Young People In Zambia Research Articles

Assessment of a screening tool to aid home-based identification of adolescents (aged 10-14) living with HIV in Zambia and South Africa: HPTN 071 (PopART) study.

The HPTN071 (PopART) for Youth (P-ART-Y) study evaluated the acceptability and uptake of a community-level combination HIV prevention package including universal testing and treatment (UTT) among young people in Zambia and South Africa. We determined whether a four-question primary care level screening tool, validated for use in clinical settings, could enhance community (door-to-door) identification of undiagnosed HIV-positive younger adolescents (aged 10-14) who are frequently left out of HIV interventions. Community HIV-care Providers (CHiPs) contacted and consented adolescents in their homes and offered them participation in the PopART intervention. CHiPs used a four question-screening tool, which included: history of hospital admission; recurring skin problems; poor health in last 3 months; and death of at least one parent. A "yes" response to one or more questions was classified as being "at risk" of being HIV-positive. Rapid HIV tests were offered to all children. Data were captured through an electronic data capture device from August 2016 to December 2017. The sensitivity, specificity, positive predictive value and negative predictive value were estimated for the screening tool, using the rapid HIV test result as the gold standard. In our 14 study sites, 33,710 adolescents aged 10-14 in Zambia and 8,610 in South Africa participated in the study. About 1.3% (427/33,710) and 1.2% (106/8,610) self-reported to be HIV positive. Excluding the self-reported HIV-positive, we classified 11.3% (3,746/33,283) of adolescents in Zambia and 17.5% (1,491/8,504) in South Africa as "at risk". In Zambia the estimated sensitivity was 35.3% (95% CI 27.3%-44.2%) and estimated specificity was 88.9% (88.5%-89.2%). In South Africa the sensitivity was 72.3% (26.8%-94.9%) and specificity was 82.5% (81.6-83.4%). The sensitivity of the screening tool in a community setting in Zambia was low, so this tool should not be considered a substitute for universal testing where that is possible. In South Africa the sensitivity was higher, but with a wide confidence interval. Where universal testing is not possible the tool may help direct resources to adolescents more likely to be living with undiagnosed HIV. Clinical Trial Number: NCT01900977.

Experiences and Perceptions of Telephone-delivery of the Common Elements Treatment Approach for Mental Health Needs Among Young People in Zambia During the COVID-19 Pandemic.

BackgroundMental and behavioral health needs are immense in low-to-middle income countries (LMIC), particularly for adolescents and young adults (AYA). However, access to mental health services is limited in LMIC due to barriers such as distance to a health care site, low number of providers, and other structural and logistical challenges. During the COVID-19 pandemic, these barriers were significantly exacerbated and, thus, mental health services were severely disrupted. A potential solution to some of these barriers is remote delivery of such services via technology. Exploration of AYA experiences is needed to understand the benefits and challenges when shifting to remotely delivered services.MethodsParticipants included 16 AYA (15–29 years) residing in Lusaka, Zambia who met criteria for a mental or behavioral health concern and received telehealth delivery of the Common Elements Treatment Approach (CETA). AYA participated in semi-structured qualitative interviews to explore feasibility, acceptability, and barriers to telephone-delivered treatment in this context. Thematic coding analysis was conducted to identify key themes.FindingsThree major response themes emerged: 1) Advantages of telehealth delivery of CETA, Disadvantages or barriers to telehealth delivery of CETA, 3) AYA recommendations for optimizing telehealth (ways to improve telehealth delivery in Zambia. Results indicate that logistical and sociocultural barriers i.e., providing AYA with phones to use for sessions, facilitating one face-to-face meeting with providers) need to be addressed for success of remotely delivered services.ConclusionAYA in this sample reported telehealth delivery reduces some access barriers to engaging in mental health care provision in Zambia. Addressing logistical and sociocultural challenges identified in this study will optimize feasibility of telehealth delivery and will support the integration of virtual mental health services in the Zambian health system.

