Sarah E Asuquo1, Kadija M Tahlil2, Kathryn E Muessig1, Donaldson F Conserve3, Mesoma A Igbokwe4,5, Kelechi P Chima4,5, Ezienyi C Nwanunu4,6, Lana P Elijah4,7, Suzanne Day8, Nora E Rosenberg1,9, Jason J Ong10,11, Susan Nkengasong12, Weiming Tang13, Chisom Obiezu-Umeh14, Ucheoma Nwaozuru14, Yesenia Merino15, Titilola Gbaja-Biamila4, David Oladele4, Juliet Iwelunmor14, Oliver Ezechi4, Joseph D Tucker10,16. 1. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 2. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 3. Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. 4. Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria. 5. College of Medicine, University of Nigeria, Nsukka, Nigeria. 6. Department of Biochemistry, Michael Okpara University of Agriculture, Umudike, Nigeria. 7. College of Medicine, Lagos State University, Lagos, Nigeria. 8. Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 9. University of North Carolina Project Malawi, Lilongwe, Malawi. 10. Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. 11. Central Clinical School, Monash University, Melbourne, Vic., Australia. 12. Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK. 13. Dermatology Hospital, Southern Medical University, Guangzhou, China. 14. Department of Behavioral Science and Health Education, Saint Louis University, Saint Louis, MO, USA. 15. Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 16. Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Abstract
INTRODUCTION: Youth engagement in HIV research is generally recognized as essential, but often neglected or minimally implemented in practice. Engagement is a process of working collaboratively with diverse groups of people to address common issues. We conducted a scoping review of youth HIV prevention interventions in sub-Saharan Africa to identify and categorize forms and levels of youth engagement across the lifespan of intervention research. METHODS: We followed Arksey and O'Malley's framework for organizing a scoping review. We searched seven databases for related articles on identified intervention studies through May 28th 2020. Included studies focused on youth (10 to 24 years old) HIV prevention interventions in sub-Saharan Africa. Two reviewers independently examined citations and full manuscripts for inclusion. Data were extracted on study characteristics, location, description of youth engagement and extent of engagement. Youth engagement approaches were categorized based on Hart's ladder as substantial engagement (strong youth decision-making power), moderate engagement (shared decision making with adults), minimal engagement (no youth decision-making power) or no engagement. RESULTS: We identified 3149 citations and included 112 studies reporting on 74 unique HIV interventions. Twenty-two interventions were in low-income countries, 49 in middle-income countries, and three were in both. Overall, only nine interventions (12%) had substantial or moderate youth engagement, two-thirds (48, 65%) had minimal youth engagement and 17 interventions (23%) had no youth engagement. We also identified specific engagement strategies (e.g. youth-led research, crowdsourcing) that were feasible in multiple settings and resulted in substantial engagement. CONCLUSIONS: We found limited youth engagement in youth HIV prevention intervention studies in sub-Saharan Africa. However, several activities resulted in substantial youth engagement and could be relevant in many low-and-middle-income-country (LMIC) settings.
INTRODUCTION: Youth engagement in HIV research is generally recognized as essential, but often neglected or minimally implemented in practice. Engagement is a process of working collaboratively with diverse groups of people to address common issues. We conducted a scoping review of youth HIV prevention interventions in sub-Saharan Africa to identify and categorize forms and levels of youth engagement across the lifespan of intervention research. METHODS: We followed Arksey and O'Malley's framework for organizing a scoping review. We searched seven databases for related articles on identified intervention studies through May 28th 2020. Included studies focused on youth (10 to 24 years old) HIV prevention interventions in sub-Saharan Africa. Two reviewers independently examined citations and full manuscripts for inclusion. Data were extracted on study characteristics, location, description of youth engagement and extent of engagement. Youth engagement approaches were categorized based on Hart's ladder as substantial engagement (strong youth decision-making power), moderate engagement (shared decision making with adults), minimal engagement (no youth decision-making power) or no engagement. RESULTS: We identified 3149 citations and included 112 studies reporting on 74 unique HIV interventions. Twenty-two interventions were in low-income countries, 49 in middle-income countries, and three were in both. Overall, only nine interventions (12%) had substantial or moderate youth engagement, two-thirds (48, 65%) had minimal youth engagement and 17 interventions (23%) had no youth engagement. We also identified specific engagement strategies (e.g. youth-led research, crowdsourcing) that were feasible in multiple settings and resulted in substantial engagement. CONCLUSIONS: We found limited youth engagement in youth HIV prevention intervention studies in sub-Saharan Africa. However, several activities resulted in substantial youth engagement and could be relevant in many low-and-middle-income-country (LMIC) settings.
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