disadvantaged. There is a need to address issues of differentials in equity to the accessibility of services among adolescents, youth, and community members by improving functional sexual and reproductive health and right-based friendly services provision infrastructures, health care workers capacity building, and mechanisms or approaches to increase adolescents’ access and uptake to SRHR services.

Child and Youth Friendly Justice for the Climate Crisis: Relying on the UN Convention on the Rights of the Child

Abstract The climate crisis is a human rights crisis, and one of the worst affected groups is children and youth. This same group has been key to climate action in and outside of the courts. As well as engaging in numerous consultative fora such as cop, and in the introduction of a General Comment on the right of children to a healthy environment, they have gone on to become key litigators in climate cases/applications at both national and international level. These justice processes are, however, notoriously ill suited to the particular needs of children and youth. Child friendly justice is a concept which has been elaborated in recent years by the Council of Europe. Yet climate litigation is very different to the cases (e.g. in family law) in which children have traditionally been parties – amongst other things it can involve very public campaigns. This article considers child and youth friendly justice in the context of the climate crisis through the UN Convention on the Rights of the Child, and through the concepts of access, participation, interests, and judgments.

Sexuality Education Between Biopolitics and Psychopolitics: A Critical Inquiry into Chile’s Youth Friendly Spaces Program

This paper analyzes the population management logics present in the YFS framework, delving into its power dynamics, prioritization processes, and the (in)visibility of themes that influence its configuration and outcomes. Through a Governmentality Studies lens, it analyses the program’s shift from biopolitical to psychopolitical rationalities. A qualitative document analysis of 43 documents reveals the program’s strategies in addressing youth sexuality: the translation of youth sexuality, the identification of social determinants, the execution of extitutional action, and the fostering of participation as competence. These findings illustrate a sophisticated governance of sexuality education, leveraging psychopolitical tactics for nuanced youth engagement, emphasizing accountability, and fostering skill development. The analysis underscores the significance of evolving sexuality education practices toward more inclusive and adaptable approaches.

High STI burden among a cohort of adolescents aged 12-19 years in a youth-friendly clinic in South Africa.

Adolescents face a higher risk for HIV, STIs, and unintended pregnancy than any other age group in sub-Saharan Africa, and have unique health care needs as they navigate this period of growth and developmental milestones. We conducted the Youth Friendly Services study among adolescents in Rustenburg, South Africa to address some of these concerns. Participants aged 12-19 were followed quarterly for 12 months, asked at baseline about demographics, their sexual behavior, and tested for HIV, STIs, and pregnancy (girls). Report of sexual activity was not a requirement for enrollment. Assent and parental consent were obtained for participants under 18. Some follow up visits fell during COVID-mandated shutdowns, and we worked with participants to reschedule and extend follow up as appropriate. Here we present data on reported behaviors, participant attrition, risk of HIV, other STI, and pregnancy. From May 2018 to August 2019, we enrolled 223 HIV-negative, non-pregnant adolescents (64% girls). The median age was 17 (IQR: 14-18). Among the 119 (53%) participants who reported being sexually active at baseline, the median age at first sex was 16 years (IQR: 15-17). During follow-up, an additional 16 (7%) participants reported having their first sexual encounter. Among the sexually active participants, the incidence of HIV was 1.5 cases / 100 person-years at risk (PYAR, 95% CI: 0.4-6.0), the incidence of chlamydia was 15.7 cases (95% CI: 10.1-24.4), gonorrhea was 4.7 cases (95% CI: 2.1-10.5), and HSV was 6.3 cases (95% CI: 3.1-12.6); we observed no cases of incident syphilis. The incidence of pregnancy among sexually active girls was 15.0 pregnancies / 100 PYAR (95% CI: 8.5-26.5). Despite small numbers, the incidence of most STIs was significantly higher in females compared to males. We also observed two pregnancies and 5 incident STIs among participants who reported never having had sex, these tended to be younger participants. From March to September 2020, the clinic was shut down for COVID-19, and 53 study visits were postponed. Follow up was concluded in November 2020, a total of 19 participants were lost to follow up, however only one participant dropped off-study during COVID-19 shutdowns. Retention at the final visit was 91.5%. We successfully completed a prospective study of adolescents to learn more about the risks they face as they navigate sexual debut in the context of a program of youth-friendly counseling and services. Among self-reported sexually active participants, we observed a high rate of HIV, STI and pregnancy, however we also observed pregnancy and STIs among those who reported no sexual activity.

