Zambian Youth Research Articles

Measles and Rubella Seroprevalence Among HIV-infected and Uninfected Zambian Youth.

Measles and congenital rubella syndrome remain significant causes of morbidity and mortality despite available vaccines. HIV-infected youth may be at increased risk of measles because of greater waning immunity after vaccination. At a population level, they constitute a potentially large pool of susceptibles to measles and rubella. More data among HIV-infected youth in sub-Saharan Africa are needed to guide vaccination policy and control strategies. This cross-sectional study was nested within 2 ongoing studies of malaria and HIV in Zambia. Dried blood spot cards from youth (5-15 years) in these studies from 2009 to 2013 were tested for IgG antibodies to measles and rubella viruses. HIV-uninfected youth, HIV-infected treatment-naive youth and HIV-infected youth receiving antiretroviral therapy (ART) were compared. A total of 617 HIV-uninfected, 144 HIV-infected treatment-naive and 128 HIV-infected youth receiving ART were included in this study. The proportion seropositive for measles virus was significantly higher among HIV-uninfected youth (92.5%) compared with HIV-infected treatment-naive youth (74.1%) and HIV-infected youth receiving ART (71.9%). No differences by age were observed. The proportion seropositive for rubella virus was significantly higher among HIV-uninfected youth (54.7%) compared with HIV-infected treatment-naive youth (41.7%) and HIV-infected youth receiving ART (49.6%), with increases observed by age for all groups. Measles seroprevalence was lower among HIV-infected than uninfected youth, consistent with waning immunity after measles vaccination. HIV-infected youth would benefit from revaccination. Half of all youth in rural Zambia were susceptible to rubella and may need targeting for catch-up rubella campaigns when measles-rubella vaccine is introduced.

Moderators of treatment response to trauma-focused cognitive behavioral therapy among youth in Zambia.

The effectiveness of mental health interventions such as trauma-focused cognitive behavioral therapy (TF-CBT) may vary by client, caregiver, and intervention-level variables, but few randomized trials in low- and middle-income countries (LMIC) have conducted moderation analyses to investigate these characteristics. This study explores moderating factors to TF-CBT treatment response among a sample of orphans and vulnerable children (OVC) in Zambia. Data were obtained from a completed randomized trial of TF-CBT among 257 OVC in Zambia. Trauma symptoms and functioning were measured at baseline and following the end of treatment. Mixed effects regression models were estimated for each moderator of interest: gender, age, number of trauma types experienced, history of sexual abuse, orphan status, primary caretaker, school status, and parental involvement in treatment. Treatment effectiveness was moderated by history of sexual abuse with greater reductions in both outcomes (trauma, p<.05; functioning, p<.01) for those that experienced sexual abuse. Primary caretaker was also a moderator with greater trauma reductions in those who identified their mother as the primary caretaker (p<.01), and better functioning in those that identified their father as the primary caretaker (p<.05). Nonorphans and single orphans (mother alive) showed greater reduction in functional impairment (p<.01) compared with double orphans. There was no significant moderator effect found by gender, age, number of trauma types, school status, or caregiver participation in treatment. This study suggests that TF-CBT was effective in reducing trauma symptoms and functional impairment among trauma-affected youth overall and that it may be particularly effective for survivors of child sexual abuse and children whose primary caretaker is a biological parent. Scale-up of TF-CBTiswarranted given the wide range of effectiveness and prevalence of child sexual abuse. Future randomized trials of interventions in LMIC should power for moderation analyses in the study design phase when feasible.

Risk factors for HIV among Zambian street youth

ABSTRACTThe sub-Saharan African region has been disproportionately affected by HIV and Zambia has one of the highest HIV prevalence rates within this region. Moreover, new incidences of HIV infection are increasing most rapidly among those 15–24 years of age. Though young people are at high risk for HIV infection, street youth are even more vulnerable given their exposure to high-risk behaviors. The current study examines multiple levels of social influence on HIV infection among 250 street youth in Zambia. Results reveal that though the majority of youth understand what behaviors increase their risk for HIV, youth still hold many misconceptions about HIV/AIDS. Additionally, youth who do not have a home to return to and those who report parental drug misuse were significantly more likely to be HIV positive. This study underscores the need for further education among street youth regarding HIV knowledge.

