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Developing family interventions for adolescent HIV prevention in South Africa

机译：在南非发展家庭干预措施以预防青少年艾滋病毒

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Adolescents and young people account for 40% of all new HIV infections each year, with South Africa one of the hardest hit countries, and having the largest population of people living with HIV. Although adolescent HIV prevention has been delivered through diverse modalities in South Africa, and although family-based approaches for adolescent HIV prevention have great potential for highly affected settings such as South Africa, there is a scarcity of empirically tested family-based adolescent HIV preventive interventions in this setting. We therefore conducted focus groups and in-depth interviews with key informants including clinicians, researchers, and other individuals representing organizations providing HIV and related health services to adolescents and parents (N = 82). We explored family perspectives and interactions around topics such as communication about sex, HIV, and relationships. Participants described aspects of family interactions that presented both challenges and opportunities for family-based adolescent HIV prevention. Parent-child communication on sexual topics were taboo, with these conversations perceived by some adults as an invitation for children to engage in HIV risk behavior. Parents experienced social sanctions for discussing sex and adolescents who asked about sex were often viewed as disrespectful and needing discipline. However, participants also identified context-appropriate strategies for addressing family challenges around HIV prevention including family meetings, communal parenting, building efficacy around parent-adolescent communication around sexual topics, and the need to strengthen family bonding and positive parenting. Findings indicate the need for a family intervention and identify strategies for development of family-based interventions for adolescent HIV prevention. These findings will inform design of a family intervention to be tested in a randomized pilot trial (ClinicalTrials.gov #NCT02432352).
机译：青少年和年轻人每年占所有新感染艾滋病毒的40％，其中南非是受灾最严重的国家之一，艾滋病毒感染者人口最多。尽管在南非已经通过多种方式开展了青少年艾滋病毒预防工作，并且尽管基于家庭的青少年艾滋病毒预防方法在南非等受高度影响的环境中具有巨大潜力，但仍缺乏经过实践检验的基于家庭的青少年艾滋病毒预防干预措施在这种情况下。因此，我们进行了焦点小组讨论，并与包括临床医生，研究人员以及代表为青少年和父母提供艾滋病毒和相关健康服务的组织的其他个人的其他人员进行了深度访谈（N = 82）。我们围绕诸如性，艾滋病毒和人际关系交流等主题探讨了家庭观点和互动。与会者介绍了家庭互动的各个方面，这些方面既为家庭青少年艾滋病毒的预防带来了挑战，也带来了机遇。亲子间关于性话题的交流是禁忌，有些成年人认为这些对话是儿童进行艾滋病毒危险行为的诱因。父母因讨论性行为而受到社会制裁，而询问性行为的青少年通常被视为不尊重人，需要纪律处分。但是，与会人员还确定了适合情境的策略，以应对有关艾滋病毒预防的家庭挑战，包括家庭会议，社区养育子女，围绕性话题的父母与青少年沟通建立效力，以及需要加强家庭联系和积极养育子女。研究结果表明需要进行家庭干预，并确定发展基于家庭的干预措施以预防青少年HIV的策略。这些发现将为家庭干预的设计提供参考，该家庭干预将在随机试验中进行测试（ClinicalTrials.gov＃NCT02432352）。

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