An Environmental Scan of Online Generalized Anxiety Resources for Canadian Youth

Background: A recent priority-setting exercise reported that youth are interested in understanding what the early signs and symptoms of generalized anxiety are, and when they should seek help. This environmental scan aimed to understand what information is currently available online for Canadian youth about the signs and symptoms of generalized anxiety disorder, what resources are available for self-assessment, and what are youth’s behaviors, experiences, and information needs around seeking help. Method: We conducted an environmental scan of Internet resources and academic literature in August 2020. Information Sources were categorized relating to the research concepts regarding signs and symptoms, self-assessments, information needs, and experiences. We complimented our environmental scan with youth consultations to understand how generalized anxiety resources are perceived by youth, and what if anything could be improved about the information they are receiving. Consultations were conducted over Zoom with three Canadian Youth Advisory Groups (2 local, 1 national) and took a semistructured focus group format. Results: Of the 12874 identified Information Sources inclusion criteria were met by 98. The majority of Information Sources on signs and symptoms ( n = 62) were webpage-based articles ( n = 53, 85%), and 38 (61%) specifically stated that they were targeting youth. Seventy-one percent ( n = 12) of the 17 self-assessment resources were provided by private organizations. The resources varied markedly in the post-assessment support provided to youth according to their source (i.e., private, academic, and governmental). The key considerations highlighted by youth across the consultations suggested resources needed to be; youth friendly; align with a credible institute (e.g., University and Health Institution); and provide tangible action items post-online assessment. Conclusions: Awareness of the information and resources available to youth, coupled with an understanding of their help-seeking behaviors and information needs regarding generalized anxiety can help support the development and dissemination of appropriate knowledge translation tools targeting youth.

The Politics of Policy and Practices to Advance Adolescent and Youth Friendly Health Services in Nigerian States

The Politics of Policy and Practices to Advance Adolescent and Youth Friendly Health Services in Nigerian States

Factors Associated with Teenage Pregnancy in Mutasa District, Zimbabwe

Teenage pregnancies are a global problem mainly in marginalised communities resulting in complications, societal rejection and deaths. In Zimbabwe, 48% of the teenage pregnancies occurred between 13-19 years. Mutasa District, one of the Districts in Zimbabwe has high rate of teenage pregnancies. Teenage abortions rose from 3/1000 in 2018 to 5/1000 in 2019. We conducted a study on the factors associated with teenage pregnancies in Mutasa District in the year 2018 and 2019. The specific objectives were to determine the prevalence of teenage pregnancies, to determine the sociocultural, economic and religious factors influencing teenage pregnancies and to assess the availability and utilisation of Adolescent Sexual and Reproductive Health Services. A multi-methods+ study design was used with a sample size of 80 cases and 80 controls from four hospitals in Mutasa. Systematic sampling was employed where every <i>3<sup>rd</sup> </i>subject was systematically selected upon satisfaction of the inclusion criteria, with sampling interval observed. A quantitative survey and Focus Group Discussions (FGDs) were used to collect data. The results showed that 72 (90%) of the cases only had primary school education. Being single orphans 60 (75%), having information and education gaps 77 (96.3%), being chased off home to go to the male partner 49 (61.3%) were the prevalent factors linked to teenage pregnancies. Having been disciplined when found with contraceptives led to 41 (51.3%) of the pregnancies. Having the boyfriend as a source of livelihood allowances contributed to 59 (73.8%) of teenage pregnancies while being a member of an Apostolic Sect contributed 65 (82.3%) of the cases. The FGDs revealed that the Youth Friendly Centres were inadequate for the community, poorly resourced having no comprehensive preventive services and therefore poorly utilised. In addition, teenage pregnancy preventions were stereotyped to females only with current interventions being predominantly reactionary than preventive. The findings of this study suggest the need for reproductive health information, gender inclusive programming, and provision of a sundry of well-resourced Youth Friendly Centres in the District and a focus on tailor-made preventive interventions rather than punitive ones.