Examining the association between HIV prevalence and socioeconomic factors among young people in Zambia: Do neighbourhood contextual effects play a role?

BackgroundThe study examined the association between HIV infection and individual and neighbourhood-level socioeconomic factors in Zambia.MethodsWe used multilevel mixed effects logistic regression to examine the association of individual and neighbourhood level variables on HIV prevalence based on data from the 2013–14 and 2018 Zambia Demographic and Health Surveys, population-based cross-sectional surveys. The analysis was restricted to young people (15–24 years) with HIV serostatus results (n = 11,751 and n = 10,154). HIV serostatus was the outcome variable and socioeconomic status was measured by wealth, education and employment.ResultsOverall, at individual level, education was associated with reduced odds of HIV infection among young women and men. Conversely, relative wealth was generally associated with increased odds of infection for both young women and men. Young, employed men were at reduced odds of HIV infection than the unemployed. Living in neighbourhoods with higher average level of education was associated with higher odds of HIV infection. In 2013–14, 13% and 11% of the variation in HIV infection among young men and women was attributed to neighbourhoods, while 20% and 11% variation was attributed to neighbourhoods in 2018. Inclusion of individual and neighbourhood variables in the full regression model accounted for 65.7% and 59.5% of explained variance in 2013–14 and 64.6% and 44.3% in 2018, for women and men, respectively. This reduced unexplained variance by an average of 56% in 2013–14 and 29% in 2018.ConclusionWe found that HIV infection among young people in Zambia is more strongly associated with individual-level socioeconomic factors compared to neighbourhood factors. Individual-level education remains an important socioeconomic factor associated with reduced odds of HIV infection. This suggests that the HIV response in Zambia should still focus on individual level prevention strategies.

Effect of Ethnicity on Risky Sexual Behaviour among Young People in Zambia: A secondary Analysis of the 2018 Demographic and Health Survey

Effect of Ethnicity on Risky Sexual Behaviour among Young People in Zambia: A secondary Analysis of the 2018 Demographic and Health Survey

Perceived Risk of Contracting HIV and AIDS among Sexually Active Unmarried Young People in Zambia

The paper explored gender differences in factors affecting perceived risk of contracting HIV and AIDS among sexually active unmarried young people in Zambia. The data used was from the Zambia Demographic Health Survey (2013-2014), logistic regression analysis was used to identify the gender differences in perceived risk of acquiring HIV and AIDS. The study revealed that 61% of females and 64.4% of males reported low perceived risk of contracting HIV and 16.5% of females and 16.6% of males reported having a high risk of getting HIV/AIDS. Logistic regression analysis also identified wealth index, exposure to media, having had STDs in the last 12 months, consistent use of condoms with all partners and drinking alcohol as strong predictors of respondent’s likelihood of low risk perception of contracting HIV and AIDS. The analysis further indicated that females who used condoms consistently with all partners were 1.2 times more likely to report being at low risk of contracting HIV and AIDS. This suggests that interventions that seek to reduce the rate of HIV infection may need to focus on increasing risk perception among young people as a protective factor.

Gender Differentials in Premarital Sexual Behavior among Never Married Young People in Zambia

Gender Differentials in Premarital Sexual Behavior among Never Married Young People in Zambia

Determinants of HIV Testing Among Sexually Active Young People in Zambia

This study used data from the 2013 Zambia Demographic Health Survey (ZDHS) based on a nationally representative sample carried out by Central Statistical Office of Zambia. This paper analyzed a special module designed to collect information on the extent of the uptake of HIV testing by sexually active young people in Zambia. The analysis of this paper is based on 1879 young women aged 15-19 and 2747 aged 20-24 years respectively. Their male counterparts were 1675 aged 15-19 and 2005 aged 20-24 years. Overall 84% of females and 57% of males reported having tested for HIV. Regression analysis further showed that age, place of residence, work status, educational level, consistency of condom use and number of sex partners were significantly related to the uptake of HIV testing for both female and male participants. Young sexually active people should be availed affordable educational opportunities which in turn will hopefully accord them to viable economic opportunities. The media exposure to the young men and women should preach consistent condom use as well as a reduction in their sexual partners.Key Words: HIV testing; Sexually active; Condom use; Prevalence

