Browsing by Author "Nonhlanhla Okesola"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Item Process evaluation of peer-to-peer delivery of HIV self-testing and sexual health information to support HIV prevention among youth in rural KwaZulu-Natal, South Africa: qualitative analysis(2022-01-19) Oluwafemi Atanda Adeagbo; Janet Seeley; Dumsani Gumede; Sibongiseni Xulu; Nondumiso Dlamini; Manono Luthuli; Jaco Dreyer; Carina Herbst; F Cowan; Natsayi Chimbindi; Karin Hatzold; Nonhlanhla Okesola; Cheryl Johnson; Guy Harling; Hasina Subedar; Lorraine Sherr; Nuala McGrath; Liz Corbett; Maryam ShahmaneshObjective: Peer-to-peer (PTP) HIV self-testing (HIVST) distribution models can increase uptake of HIV testing and potentially create demand for HIV treatment and pre-exposure prophylaxis (PrEP). We describe the acceptability and experiences of young women and men participating in a cluster randomised trial of PTP HIVST distribution and antiretroviral/PrEP promotion in rural KwaZulu-Natal. Methods: Between March and September 2019, 24 pairs of trained peer navigators were randomised to two approaches to distribute HIVST packs (kits+HIV prevention information): incentivised-peer-networks where peer-age friends distributed packs within their social network for a small incentive, or direct distribution where peer navigators distributed HIVST packs directly. Standard-of-care peer navigators distributed information without HIVST kits. For the process evaluation, we conducted semi-structured interviews with purposively sampled young women (n=30) and men (n=15) aged 18-29 years from all arms. Qualitative data were transcribed, translated, coded manually and thematically analysed using an interpretivist approach. Results: Overall, PTP approaches were acceptable and valued by young people. Participants were comfortable sharing sexual health issues they would not share with adults. Coupled with HIVST, peer (friends) support facilitated HIV testing and solidarity for HIV status disclosure and treatment. However, some young people showed limited interest in other sexual health information provided. Some young people were wary of receiving health information from friends perceived as non-professionals while others avoided sharing personal issues with peer navigators from their community. Referral slips and youth-friendly clinics were facilitators to PrEP uptake. Family disapproval, limited information, daily pills and perceived risks were major barriers to PrEP uptake. Conclusion: Both professional (peer navigators) and social network (friends) approaches were acceptable methods to receive HIVST and sexual health information. Doubts about the professionalism of friends and overly exclusive focus on HIVST information materials may in part explain why HIVST kits, without peer navigators support, did not create demand for PrEP.Item The association of exposure to DREAMS on sexually acquiring or transmitting HIV amongst adolescent girls and young women living in rural South Africa: A cohort study(2024-06-15) Nondumiso Mthiyane; Kathy Baisley; Natsayi Chimbindi; Thembelihle Zuma; Nonhlanhla Okesola; Jaco Dreyer; Carina Herbst; Theresa Smit; Siva Danaviah; Nuala McGrath; Guy Harling; Lorraine Sherr; Janet Seeley; Sian Floyd; Isolde Birdthistle; Maryam ShahmaneshObjective: We investigate how risk of sexually acquiring or transmitting HIV in adolescent girls and young women (AGYW) changed following the real-world implementation of DREAMS (Determined, Resilient, Empowered, AIDS free, Mentored and Safe) HIV prevention programme. Design: A representative population-based prospective cohort study of AGYW living in rural KwaZulu-Natal. Methods: Between 2017–2019 we interviewed a random sample of AGYW aged 13–22 annually. We measured exposure to DREAMS as self-reported receipt of an invitation to participate and/or participation in DREAMS activities that were provided by DREAMS implementing organizations. HIV and Herpes Simplex Virus type 2 (HSV-2) statuses were ascertained through blood tests on Dried Blood Spot (DBS). We used multivariable regression analysis to assess the association between exposure to DREAMS and risk of acquiring HIV: measured as incident HSV-2 (a proxy of sexual risk) and incident HIV; and the risk of sexually transmitting HIV: measured as being HIV positive with a detectable HIV viral load (>=50 copies per millitre (mL)) on the last available DBS. We adjusted for socio-demographic, sexual relationship, and migration. Results: 2184 (86.4%) of those eligible agreed to participate and 2016 (92.3%) provided data for at least one follow-up time-point. 1030 (54%) were exposed to DREAMS; HIV and HSV-2 incidence were 2.2/100 person-years (95% Confidence Interval [CI]: 1.66–2.86) and 17.3/100 person-years (95%CI: 15.5–19.4) respectively. There was no evidence that HSV-2 and HIV incidence were lower in those exposed to DREAMS: adjusted rate ratio (aRR) 0.96 (95%CI: 0.76–1.23 and 0.83 (95%CI: 0.46–1.52) respectively. HIV viral load was detectable for 169 (8.9%) respondents; there was no evidence this was lower in those exposed to DREAMS with an adjusted risk difference, compared to those not exposed to DREAMS, of 0.99% [95%CI: −1.52–3.82]. Participants who lived in peri-urban/urban setting were more likely to have incident HIV and transmissible HIV. Both HSV-2 incidence and the transmissible HIV were associated with older age and ever having sex. Findings did not differ substantively by respondent age group. Conclusions: DREAMS exposure was not associated with measurable reductions in risk of sexually acquiring or transmitting HIV amongst a representative cohort of AGYW in rural South Africa.