Inadvertent Disclosure of HIV Status to Adolescents Living with HIV and Subsequent Impact on Medico-Social Wellbeing in Kaduna, Nigeria

Background: Inadvertent disclosure of HIV status poses significant challenges for adolescents living with HIV, particularly in settings where stigma and discrimination are prevalent. Objective: This research seeks to delve into the prevalence and ramifications of accidental disclosures of HIV status among adolescents frequenting a Youth Friendly Clinic (YFC) at a major hospital in Kaduna, Nigeria. It further aims to uncover the medical and social repercussions following such incidents. Methods: Employing a comprehensive mixed-methods strategy, this study combined quantitative and qualitative analyses. Initially, a survey was conducted among 217 adolescents aged between 10 and 19 years, who were patients at the YFC of a tertiary care facility. This survey gathered information on demographic factors, experiences related to the disclosure of HIV status, and the effects of accidental disclosures on emotional health and the consistency of antiretroviral treatment adherence. Subsequently, the study engaged in qualitative research through detailed interviews and group discussions with 85 adolescents who had unintentionally disclosed their HIV status. This allowed for an exploration of the experiences surrounding these disclosures, the coping strategies adopted, and their perceptions of available support. Ethical clearance was secured to ensure the confidentiality and integrity of the research process. Results: The initial analysis revealed that a significant portion (39.2%) of the adolescent participants had inadvertently disclosed their HIV status, mostly by overhearing conversations (56%) and through discussions with peers at the clinic (17%). The qualitative exploration identified key themes such as heightened experiences of stigma and discrimination, difficulties in securing social support, and detrimental effects on mental health. Following these unintended disclosures, adolescents reported feelings of social isolation, changed perceptions by family members, and battles with depression and anxiety. The findings highlight the intricate relationship between accidental disclosure and its social and medical impacts, emphasizing the necessity for bespoke interventions aimed at addressing the needs of this at-risk demographic. Conclusion: The confidentiality of adolescent patients must be a top priority for healthcare professionals, alongside the development of preventative measures against accidental disclosures and the provision of comprehensive support services to counteract the adverse outcomes. By enhancing privacy protection and offering individualized support, it is feasible to mitigate the negative effects associated with unintended disclosures, including stigma and mental health challenges. This investigation enriches our comprehension of accidental HIV status disclosure among adolescents and accentuates the critical need for creating interventions that improve their overall well- being and social inclusion.

Factors influencing the utilisation of Youth Friendly Health Services in Blantyre, Malawi.

Usage of Youth Friendly Health Services (YFHSs) remains unsatisfactory in sub-Saharan Africa despite global agreements on the utilisation of these services among the youths. The aim of the study was to identify factors that influence the utilisation of YFHSs in Blantyre, Malawi. Four health centres in Blantyre, Malawi. A descriptive quantitative research design using multistage sampling was used to randomly sample (N = 293) unmarried youths and collect data using a structured questionnaire. Data were analysed using a computerised statistical package for social sciences (SPSS) version 26. Chi-square (χ²) was used to test the significance of the association between variables, and the p-value (p < 0.05) was considered significant. Regression analysis was used to examine the influence of independent variables on the utilisation of the services. Less than half of the respondents have ever accessed YFHSs (43%). The Chi-square test showed that the following variables had a significant association with utilisation of the services (p < 0.05): gender, age, knowledge, signage, printed health education materials, provider attitudes and being shy or fear of being seen at the services. Age, knowledge, signpost, printed health education materials, provider attitudes and being shy or fear of being seen at the YFHSs are factors that influenced the utilisation of the services. Working on these factors would help to increase utilisation. The study findings will help to fill the gap in the provision of YFHSs and thus increase utilisation of the services.

