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Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa

Author

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  • Elona Toska
  • Marija Pantelic
  • Franziska Meinck
  • Katharina Keck
  • Roxanna Haghighat
  • Lucie Cluver

Abstract

Background: Evidence on sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa is urgently needed. This systematic review synthesizes the extant research on prevalence, factors associated with, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa. Methods: Studies were located through electronic databases, grey literature, reference harvesting, and contact with researchers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Quantitative studies that reported on HIV-positive participants (10–24 year olds), included data on at least one of eight outcomes (early sexual debut, inconsistent condom use, older partner, transactional sex, multiple sexual partners, sex while intoxicated, sexually transmitted infections, and pregnancy), and were conducted in sub-Saharan Africa were included. Two authors piloted all processes, screened studies, extracted data independently, and resolved any discrepancies. Due to variance in reported rates and factors associated with sexual risk-taking, meta-analyses were not conducted. Results: 610 potentially relevant titles/abstracts resulted in the full text review of 251 records. Forty-two records (n = 35 studies) reported one or multiple sexual practices for 13,536 HIV-positive adolescents/youth from 13 sub-Saharan African countries. Seventeen cross-sectional studies reported on individual, relationship, family, structural, and HIV-related factors associated with sexual risk-taking. However, the majority of the findings were inconsistent across studies, and most studies scored

Suggested Citation

  • Elona Toska & Marija Pantelic & Franziska Meinck & Katharina Keck & Roxanna Haghighat & Lucie Cluver, 2017. "Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-30, June.
    • Handle: RePEc:plo:pone00:0178106
    DOI: 10.1371/journal.pone.0178106
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    References listed on IDEAS

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    3. Mburu, Gitau & Ram, Mala & Oxenham, Danielle & Haamujompa, Choolwe & Iorpenda, Kate & Ferguson, Laura, 2014. "Responding to adolescents living with HIV in Zambia: A social–ecological approach," Children and Youth Services Review, Elsevier, vol. 45(C), pages 9-17.
    4. Sophie J S Pascoe & Lisa F Langhaug & Webster Mavhu & James Hargreaves & Shabbar Jaffar & Richard Hayes & Frances M Cowan, 2015. "Poverty, Food Insufficiency and HIV Infection and Sexual Behaviour among Young Rural Zimbabwean Women," PLOS ONE, Public Library of Science, vol. 10(1), pages 1-21, January.
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