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UNICEF Innocenti's complete catalogue of international peer reviewed journals

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Uptake of HIV testing among adolescents and associated adolescent-friendly services

AUTHOR(S)
Jennifer Waidler, Rachel Kidman, Tia Palermo

Published: 2020

HIV testing remains low among adolescents. Making public health services more adolescent-friendly is one strategy used to encourage testing. However, it remains unclear whether government-led initiatives have a meaningfully impact. The current study is observational and utilizes two sources of data (health-facility and adolescent-level) from one round of data collection of an on-going, longitudinal impact evaluation of a pilot cash plus program targeting adolescents. This study linked data from adolescent surveys (n = 2191) to data collected from nearby government-run health facilities (n = 91) in two rural regions of Tanzania. We used log binomial regression models to estimate the association between specific adolescent-friendly health service (AFHS) characteristics and adolescents’ uptake of 1) HIV testing and 2) visiting a health care facility in the past year for sexual and reproductive health (SRH) services.

Most adolescents (67%) lived in a village with a health facility, and all offered HIV services. We find, however, that AFHS have not been fully implemented. For example, less than 40% of facilities reported that they had guidelines for adolescent care. Only 12% of facilities had a system in place for referral and follow-up with adolescent clients, yet this was an important predictor of both past-year HIV testing (RR = 1.28, p < 0.1) and SRH visits (RR = 1.44, p < 0.05). Less than half (44%) offered services for survivors of gender-based violence (GBV), a significant predictor of past-year HIV testing (RR = 1.20, p < 0.05) and SRH visits (RR = 1.41, p < 0.01) among sexuallyactive adolescents.

We find that national guidelines on AFHS have not been fully translated into practice at the local level. We highlight particular gaps in adolescent referral systems and GBV services. Scaling up these two essential services could encourage greater HIV testing among a high-risk population, in addition to providing much needed support for survivors of violence.

Understanding the Relationships Between HIV and Child Marriage: Conclusions From an Expert Consultation

AUTHOR(S)
Suzanne Petroni, Rachel Yates, Mannahil Siddigi, Chewe Luo, Arwyn Finnie, Damilola Walker, Alice Welbourn, Catherine J. Langevin-Falcon, Tia Palermo, Claudia Cappa

Published: 2019
Stimulated by careful reviews of the literature undertaken by the World Health Organization and Girls Not Brides, in November 2018, the United Nations International Children's Emergency Fund (UNICEF) and Girls Not Brides convened experts from academia, civil society, and bilateral and multilateral institutions for a consultation that aimed to better understand what is and what is not known about this relationship, as well as to identify priorities for policies and programs. This article summarizes some key conclusions and recommendations from that convening.
Cite this publication | No. of pages: 694–696 | Tags: early marriage, HIV and AIDS
Children, HIV, emergencies and Sustainable Development Goals: roadblocks ahead and possible solutions

AUTHOR(S)
Dick Chamla, Chewe Luo, Priscilla Idele

Published: 2018
Climate change, violent conflicts, and HIV/AIDS are linked to multiple Sustainable Development Goals (SDGs) through complex pathways (Figure 1) that include food insecurity, population displacements and migration, disruptions of health and HIV services, and increased incidences of sexual based violence. This interlinkage has the potential to result in high newborn and under five mortality rates and increased burden of HIV, directly affecting SDG 3.2 and 3.3 with children and adolescents being primarily affected.
How does a national poverty programme influence sexual debut among Kenyan adolescents?

AUTHOR(S)
Sudhanshu Handa, Tia Palermo, Molly Rosenberg, Audrey Pettifor, Carolyn Tucker Halpern, Harsha Thirumurthy

Published: 2016
Cash transfer programmes have recently emerged as promising interventions for HIV prevention among adolescents in Africa. However, the pathways through which risk reduction occurs are not well understood. We examine data on 1429 adolescents and youth from the Kenya Cash Transfer for Orphans and Vulnerable Children, which has been shown to result in delayed sexual debut among adolescents. We explored three potential mediating pathways: schooling, socio-economic status and psycho-social status. None of these hypothesised mediators greatly altered the main effect. However, school attendance had a larger protective effect on sexual debut among females but was only increased by the programme among males. This gendered pattern of effects may explain why we did not see a mediating effect of the cash transfer through schooling, despite schooling's protective effects against early sexual debut. Results also suggest that cash transfer programmes in Africa can contribute to the reduction of HIV related risk behaviours.
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