Роль межличностных отношений в становлении личности (на примере жизненного пути Ф. М. Достоевского)

The environment, contacts with people from biographies provide inexhaustible information for understanding the meaning of personal relationships. In modern society, there is a high interest in the life and work of F. M. Dostoevsky as a deep thinker and a brilliant writer. The article considers Dostoevsky's social circle in the meaning for the formation of his personality in unity of inner content of life and its external outline, including the circle of communication in different periods of life. In this regard, the influence of parental family, family ties and friends of youth, social circle in hard labor and exile, literary relationships, as well as relationships with the clergy are analyzed. This analysis is carried out in connection of biographical facts with the data of scientific literature on interpersonal relationships in their significance for personality. Not only relatives, friends and fellow writers, but also people who seemed to be quite far away left their mark on Dostoevsky's life. It is shown that in the process of gaining personal maturity, a gradual autonomy of the subject from life circumstances occurs throughout life, when a person with a mature personality acquires the ability to behave independently of circumstances and moves on to conscious self-government. The presence of a self-development strategy is an important indicator of a person's reaching a level of maturity and experiencing life satisfaction.

Challenges experienced by nurses in implementing Adolescent and Youth Friendly Services in clinics of the Limpopo province.

Effective implementation of Adolescent and Youth Friendly Services (AYFS) that are accessible, acceptable and effective for diverse youth population groups is significant to enhancing youth health. Because of various factors, improving youth health is a challenge in clinics in rural areas. This study aims to explore and understand the challenges nurses experience while implementing AYFS programmes in Kganya local area clinics of the Capricorn district, Limpopo province, South Africa. The study was conducted in the clinics of Kganya local area of Capricorn district, Limpopo province, South Africa. A qualitative, phenomenological, exploratory, descriptive design is employed in this study. Twelve nurses were selected using purposive sampling. Data were collected through semi-structured interviews with an interview guide. Notably, data were analysed using Tesch's open coding method. Two themes emerge from this study: 'Challenges experienced related to the implementation of Adolescent and Youth Friendly Services' and 'Suggestions to improve Adolescent and Youth Friendly Services'. The results of this study confirm that nurses experience diverse challenges while implementing AYFS. Challenges include a lack of trained staff and material resources and the negative attitudes of adolescents, parents and community members. This study's findings might help identify the gaps in implementing the AYFS programmes. The findings may assist policymakers and the National Department of Health (NDoH) to monitor and review the effectiveness of the AYFS programme standards.

Health Education Impact on Stigma and Discrimination against People Living with Humman Immunodeficient Virus Infection among Adolescents in South Western Nigeria- A Community Based Experimental Study

Introduction: Young people in Nigeria constitute an important group due to their vulnerability and sexual inexperience and there are still relatively high levels of misconceptions and stigma. This study was therefore carried out to investigate effect of health education on stigma and discrimination of PLWHAs among adolescents in Ogun State, Nigeria.&#x0D; Methodology: This was a quasi-experimental community-based study. The study was carried out in three (3) phases. A multistage random sampling technique was used in choosing the required samples for this study. Two Local Governments which was selected in the State formed the experimental and control groups. A semi-structured pretested interviewer-administered questionnaire was used for data collection. Data analysis was done using SPSS statistical software version 19.&#x0D; Results: A total of 215 participants were recruited into the study,31.2% were males, 52.6% were adolescents aged 10-14 years and 47.4% were aged 15-19 years, while 67.3% were Christians, both the control and experimental groups were similar[p=0.128]. Stigma scores at baseline were also correlated with knowledge scores. There was a weak negative but significant correlation between knowledge and stigma (r = -0.27, p&lt;0.001). There was a significant reduction in stigma scores for both the intervention (t = 4.92, p &lt;0.001) and control groups at 4 months post intervention (t = 4.33, p &lt; 0.001). There was only a significant difference for family type, where the mean stigma scores were higher among respondents from polygamous homes and those with widowed parents compared to those from monogamous homes (F = 3.22, p = 0.008).&#x0D; Conclusion: The study shows that adolescents from dysfunctional families such as polygamous homes and widowed parents had a significantly higher score. Establishment of Youth Friendly Clinics that would focus more on adolescents from dysfunctional homes is needed among adolescents in Nigeria and other low income population.

What's holding back youth-friendly health services in Blantyre, Malawi? A qualitative exploration.