Multi-Level Risk and Protective Factors for Substance Use Among Zambian Street Youth

ABSTRACTBackground: High rates of substance use have been reported among youth in Zambia. This is particularly concerning given that substance use is one of the biggest risk factors placing young people at risk for HIV infection. Objectives: The purpose of the current study is to examine how multi-level risk and protective factors (i.e., community, family, peers, individual) influence alcohol and marijuana use. Methods: A total of 250 street youth in Lusaka, Zambia were interviewed in the summer of 2014 about their alcohol and marijuana use and reasons for usage. Data were analyzed using descriptive and multivariate methods. Results: Youth reported high rates of alcohol use. At the multivariate level, peer and individual level variables (e.g., using alcohol or drugs for coping or for fun) explained the most variance, followed by family level factors. Community level variables explained the least variance in all models. Conclusion/Importance: A better understanding of multi-level risk and protective factors for young people's alcohol and marijuana use could lead to the development of better intervention strategies to reduce this behavior among Zambian street youth.

Alcohol use among traumatized youth in Zambia

Alcohol use among traumatized youth in Zambia

Burn Prevention in Zambia

The aim of this study was to assess both burn prevention knowledge and the effectiveness of educational intervention in alleviating the current knowledge deficit in Zambian youth. In one rural Zambian district, a burn prevention program was implemented in June 2011. Children at two elementary schools completed a 10-question survey that aimed to assess knowledge regarding burn injuries. After completing the survey, children received a burn and fire safety presentation and a burn prevention coloring book. Children were reassessed in May 2012 using the same survey to determine program efficacy and knowledge retention. Burn knowledge assessments were also completed for children at other schools who did not receive the burn prevention program in 2011. Logistic regression analysis was used for statistical adjustment for confounding variables. Between June 2011 and May 2012, 2747 children from six schools were assessed for their burn knowledge, with 312 of them resurveyed after educational intervention since initial survey. Reassessed children performed significantly better on three questions after controlling for confounders. They did better on five questions but their performance on these failed to achieve statistical significance. Children performed significantly worse on one concept about first aid treatment of a burn. A majority of the children demonstrated knowledge deficit in three concepts, even after educational intervention. There is a large variation in first burn knowledge survey performance of children from different schools, with inconsistency between concepts. With half the questions, knowledge deficit did not improve with advancement in school grade. Low- and moderate-income countries (LMICs) face the largest burns burden. With the lack of adequate burn care facing LMICs, burn injury prevention is of particular importance in those countries. This study shows that burn educational intervention could be effective in reducing burn knowledge deficit; however, the residual deficit posteducation could still be large and potentially contributing to heightened burn injury incidence. Customized and integrated educational programs may be proposed regarding the epidemiological profile of burn knowledge deficit from various schools. This study represents one of the few reports on the effectiveness of a burn prevention program in an LMIC. Future epidemiological data will be needed from nearby healthcare facilities to determine whether this program decreased burn morbidity and mortality at the hospital level.

YOUNG ZAMBIANS ‘WAITING’ FOR OPPORTUNITIES AND ‘WORKING TOWARDS’ LIVING WELL: LIFECOURSE AND ASPIRATION IN YOUTH TRANSITIONS

AbstractIt has become increasingly difficult for young Zambians to construct youth‐to‐adult transitions that meet the normative expectations of coherent life trajectories towards being successful. We explore 60 young Zambians' experiences through qualitative life history interviews focusing on processes of economic (dis)empowerment. We focus closely on what these Zambian youth aspire to, their ‘models’ for life course achievement and how they position their own progress towards and prospects for ‘success’ in relation to their peers. In doing so, we contribute to understanding the importance of youth wellbeing in times of increasing uncertainty. Copyright © 2012 John Wiley &amp; Sons, Ltd.

Alcohol marketing, drunkenness, and problem drinking among Zambian youth: findings from the 2004 Global School-Based Student Health Survey.

This study examines the associations between alcohol marketing strategies, alcohol education including knowledge about dangers of alcohol and refusal of alcohol, and drinking prevalence, problem drinking, and drunkenness. Analyses are based on the Global School-Based Student Health Survey (GSHS) conducted in Zambia (2004) of students primarily 11 to 16 years of age (N = 2257). Four statistical models were computed to test the associations between alcohol marketing and education and alcohol use, while controlling for possible confounding factors. Alcohol marketing, specifically through providing free alcohol through a company representative, was associated with drunkenness (AOR = 1.49; 95% CI: 1.09–2.02) and problem drinking (AOR = 1.41; 95% CI: 1.06–1.87) among youth after controlling for demographic characteristics, risky behaviors, and alcohol education. However, alcohol education was not associated with drunkenness or problem drinking. These findings underscore the importance of restricting alcohol marketing practices as an important policy strategy for reducing alcohol use and its dire consequences among vulnerable youth.

