scholarly journals A qualitative study to identify critical attributes and attribute-levels for a discrete choice experiment on oral pre-exposure prophylaxis (PrEP) delivery among young people in Cape Town and Johannesburg, South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Janan J. Dietrich ◽  
Millicent Atujuna ◽  
Gugulethu Tshabalala ◽  
Stefanie Hornschuh ◽  
Mamakiri Mulaudzi ◽  
...  
Keyword(s):  
South Africa ◽  
Young People ◽  
User Preferences ◽  
Dosing Regimen ◽  
Group Discussions ◽  
On Demand ◽  
Study Team ◽  
Attribute Levels ◽  
Depth Interviews ◽  
Oral Prep

Abstract Background The uptake and adherence of daily oral PrEP has been poor in high-risk populations in South Africa including young people. We used qualitative research methods to explore user preferences for daily and on-demand oral PrEP use among young South Africans, and to inform the identification of critical attributes and attribute-levels for quantitative analysis of user preferences, i.e. a discrete choice experiment (DCE). Methods Data were collected between September and November 2018 from eight group discussions and 20 in-depth interviews with young people 13 to 24 years in Cape Town and Johannesburg. Using a convenience sampling strategy, participants were stratified by sex and age. Interviewers used a semi-structured interview guide to discuss several attributes (dosing regimen, location, costs, side effects, and protection period) for PrEP access and use. Group discussions and in-depth interviews were audio-recorded, transcribed verbatim and translated to English. We used framework analysis to explore context-specific attributes and attribute-levels for delivering oral PrEP in South Africa. The adolescent community advisory board, expert and study team opinions were consulted for the final DCE attributes and levels. Results We enrolled 74 participants who were 51% (n = 38/74) male, had a median age of 18.5 [Interquartile range = 16–21.25] years, 91% (n = 67/74) identified as heterosexual and 49% (n = 36/74) had not completed 12th grade education. Using the qualitative data, we identified five candidate attributes including (1) dosing regimen, (2) location to get PrEP, (3) cost, (4) route of administration and (5) frequency. After discussions with experts and the study team, we revised the DCE to include the following five attributes and levels: dosing regime: daily, and on-demand PrEP; location: private pharmacy, public clinic, mobile clinic, ATM); cost: free-of-charge, R50 (~2GBP), R265 (~12GBP); side effects: nausea, headache, rash; and duration of protection: fulltime protection versus when PrEP is used). Conclusions There is limited literature on qualitative research methods describing the step-by-step process of developing a DCE for PrEP in adolescents, especially in resource-constrained countries. We provide the process followed for the DCE technique to understand user preferences for daily and on-demand oral PrEP among young people in South Africa.

scholarly journals A qualitative study to identify critical attributes and attribute-levels for a Discrete Choice Experiment on oral Pre-Exposure Prophylaxis (PrEP) delivery among young people in Cape Town and Johannesburg, South Africa.

2020 ◽  
Author(s):  
Janan Janine Dietrich ◽  
Millicent Atujuna ◽  
Gugulethu Tshabalala ◽  
Stefanie Hornschuh ◽  
Mamakiri Mulaudzi ◽  
...  
Keyword(s):  
South Africa ◽  
Young People ◽  
Choice Experiment ◽  
User Preferences ◽  
Dosing Regimen ◽  
On Demand ◽  
Study Team ◽  
Attribute Levels ◽  
Depth Interviews ◽  
Oral Prep

Abstract Background The uptake and adherence of daily oral PrEP has been poor in high-risk populations in South Africa including young people. We used qualitative research methods to explore user preferences for daily and on-demand oral PrEP use among young South Africans, and to inform the identification of critical attributes and attribute-levels for quantitative analysis of user preferences, i.e. a discrete choice experiment (DCE). MethodsData were collected between September and November 2018 from eight group discussions and 20 in-depth interviews with young people 13 to 24 years in Cape Town and Johannesburg. Using a convenience sampling strategy, participants were stratified by sex and age. Interviewers used a semi-structured interview guide to discuss several attributes (dosing regimen, location, costs, side effects, and protection period) for PrEP access and use. Groups discussions and in-depth interviews were audio-recorded, transcribed verbatim and translated to English. We used framework analysis to explore context-specific attributes and attribute-levels for delivering oral PrEP in South Africa. The adolescent community advisory board, expert and study team opinions were consulted for the final DCE attributes and levels. ResultsWe enrolled 74 participants who were 51% (n=38/74) male, had a median age of 18.5 [Interquartile range=16-21.25] years, 91% (n=67/74) identified as heterosexual and 49% (n=36/74) had not completed 12th grade education. Using the qualitative data, we identified five candidate attributes including (1) dosing regimen, (2) location to get PrEP, (3) cost, (4) route of administration and (5) frequency. After discussions with experts and the study team, we revised the DCE to include the following five attributes and levels: dosing regime: daily, and on-demand PrEP; location: private pharmacy, public clinic, mobile clinic, ATM); cost: free-of-charge, R50 (~2GBP), R265 (~12GBP); side effects: nausea, headache, rash; and duration of protection: fulltime protection versus when PrEP is used). ConclusionsThere is limited literature on qualitative research methods describing the step-by-step process of developing a DCE for PrEP in adolescents, especially in resource-constrained countries. We provide the process followed for the DCE technique to understand user preferences for daily and on-demand oral PrEP among young people in South Africa.