The use of Youth Friendly Health Services remains sub-optimal in Sub-Saharan Africa despite global agreements on the same. The aim of this study was to explore barriers to utilization of Youth Friendly Health Services in Blantyre, Malawi. This was a qualitative study drawing on three focus group discussions of youths aged 10 to 24 (N=24) and individual interviews with Youth Friendly Health Service providers from four health facilities (N=6). Thematic analysis by Braun and Clark 2006 was used to analyse collected data. Seven themes emerged from the findings: frequent stockouts of medical supplies, lack of entertainment, sporting activities and supporting equipment, lack of dedicated space for Youth Friendly Health Services, lack of knowledge, financial constraints, misconceptions, and distance to the health facilities. Addressing these barriers would increase the utilization of Youth Friendly Health Services and, in turn, increase contraceptive uptake, hence reducing unintended pregnancies and their associated complications.

The Social Dynamics of Fun: Can Fun Youth Bring Peers Together and Positively Influence Their Friends?

There is a critical gap in our understanding of how peer relationships contribute to positive youth development. To address this gap the current study uses longitudinal social network data to examine if fun youth were socially desirable, inclusive of peers, and positive agents of social influence during the transition to adolescence. Participants were 210 students (47% female; Mage = 11.55 years at the outset) from 8 classes in 3 schools in a small Lithuanian city. Each child received a fun score consisting of nominations from classmates as "someone who is fun to be around". Participants also nominated up to five classmates as friends. Fun students received more friendship nominations than their peers and they maintained higher levels of social desirability over time. Fun youth appeared to be inclusive of their peers in that fun youth did not appear to have preferences to befriend only those like themselves. The friends of fun youth were positively influenced such that they were perceived to be more fun over time. The findings suggests that fun youth may promote positive social change within peer groups.

Consequences of Victimization on Perceived Friend Support during Adolescence.

Victimization can harm youth in various ways and negatively affect their friendships with peers. Nevertheless, not all victimized youth are impacted similarly, and the literature is unclear regarding why some victims are more likely than others to experience friendship-based consequences. Using five waves of data on 901 adolescents (6th grade at wave 1; 47% male; 88% White) and a subsample of 492 victimized youth, this study assessed (1) whether victimization leads to decreases in perceived friend support, and (2) the factors that explain which victimized youth are most likely to experience decreases in perceived friend support. Explanatory factors included subsequent victimization, victims' social network status (self-reported number of friends, number of friendship nominations received), and victims' risky behaviors (affiliating with deviant friends, delinquency, aggression, binge drinking). Random effects regressions revealed that, among the full sample, victimization was linked to decreases in friend support. Among victimized youth, subsequent victimization and deviant friends decreased friend support. Having more friends was associated with increased friend support among victims, though this association weakened as the number of friends increased. The results emphasize that victimized youth are a heterogeneous group with varying risks of experiencing friendship-based consequences.

Formation of Specialist’s Competency Model Is an Important Condition for Quality in Family Doctors Undergraduate Education

Competency-oriented training is becoming the main direction of higher education development in Ukraine, which requires implementation of new teaching methods. The main value of project based learning technology lies in directing students to the creation of an intellectual or material product as a result of learning, and not to the simple study of a certain topic. This is a form of organizing classes aimed at developing of communication skills and the ability to work in diverse groups. The objective: to reveal the essence and methodology of the implementation into the educational process of the project method in teaching the discipline “General practice-family medicine” at undergraduate level at the department of therapy and family medicine of the medical faculty. Materials and methods. The method of project activity of students was tested as a part of students practice in the “Youth Friendly Clinic”. The basis for the project technology implementation was the presence of the complex medical and social factors that influence teenagers health, which requires integrated knowledge and a research for its solution. Students created and implemented medical and social prevention projects among teenagers. Results. As a result of working on the project, the students found a specific problem solution and specific result suitable for implementation. This approach creates conditions for creative development and self-realization of students, formation of all necessary professional and general life competencies. Conclusions. Project technology is the main technology for the formation of key professional and general cultural competences of students, helps students master basic knowledge, acquire communicative and social skills, develops analytical thinking, research skills, and creative abilities.

A Mobile Application for Teaching and Learning Critical Thinking About Health Choices Among Youth in Rwanda: A Digital Tool for Youth Friendly Center Counsellors.

