Cultural Consensus Modeling to Understand South African Adolescent Girls' Attitudes, Awareness, and Uptake of Dual Protection Strategies

• Type of Material: Article
• Authors: Jennifer L. Brown, University of Cincinnati; Lochner Marais, University of the Free State; Carla Sharp, University of the Free State; Jan Cloete, University of the Free State; Molefi Lenka, University of the Free State; Kholisa Rani, University of the Free State; Philile Marime, University of the Free State; Irene Ditlhare, University of the Free State; Refuwe Moqolo, University of the Free State; Disebo Peterson, University of the Free State; Jessica Sales, Emory University
• Language: English
• Date: 2020-12-01
• Publisher: ELSEVIER SCIENCE INC
• Publication Version: Final Published Version
• Copyright Statement: © 2020 Society for Adolescent Health and Medicine
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jadohealth.2020.07.003
• Title of Journal or Parent Work: JOURNAL OF ADOLESCENT HEALTH
• Volume: 67
• Issue: 6
• Start Page: 793
• End Page: 803
• Grant/Funding Information: This study was funded by the Bill & Melinda Gates Foundation (OPP1161907; principal investigator: Jennifer L. Brown). The project described was also supported by the National Center for Advancing Translational Sciences of the National Institutes of Health, under Award Number UL1TR000077.
• Keywords: Life Sciences & Biomedicine; South African adolescents; Pediatrics; CONDOM USE; Dual protection; Science & Technology; Public, Environmental & Occupational Health; Social Sciences; STI/HIV prevention; Psychology; WOMEN; Psychology, Developmental; HIV PREVENTION; PREGNANCY; REPRODUCTIVE HEALTH; Pregnancy prevention; Cultural consensus modeling
• Research Categories: Psychology, Developmental; Health Sciences, Immunology; Health Sciences, Public Health

Abstract

Purpose: This study used cultural consensus modeling to elucidate culturally relevant factors associated with dual protection use (strategies to prevent both pregnancy and sexually transmitted infection [STI]/HIV) among South African adolescent girls aged 14–17 years. Methods: In Phase 1, participants (N = 50) completed a free-listing survey assessing pregnancy and STI/HIV methods used by peers. In Phase 2, participants (N = 100) completed a rating survey to examine perceived peer acceptability of Phase 1 pregnancy and STI/HIV prevention methods. In Phase 3, qualitative individual interviews (N = 25) gathered in-depth information regarding the cultural acceptability of pregnancy and STI/HIV prevention strategies. In Phase 4, participants (N = 300) completed the Phase 2 rating survey for individual beliefs regarding the acceptability of pregnancy and STI/HIV prevention methods. Results: In Phase 1, 41 pregnancy and 29 STI/HIV prevention strategies, along with 16 factors influencing pregnancy prevention method acceptability were endorsed; male condoms were the most commonly endorsed pregnancy and STI/HIV prevention method. In Phase 2, using cultural consensus analysis, participants were consistent in the perceived acceptability of pregnancy and STI/HIV prevention methods (73.4% variance accounted for in single cultural model). In Phase 3, qualitative findings provided in-depth information regarding factors influencing commonly used pregnancy (e.g., injectable contraception) and STI/HIV (e.g., condoms) prevention methods. In Phase 4, a single cultural model was identified (56.3% variance accounted for), with similar acceptability ratings as Phase 2. Conclusions: A singular cultural model of pregnancy and STI/HIV prevention method acceptability was observed, with little awareness of dual protection. The findings highlight cultural factors for future culturally tailored dual protection interventions for South African adolescent girls.