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Doctoral Degrees (Psychology)

Permanent URI for this collectionhttps://hdl.handle.net/10413/6475

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Browsing Doctoral Degrees (Psychology) by SDG "SDG3"

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    Analysis of policy for protection of HIV positive adolescent girls against vulnerabilities faced in using contraception in Malawi.
    (2022) Bulage, Patience.; Govender, Kaymarlin.
    There are challenges faced in accessing and using contraception by adolescent girls, but the reality is worse for adolescent girls living with HIV. Thus, it is important to investigate the extent to which current policies in Malawi put into account the vulnerabilities faced by this sub-population. This study therefore sought to answer the following research questions: 1. What are the structural and socio-cultural issues affecting the use of contraception among AGLHIV in Malawi? 2. What policy provisions are in place in Malawi to address the issues/risks faced by AGLHIV during reach and use of contraception? 3. What implementation challenges affect the effectiveness of the available policy provisions? This study was guided by the healthy policy triangle (HPT) framework and it was qualitative in nature, using both secondary and primary data collection methods. The findings include; • Access to contraception by adolescent girls living with HIV is hampered by several structural and socio-cultural issues, mainly; the mode of service provision, supply chain and infrastructural challenges, age restrictions, conditioned access, as well as integration challenges. The socio-cultural issues include; the high momentum for children, male dominance, social labelling, non-disclosure of HIV serostatus to sexual partners, social sensitivity, perpetuation of harmful content, and a general lack of social support, and poor risk perception. • The available provisions include those addressing gender-based violence, discrimination and stigma, community engagement, confidentiality, and emphasis on adolescent girls and young women. However, most of the provisions are broadly stated and gaps exist too. • Effective implementation is affected largely by cascading challenges, lack of sufficient funding, limited political will, low comprehension of policy directives, limited participation of target population, coordination challenges, social resistance, effects of decentralization, low capacity of implementing partners and the slow pace of behaviour change among the targeted population and communities. While the policy environment in Malawi is seemingly favourable, undertones exist around harmonization, and representation of interest groups, mainly PLHIV groups. Policy makers ought not to continue ignoring the importance of formulating HIV-sensitive policies which can give way to social protection programs for the most vulnerable within the society, given the benefits of a healthy youthful population.
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    Narratives from women using the dapivirine vaginal ring in an open label extension study by Kalendri Naidoo.
    (2022) Naidoo, Kalendri.; Mansoor, Leila Essop.; Montgomery, Elizabeth T.
    In sub-Saharan Africa, women and girls represented 63% of new Human Immunodeficiency Virus (HIV) infections in 2020. Adolescent girls and young women (AGYW) aged 15–24 years are twice as likely to be living with HIV as compared to young men. Therefore, efforts to develop and roll out safe, effective and acceptable HIV prevention products for women, are continuing. An important example of a female-initiated HIV prevention strategy is the dapivirine vaginal ring which showed a 27% reduction in HIV-1 incidence in the Microbicides Trials Network (MTN)-020/A Study to Prevent Infection with a Ring for Extended Use (ASPIRE) study and by 31% in the International Partnership for Microbicides (IPM)-027 The Ring study. The dapivirine vaginal ring was subsequently tested for safety and adherence in the Open Label Extension (OLE), MTN-025/HIV Open-label Prevention Extension (HOPE) study. The MTN-032/Adherence in HOPE and ASPIRE (AHA) study was a two-phase exploratory sub-study of the ASPIRE (AHA part 1, after ASPIRE and before HOPE study initiation) and HOPE (AHA part 2, after HOPE was completed) studies which utilised single qualitative indepth interviews (IDIs) to explore social conditions and issues related to participation around the use of the dapivirine vaginal ring as well as suitable approaches to market the study product. I report on the narratives from women participating in the AHA study (Part 2) within the context of known safety, partial product efficacy and choice, focusing on what motivated women to join the HOPE OLE study, women’s understanding of the vaginal rings’ efficacy, how they understood it to work in their bodies to prevent HIV and barriers and motivators to vaginal ring adherence.