scholarly journals Identifying Critical Attributes and Attribute-Levels for a Discrete Choice Experiment on Oral Pre-Exposure Prophylaxis (PrEP) Delivery Among Young People in Cape Town and Johannesburg, South Africa.

2020 ◽  
Author(s):  
Janan Janine Dietrich ◽  
Millicent Atujuna ◽  
Gugulethu Tshabalala ◽  
Stefanie Hornschuh ◽  
Mamakiri Mulaudzi ◽  
...  
Keyword(s):  
South Africa ◽  
Young People ◽  
Qualitative Data ◽  
User Preferences ◽  
Dosing Regimen ◽  
On Demand ◽  
Study Team ◽  
Attribute Levels ◽  
Exposure Prophylaxis ◽  
Oral Prep

Abstract Background Oral Pre-Exposure Prophylaxis (PrEP) was approved for use in South Africa (SA) in 2017. The uptake and adherence of daily oral PrEP has been poor in high-risk populations in SA including adults and young people. We used a Discrete Choice Experiment (DCE) technique to identify critical attributes and attribute-levels to understand user preferences for daily and on-demand oral PrEP use among young people, including adolescents, in two South African cities. Methods Qualitative data were collected between September and November 2018 from 8 group discussions and 20 in-depth interviews with young people aged 13 to 24 years in Cape Town and Johannesburg. Participants were selected based on stratified (gender and age) purposive sampling. Using a semi-structured interview guide, interviewers discussed several attributes (dosing regimen, location, costs, side effects, and protection period) for PrEP access and use. Transcripts were coded to identify context-specific attributes and attribute-levels for delivering oral PrEP in South Africa. The adolescent community advisory board, expert and study team opinions were consulted for the final DCE attributes and levels. Results We enrolled 74 participants: 51% (n=38/74) male, median age of 18.5 [IQR=16-21.25] years, 91% (n=67/74) identified as heterosexual and 49% (n=36/74) had not completed 12th grade education. Using the qualitative data, we identified five candidate attributes including (1) dosing regimen, (2) location to get PrEP, (3) cost, (4) route of administration and (5) frequency. After discussions with experts and the study team, we revised the DCE to include the following five attributes and levels: dosing regime: daily, and on-demand PrEP; location: private pharmacy, public clinic, mobile clinic, ATM); cost: free-of-charge, R50 (~2GBP), R265 (~12GBP); side effects: nausea, headache, rash; and duration of protection: fulltime protection versus when PrEP is used). Conclusions There is limited methodological literature describing the step-by-step process of developing a DCE for PrEP in adolescents, especially in resource-constrained countries. We provide the process followed for the DCE technique to understand user preferences for daily and on-demand oral PrEP among young people in South Africa.

scholarly journals The Dangers Associated with Female Adolescents Consuming Nyaope Drug in Butterworth, South Africa

2021 ◽  
Author(s):  
Samkelo Bala ◽  
Simon M. Kang’ethe
Keyword(s):  
South Africa ◽  
Young People ◽  
Focus Group ◽  
Educational Interventions ◽  
Qualitative Approach ◽  
Female Adolescents ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Fertile Ground ◽  
Potent Drug

AbstractNyaope is a potent drug that is currently challenging South Africa; its ramifications have destroyed the country’s youth. The study described in this paper sought to explore the dangers associated with the consumption of Nyaope in Butterworth, South Africa. This study adopted an explorative and descriptive qualitative approach that involved the facilitation of focus group discussions and one-on-one interviews with twenty-six participants. An analysis of the findings of the study revealed the health hazards associated with consuming Nyaope and the tendency of Nyaope consumption to induce hallucinations and delusions in young people. Moreover, the study showed that Nyaope stimulated mood swings among female adolescents, its consumption created a fertile ground for conflict, and the addiction to Nyaope led to the destruction of the future of female adolescents. The researchers recommend the application of multiple approaches to preventing the initiation of Nyaope consumption. These approaches include attempts to control the peddling of Nyaope in schools and communities as well as the introduction of pro-active educational interventions regarding the dangers of Nyaope on the part of relevant institutions and government.