Gender Differentials in Consistent Condom Use among Young People in Zambia

The aim of this paper is to determine socio-economic and demographic factors that influence gender differentials in consistent use of condoms among young people in Zambia. Data for this paper were collected from a household questionnaire that was administered to sexually active youth (N=3554) between the ages of 15-24 during the 2013 Demographic Health survey. Cross tabulation and chi-square results revealed a relationship between age, gender, place of location, socio-economic background, employment status, level of education media exposure, alcohol consumption and perceived risk of contracting HIV with the consistent use of condoms. For females, regression analyses revealed that wealth status, work status, educational level and drinking alcohol were positively associated with reporting consistent use of condoms. For males, age, work status, educational level, perceived risk of contracting HIV and drinking alcohol are associated with increased likelihood of reporting consistent condom use within the last 6 months.Key Words: Gender Differentials, Condom use, Youth, Zambia

Caring Responsibilities, Change and Transitions in Young People’s Family Lives in Zambia

Young people in Zambia and other African countries affected by the HIV epidemic are under increasing pressure to obtain a good education and employment to support their families, whilst some also have to cope with the loss of parents and care for relatives with little external support. This article discusses the findings of qualitative research that explored the experiences of young people (aged 14-30) who had significant family caring responsibilities and those without such responsibilities in Zambia. Interviews and life-mapping methods were conducted with a total of 35 young people living in rural and urban areas, 12 parents and relatives and 12 professionals. The paper analyses young people’s perceptions of significant transitions and the strategies they adopt to manage change. This includes socially expected transitions, such as initiation rites, marriage, leaving school and earning an income, in addition to more unpredictable changes in young people’s lives, such as family illness and disability, caregiving, bereavement, mobility and migration. A range of life transitions were regarded as significant to young people’s past, present and future lives and aspirations.

Correction: Decline in Sexual Risk Behaviours among Young People in Zambia (2000–2009): Do Neighbourhood Contextual Effects Play a Role?

Correction: Decline in Sexual Risk Behaviours among Young People in Zambia (2000–2009): Do Neighbourhood Contextual Effects Play a Role?

Changes in sexual behaviour and practice and HIV prevalence indicators among young people aged 15–24 years in Zambia: An in-depth analysis of the 2001–2002 and 2007 Zambia Demographic and Health Surveys

HIV and AIDS still pose a major public health problem to most countries in sub-Saharan Africa, Zambia included. The objective of the paper is to determine changes in selected sexual behaviour and practice and HIV prevalence indicators between 2001–2002 and 2007. We used the Demographic and Health Survey Indicators Database for the computation of the selected indicators. We further used STATA 10.0 to compute significance tests to test for statistical difference in the indicators. The results indicate some changes in sexual behaviour, as indicated by an increase in abstinence, use of condoms and the decrease in multiple partnerships. The overall percentage of abstinence among never-married young men and women aged 15–24 years in Zambia increased significantly by 15.2% (p = .000) and 5.9% (p = .001) respectively, between 2001–2002 and 2007. A statistically significant increase of 6.6% (p = .029) was observed in the percentage of young women who reported having used a condom during the last time they had had premarital sex. A statistically significant decrease of 11.0% (p = .000) and 1.4% (p = .000) was observed among young men and women, respectively, who reported having multiple partners in the preceding 12 months. The factorial decomposition using multivariate analysis reveals that the indicators which contributed to the statistically significant 2.6% decline in HIV prevalence among young women aged 15–24 years in Zambia include proportion reporting condom use during premarital sex (+6.6%), abstinence (+5.9%), sex before age 15 (−4.5%), premarital sex (−2.6%), sex before age 18 (−2.4%) and proportion reporting multiple partnerships (−1.4%). Remarkable strides have been achieved towards promoting responsible sexual behaviour and practice among young people in Zambia. Further research focusing on factors that predispose young women in Zambia to higher risk of infection from HIV is required. The results from this paper should be useful in the design of programmes to control the spread of HIV and AIDS, particularly among young people in Zambia and other sub-Saharan countries.