Schooling in the Shadow of Death

This article explores how Zambian youth encounter HIV/AIDS in their schools and communities, and presents ways in which they demonstrate their agency in creating new language, identities, and self-conceptions in response to these encounters. Utilizing qualitative interviews, participant observation, and student diaries, this study suggests that the role and delivery of schooling must be re-examined given high teacher mortality, teacher misinformation, and young people's exposure to the disease outside of schools. Students' diverse experiences in and outside of school shape their knowledge and beliefs about HIV/AIDS in a time when all social institutions in Zambia have been affected by the disease.

Reducing the risk of HIV transmission among adolescents in Zambia: Psychosocial and behavioral correlates of viewing a risk-reduction media campaign

Purpose The purpose of this study was to evaluate phase I of a theoretically informed media campaign designed by youth in Zambia to encourage their peers to adopt risk-reduction practices to protect themselves from sexually transmitted infections and human immunodeficiency virus (HIV). The Helping Each other Act Responsibly Together (HEART) campaign conveys information for young people ages 13 to 19 years about sexually transmitted infections, HIV, and acquired immune deficiency syndrome transmission and prevention, and promotes abstinence, a return to abstinence, or consistent condom use as viable risk-reduction practices. Methods Separate sample baseline and follow-up designs were used to evaluate phase I of the HEART campaign among adolescents aged 13 to 19 years. The 1999 baseline survey had a sample of 368 male and 533 female adolescents; the 2000 follow-up survey comprised 496 male and 660 female adolescents. Results Controlling for age, sex, educational attainment, and urban or rural residence, logistic regression analyses demonstrated that, compared with nonviewers, campaign viewers were 1.61 times more likely to report primary or secondary abstinence and 2.38 times more likely to have ever used a condom. The odds ratio of condom use during last sex was 2.1 for respondents who recalled at least 3 television spot advertisements compared with other respondents. Conclusions The positive correlations between HEART campaign viewership and HIV risk-reduction practices demonstrate that mediated messages can influence adolescents. The HEART campaign is among a range of programs in Zambia designed to enable young people to protect their reproductive health. Future research should capture the independent as well as the synergistic effects of multiple campaigns and interventions.

Reproductive health risk and protective factors among youth in Lusaka, Zambia.

To: (a) identify risk and protective factors for behaviors that expose Zambian youth to risk of HIV infection and, (b) assess whether research findings from the United States concerning protective factors in "high-risk" environments might apply to other settings. A community-based sample of 2328 youth ages 10-24 years residing in Lusaka, Zambia was interviewed. Multivariate statistical methods were used to isolate risk and protective factors for selected sexual and contraceptive behaviors. Seven categories of factors were considered: sociodemographic factors, sexual-reproductive health knowledge and perceptions, nonsexual risk behaviors, peer influence, connections with parents and social institutions, and communication with sexual partners. A sizeable number of factors were associated with each outcome. Only two factors, school attendance and knowledge of AIDS, were associated with both lower levels of sexual activity and consistent use of condoms, and only engaging in higher-risk social activities with close friends was a risk factor for both. The effects of the other factors considered varied by outcome and gender. As in prior research, strong influences of peers were observed, but connections with parents and social institutions unexpectedly did not emerge as protective. Because of the number and diverse nature of factors influencing adolescent behaviors, it is unlikely that a single intervention will be found to immediately change sexual risk-taking behaviors in Zambia.

Partnering Zambian Youth and Mass Media for Social Change

With the assistance from Johns Hopkins University Center for Communication Programs and Population Services International/Society for Family Health the youth in Zambia launched a two-phase national mass media campaign. It focused on the promotion of safe sex for young people through their leadership and full participation in the planning design implementation monitoring and evaluation of the campaign. The preliminary results indicate high levels of comprehension and acceptance of campaign messages and reported discussions of the spots with peers and parents. Moreover the campaign had significant impact on the behavior of the young people related to abstinence and consistent condom use. During the phase-two of the campaign a controversy surfaced in relation to the way condom was promoted. In this regard young people became more vocal in the debate and sought to make their position known to the public. Subsequently they developed their analytical and communication skills. Furthermore the campaign had strengthened the networks of youth and youth-serving nongovernmental organizations.

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.