Response to a sexual risk reduction intervention provided in combination with hepatitis C treatment by HIV/HCV co-infected men who have sex with men: a reflexive thematic analysis

Background Hepatitis C virus reinfections in HIV-positive men-who-have-sex-with-men (MSM) challenge the effectiveness of antiviral treatment. To fight this problem, an adapted sexual risk reduction intervention was implemented within a hepatitis C treatment trial. Following this, the current study had two aims and describes 1) how the program was received by participants; and 2) their responses to the program regarding sexual risk taking. Based on the participants’ input, we hoped to judge the intervention’s potential for scale-up. Methods Seventeen participants who received the sexual risk reduction intervention in addition to hepatitis C treatment were recruited for semi-structured interviews six to 12 months post-intervention. We evaluated the responses via reflexive thematic analysis and applied the concept of sense-making. Results Giving hepatitis C a place and living without it again illustrates how participants received the program and how their experiences were altered by the impact of sense-making. Based on their responses, we allocated participants to three groups: 1. Avoid risks: get rid of hepatitis C for life. For these men, hepatitis C remained a life-threatening disease: they actively modified their risk behavior and felt supported by the intervention in maintaining their behavioral changes. 2. Minimize risks: live as long as possible without hepatitis C. In contrast to group 1, these men saw hepatitis C as a manageable disease. The intervention facilitated reflection on risks and how to develop behavioral changes that suited them individually. 3. Accept risks; live with the risk of hepatitis C. These men perceived behavioral changes as much more difficult than “easy” medical treatment. They expected to either undergo repeated rounds of treatment or stay HCV re-infected. Conclusion These results illustrate the diversity of men’s responses and their decisions regarding sexual risk behavior after participating in a combination of antiviral treatment and a sexual risk reduction intervention. Two major aspects were identified: 1) Teachable moments, particularly at the time of diagnosis/treatment, could offer an opportunity to develop openness for behavioral change; 2) adapting sexual risk reduction interventions to sense-making patterns could help to improve its effectiveness. Support for reducing infection risk and raising awareness of preventative measures are additional benefits. Trial registration Clinical Trial Number: NCT02785666, 30.05.2016.

Parent-Adolescent Communication on Sexual Issues as Predictor of Sexual-Risk Reduction behaviour among in-School Adolescents in Selected Secondary Schools in Yei River State-South Sudan

The study investigated the parent-adolescent communication on sexual issues as predictors of sexual-risk reduction among in-school adolescents in secondary school. Teenage pregnancy and adolescent birth rates are high at 300/1000 and 158/1000 live births respectively in 2018. Frequent discussion on sexual behaviour is more likely to reduce adolescent risk-taking sexual behaviors. However, there is a paucity of evidence about adolescent parent communication in Yei River State. A cross-sectional study using both quantitative and qualitative approaches involving 156 participants to explore the parent-adolescent communication frequency and topics discussed among secondary school adolescents was carried out. Respondents were recruited from the ten functional secondary schools in Yei River state from secondary school class 1 to 4. The inclusion criteria consider secondary school adolescent aged 15 to 19, parental consent and adolescent acceptance to participate in the study. Adolescent below the age 15 and young men above 19 years of age were excluded from the study. Data was collected using semi-structured questionnaire, the date collected were coded first and analyzed suing SPSS version 21. The percentage of adolescents who had more than three sessions of communication with their parents about sexual behaviour was nearly 43% in which, majority 67% reported to have frequent discussions with their mothers and the commonly discussed topics were biological and physical development. The study concluded that a few adolescents have frequent communication with their parents on sexual behaviours. This study recommends, repeat of the current study in some states for comparison, as well as a study focusing on both out of school and school adolescent to explore more.

Novel Service Delivery Approach to Address Reproductive Health Disparities within Immigrant Latino Communities in Geographic Hot Spots: An Implementation Study

Latinx youths continue to have the highest rates of teenage births in the United States and are at increased risk of acquiring sexually transmitted infections, including HIV/AIDS. A community-based research partnership piloted Families Talking Together, a brief, parent-based sexual risk reduction program using a novel and culturally relevant approach. This mixed-methods study examined the feasibility and acceptability of Spanish-speaking promotoras de salud (that is, community health workers) as implementers of an evidence-based intervention (EBI) to reach underserved immigrant communities. Findings suggest that promotoras are capable of implementing the EBI with positive organizational, client, and implementation outcomes. Furthermore, promotoras hold particular promise for addressing reproductive health disparities as they are indigenous and trusted members of the community who can reach members of marginalized Latino populations.