Decline in Sexual Risk Behaviours among Young People in Zambia (2000–2009): Do Neighbourhood Contextual Effects Play a Role?

ObjectiveThis study examined trends in premarital sex, multiple partnership and condom use among young people (15–24 years) in Zambia from 2000 to 2009, and assessed the effects of individual and neighbourhood variables on these sexual behaviour indicators in 2000 and 2009.MethodologyWe analysed data from the Zambia Sexual Behaviour Survey, conducted in 2000, 2003, 2005 and 2009. Multi-stage cluster sampling was used to select 385 neighbourhoods, giving a population sample of 6,500 young people. Using linear-by-linear trend test, trends in the three indicators were examined. Multilevel logistic regression was used to assess the effects of individual and neighbourhood variables on the indicators.ResultsPremarital sex among young people decreased significantly from 51 to 42% between 2000 and 2009. Multiple partnerships of men also decreased from 26 to 14% during the same period. The use of condoms by young people remained stable during this period. Full multilevel regression models explained 29 and 34% of the neighbourhood variance of premarital sex in 2000 and 2009. For multiple partnerships and condom use, the explained variance was 29 and 18% in 2000; whereas in 2009 it was extremely low. Urban residence and living in neighbourhood with higher average duration of residence were associated with low premarital sex and higher condom use. Living in a neighbourhood with higher average level of comprehensive knowledge of HIV was associated with less risky sexual behaviour.ConclusionDeclining trends in premarital sex and multiple partnerships are among the factors that might explain the decrease in HIV incidence in Zambia among young people. However, condom use among young people has remained low and stable over the years. The results also suggest that behaviour change interventions should take stock of the social context when introducing individual-level programmes because neighbourhood factors play a considerable role in influencing sexual behaviour.

Young People as Agents in Development Processes: reconsidering perspectives for development geography

This paper explores the role of young people in development processes. This is achieved through an examination of the latest developments in literature concerning young people's identity, agency and experiences of power relations and by reflecting on our own empirical research with young people in Zambia (child-headed households) and Uganda (empowerment and sexual health). In particular, we discuss the opportunities and challenges faced by young people in terms of taking greater control over their own lives and contributing to the development of their communities. In doing so we further understanding of how young people (inter)act to improve their own lives and negotiate the challenging—and changing—realities and relationships they experience.

Reasons for multiple sexual partnerships: perspectives of young people in Zambia

Epidemiological evidence so far suggests that multiple sexual partnerships are an important factor driving the HIV epidemic. Recently, there has been renewed emphasis on fidelity and partner-reduction in preventing HIV infections. Like many countries in sub-Saharan Africa, Zambia is facing a severe HIV epidemic and young people are heavily affected. This study explores youths' perspectives on multiple sexual partnerships in the context of HIV and AIDS. The study draws on four focus group discussions and 10 in-depth interviews with university students in Lusaka, Zambia, in 2006. While the young people were generally aware of the HIV-related risk associated with multiple sexual partnerships, they felt several obstacles prevented them from changing their sexual behaviour. Of special interest are their perceptions related to socio-economic disadvantages and cultural factors.

Youths and the Problems of Social Life in Africa: The Case of Zambia

ABSTRACT This article focuses on the importance of integrating youth into the larger culture, a goal that all societies struggle with. The paper concludes that youth in Zambia have similar values as their parents. As in most societies, youth in Zambia see education as the major factor in achieving personal success. However the researchers found that young people in Zambia are largely alienated from the political system. They concluded that young people in Zambia face the constant problem of balancing their dependence needs with their push towards independence. Since the means to achieve independence are not always readily available, this further strengthens the process of alienating youth from the economic, social, and political institutions.