scholarly journals Young people’s experiences using an on-demand mHealth sexual and reproductive health text message intervention in Kenya: A qualitative study (Preprint)

2020 ◽  
Author(s):  
Jefferson Mwaisaka ◽  
Lianne Gonsalves ◽  
Mary Thiongo ◽  
Michael Waithaka ◽  
Hellen Sidha ◽  
...  
Keyword(s):  
Young People ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Digital Health ◽  
Intervention Development ◽  
Ease Of Use ◽  
Clinical Trial Registration ◽  
On Demand ◽  
Wide Range ◽  
Depth Interviews

BACKGROUND Digital health usability assessments can help explain how mHealth applications targeting young people with sexual and reproductive health information performed and whether or not the intended purpose was achieved. Few digital health assessments have however been conducted to evaluate young people’s perceptions regarding mHealth system interactions and content relevance on a wide range of sexual and reproductive health (SRH) topics. Additionally, majority of randomized control trials (RCTs) have focused on push messaging platforms; the mHealth field therefore lacks enough RCTs investigating on-demand mHealth SRH platforms. OBJECTIVE The objective of our study was to explore young people’s experiences using an on-demand SRH mHealth platform in Kenya. METHODS We used qualitative data related to usability of an mHealth (ARMADILLO) platform collected at the end of the intervention period. Thirty (15 females & 15 males) in-depth interviews were held with the intervention participants to elicit their experiences, opinions and perspectives on the ARMADILLO’s design and platform’s content. Study participants were randomly selected from a list of intervention arm participants to participate in the in-depth interviews. Interviews were later transcribed verbatim, translated into English, coded and analyzed thematically using NVivo version 12. RESULTS Respondents reported varied user experiences and levels of satisfaction ranging from ease of use by majority of the respondents to systematic frustrations preventing some participants from progressing to other stages. Interesting mHealth platform’s features included immediate response participants received when requesting messages, weekly remunerated quizzes, educative and informative contents’ and messages’ perceived ‘ability’ to change behaviors. Proposed platform’s enhancements included revising some concepts and words for easy understanding; make the platform interactive where young people can seek clarity when they come across difficult terms or had additional questions about the information received. CONCLUSIONS The importance of understanding the range of health literacy and technological variations when dealing with young people cannot be overemphasized. Young people as mHealth end users must be considered throughout intervention development in order to achieve optimum functionality. Additionally, young people targeted with mHealth SRH interventions need to be sensitized on mHealth platform’s interactions or any other digital health applications if implemented in a non-research setting for optimal use by the targeted audience. CLINICALTRIAL Clinical trial registration: ISRCTN85156148

scholarly journals We Have Come to Stay and We Shall Find All Means to Live and Work in this Country: Nigerian Migrants and Life Challenges in South Africa

2016 ◽  
Vol 9 (2) ◽  
pp. 371 ◽  
Author(s):  
Adediran Daniel Ikuomola ◽  
Johan Zaaiman
Keyword(s):  
South Africa ◽  
Focus Group ◽  
South African ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Cultural Challenges ◽  
Economic Disparity ◽  
Life Challenges ◽  
The Social ◽  
Depth Interviews

In recent times many Nigerians have been singled out when it comes to criminal activities and xenophobic attacks in South Africa, which leads to disruption of the hitherto cordial relationship between South African host communities and Nigerian migrants. Nevertheless, the rate of Nigerians migrating to South Africa keeps soaring. Studies of migration between Nigeria and South Africa, have been scanty, often limited to the study of traditional economic disparity between the two countries with less emphasis on the social-cultural challenges facing Nigerian migrants in the host communities.This paper thus examined the socio-economic and cultural challenges facing Nigerian migrants in selected communities in Johannesburg, South Africa. Data for the study were collected through in-depth interviews and focus group discussions with Nigerian migrants in Hillbrow, Braamfontein and Alexandra suburbs in Johannesburg, South Africa.

scholarly journals Sexual Attitudes, Beliefs, Practices, and HIV Risk During Pregnancy and Post-delivery: A Qualitative Study in Malawi, South Africa, Uganda, and Zimbabwe

2021 ◽  
Author(s):  
Julia H. Ryan ◽  
Alinda Young ◽  
Petina Musara ◽  
Krishnaveni Reddy ◽  
Nicole Macagna ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Risk ◽  
Study Groups ◽  
Group Discussions ◽  
Single Sex ◽  
Sexual Beliefs ◽  
Pregnancy And Postpartum ◽  
Willingness To Use ◽  
The Relationship ◽  
Depth Interviews

