Amsterdam 2015
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| Abstract #2128 - Family matters: Relationships and HIV | ||||
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Session: 28.5: Family matters: Relationships and HIV (Parallel) on Thursday @ 11.30-13.00 in C002 Chaired by Eline Op de Coul, Francine Cournos Authors: Presenting Author: Dr. Caroline Kuo - Brown University School of Public Health, United States |
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| Additional Authors: | ||||
| Aim: Early adolescents (13-15 years) are an ideal target population for preventive interventions for sexual and mental health. Early adolescents are considering or engaging in their first sexual experiences, and entering into an age where there is elevated risk for depression. Families are an important source of support and influence during this developmental stage. As such, engaging families in a preventive intervention for adolescent HIV risk behaviors and depression is developmentally appropriate for this age group. However, few empirically tested community interventions for families have taken an integrated HIV-mental health approach in South Africa. We describe a qualitative study conducted to guide the design of a resilience-focused family intervention targeting prevention of adolescent HIV risk and depression. The intervention targets families who are at elevated risk for HIV and depression. | ||||
| Method / Issue: The study took place in Khayelitsha, South Africa during 2013-2014. This intervention is derived from the integration and adaptation of two existing best-evidence models for HIV risk reduction and prevention of depression. Adaptation was guided by theory and findings from k=8 focus groups with Xhosa-speaking mixed gender adolescents and parents or guardians, and n=25 interviews with HIV and mental health experts. Qualitative data were recorded, transcribed verbatim, translated from Xhosa to English, and analyzed in NVivo using a thematic analysis. Brown University and University of Cape Town provided ethical approvals. | ||||
| Results / Comments: Respondents identified social and contextual challenges that need recognition in a South African family intervention for adolescent sexual and mental health. Challenges for HIV risk included engagement in age disparate sexual relationships driven by economic needs, adolescent gang violence, and sexual violence. Challenges for depressive risk included violence, poverty, and family illness and bereavement. Respondents described aspects of family interactions that presented both challenges and opportunities for family-based interventions to address adolescent sexual and mental health. Parent-child communication on mental health and sexual topics were taboo. Parents who did not fulfill their caregiving roles due to mental distress or who chose to discuss sex with adolescents were at risk for experiencing social sanctions. However, respondents also identified unique cultural conceptions of family resilience that could be leveraged to increase intervention engagement, including family meetings and communal parenting. | ||||
| Discussion: Qualitative findings guided alteration of existing intervention content, and the addition of new content, topics, and delivery modalities for South Africa. The final adapted family intervention model includes: strengthened emphasis on family resilience, modules that address how mental health affects sexual decision making, and skills strengthening in parental monitoring, positive parenting, and parent-adolescent communication on the topics of sex and mental health. The adapted family intervention is being tested in a randomized pilot trial in 2015-2016. | ||||
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