Mobile health applications can help to disseminate educational health interventions and be widely used. However, mobile health applications not carefully developed will likely not be adopted by the intended users. This paper describes the methodology used to develop a mobile health application for teaching critical thinking about health to youth attending youth friendly centres in Rwanda. The app includes the adapted content of a children's "health choices book". We adapted the book into audio podcasts to fit the context of young adults. The application was developed following a framework for developing mobile health applications. The framework follows three theories: health belief model, the theory of planned behavior and technology acceptance model. We developed an Android based application which can be freely accessed in the Play store. The content in the app explains the need for critical thinking, the 10 audio podcasts, the support, and chat window where users share their experience of using the app. The app will be piloted in two youth centers in Rwanda.

Availability and Readiness of Health Facilities to Deliver Sexual and Reproductive Health Services for Young People: A Case of the “Get Up Speak Out” Programme Implemented in Western Kenya

Young people have reported poor Sexual and Reproductive Health (SRH) indicators over the years including teenage pregnancy, unsafe abortion, neonatal mortality, and Sexually Transmitted Infections (STIs) including HIV/AIDs, among others. Further, study findings have shown barriers to young people’s access to and utilization of SRH services at health facilities include lack of confidentiality and privacy, stigma and discrimination, the unfriendly and negative attitude among service providers, long waiting time for services, and lack of information among young people on availability of SRH services at the health facilities. The limited access to SRH services among young people poses greater health risks to these groups such as a high risk of sexual and gender-based violence, a higher risk of unwanted pregnancies, and unsafe abortions. It is on this basis that the researchers conducted a study aimed at assessing the availability and readiness of Health Facilities to Deliver SRH Services for Young People in its implementation sites. A full-coverage survey across all 24 link health facilities of the Get Up Speak Out (GUSO) program implementation was conducted in May 2020 adopting an electronic approach in adherence to the MOH Covid-19 preventive guidelines. The study shows the alignment of health facilities’ activities with the Youth Friendly Services (YFS) guidelines, such as staff YFS training, YFS time allocation, and meaningful youth participation in governance and decision-making structures. However, the study has highlighted gaps such as inadequate display of SRH information; inadequate engagement and adoption of young people’s recommendations in health facilities’ governance structures for improved delivery, access, and uptake of SRH services by young people.

Potential Pathways From Peer Victimization to Alcohol Use Among Biracial Adolescents: The Intervening Role of Parental Support.

This study examined pathways from peer victimization to alcohol use and the role of parental support in mediating potential peer effects among biracial youth. Given a significant dearth of research on biracial youth, this study addresses this significant gap in the extant literature. Secondary data analyses were conducted using the Health Behavior in School-Aged Children (HBSC) study in the United States. This study enrolled 492 self-identified biracial school-aged youth using a nationally representative sampling of public and private schools. Structural equation modeling was computed to test the mediational effects of low number of close friends, affiliation with delinquent friends, and parental support on alcohol use. Major findings indicated that affiliation with delinquent friends was correlated with higher alcohol use, higher levels of parental support were correlated with lower peer victimization, and higher levels of parental support were negatively correlated with affiliation with delinquent peers and alcohol use. Parental and peer effects remain salient for biracial youth who are navigating adolescence and experiencing peer victimization. School-based interventions that include parents and friends of biracial youth are likely to be effective in reducing peer victimization and its negative sequelae.

A qualitative study of risks and protective factors against pregnancy among sexually-active adolescents in Soweto, South Africa.

Risky sexual behaviors contribute to increased risk of adolescent pregnancy. This qualitative study sought to understand risks and protective factors against pregnancy amongst sexually-active adolescents in Soweto, South Africa. We used purposive sampling to recruit women at age 24 years from Soweto, who self-reported having sexual debut by age 15 years. Twenty women were recruited: (i) women who did not become pregnant before 18 years (n = 10) and (ii) women who became pregnant before 18 years (n = 10). In-depth interviews were conducted to understand their family backgrounds, conversations about sex, sexual behaviors, and initiatives taken (or not) during adolescence to prevent pregnancy. Both groups of women reported predisposing risks to early pregnancy including influence from peers to engage in early sex, unstable family relationships and limited conversations about sex. We found that the family is a key institution in supporting adolescents' decisions regarding their behaviors and choices, as are peers and exposures to information. Community Youth Centers, high schools and Youth Friendly Health Services should ensure that adolescents have access to relevant information, including sex education and contraceptives.