AbstractWomen who acquire HIV during the pregnancy and breastfeeding periods have a higher risk of transmitting the virus to their child than women who become infected with HIV before pregnancy. We explore the context of sexual beliefs and practices that may shape both HIV risk and willingness to use HIV prevention products during pregnancy and postpartum in Malawi, South Africa, Uganda and Zimbabwe. Twenty-three single sex focus group discussions and 36 in-depth interviews took place between May and November 2018 with recently pregnant or breastfeeding women, men, mothers and mothers-in-law of pregnant or breastfeeding women, and key informants. Participants across study groups and sites (N = 232) reported various perceived benefits and harms of sex during pregnancy and postpartum. Participants discussed reasons why men might seek sex outside of the relationship. There is a critical need for alternative prevention options to protect pregnant and breastfeeding women from HIV.

scholarly journals Khuluma: Using Participatory, Peer-Led and Digital Methods to Deliver Psychosocial Support to Young People Living With HIV in South Africa

2021 ◽  
Vol 3 ◽  
Author(s):  
Millicent Atujuna ◽  
Nikita Simpson ◽  
Malebo Ngobeni ◽  
Tebogo Monese ◽  
Danielle Giovenco ◽  
...  
Keyword(s):  
South Africa ◽  
Pilot Study ◽  
Young People ◽  
Mobile Technology ◽  
Psychosocial Support ◽  
Intervention Design ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Mhealth Intervention ◽  
Living With Hiv

Khuluma is a psychosocial and peer-to-peer mHealth intervention that uses text messaging to facilitate support groups for adolescents living with HIV (ALWH) with the aim of contributing toward positive health outcomes. Although use of mobile technology in the form of mHealth interventions has proliferated recently in the field of health, published literature describing methods and processes of its application are limited. We present a set of methods and processes utilised to develop and pilot the Khuluma mHealth intervention amongst young people (15–20 years) in South Africa. We recruited and enrolled 52 adolescents (15–20-year olds) from four clinics in Pretoria and Cape Town to participate in a 6-month pilot of Khuluma. Participants were ALWH, aware of their status, on antiretroviral therapy for more than 12 months, and not suffering from severe depression. We conducted four pre and post intervention focus group discussions (FGDs) with a proportion of ALWH (n = 36) enrolled in the pilot study using participatory methods. Several processes were utilised to then implement this pilot study. These included engaging ALWH for minor study implementation modifications; forming virtual groups; activating the mHealth platform; facilitating and delivering the Khuluma intervention. The acceptability of the intervention was informed by follow-up focus group discussions and text message data. The initial participatory processes helped to tailor the intervention design to participants' needs. The peer-led facilitation of the groups allowed for the provision of sensitive psychosocial support that allowed young people to express themselves freely, develop a sense of self-worth, and interact more. The nature of the mobile technology also allowed participants to build friendships beyond their geographic area and interact with their peers in real time. Within the evolving context of COVID-19, establishing evidence-based processes and methods for intervention design and curation in virtual spaces is critical.

scholarly journals Seeking Secrecy

Young ◽  
2017 ◽  
Vol 26 (4) ◽  
pp. 313-331 ◽  
Author(s):  
Amy Chandler
Keyword(s):  
Qualitative Research ◽  
Young People ◽  
Help Seeking ◽  
Online Survey ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Limited Experience ◽  
Seeking Help ◽  
Self Harm ◽  
Depth Interviews

Young people who self-harm face challenges in seeking help, and there is a lack of qualitative research with under 16s despite rates of self-harm being high and help-seeking low. Data were collected from 122 young people aged 13–26 years, 108 of whom were aged 13–16 years, through multiple methods. This included six focus group discussions with 33 young people who had limited experience of self-harm; in-depth interviews with five people who had self-harmed and a qualitative online survey completed by 88 young people who had self-harmed. The analysis was thematic. Participants articulated views which could inhibit help-seeking: Young people provided strong negative judgements about ‘attention-seeking’ as a motive for self-harm, while ‘private’ self-harm was valorized. Talking to others about self-harm was identified as beneficial, but it was unclear how possible this would be, if self-harm must also be kept ‘secret’. Findings suggest that framing self-harm as private and secretive may be counterproductive.

Global Impacts upon Ngoma

Utafiti ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 126-144
Author(s):  
Daines Nicodem Sanga
Keyword(s):  
Young People ◽  
Dar Es Salaam ◽  
Musical Instruments ◽  
Group Discussions ◽  
Global Impact ◽  
Intangible Heritage ◽  
Traditional Dance ◽  
Aesthetic Sense ◽  
Global Impacts ◽  
Depth Interviews

Abstract Ngoma is a Kiswahili term which means traditional dance. In this essay the terms ‘ngoma’ and ‘dance’ are used interchangeably. The research was conducted in Dar es Salaam and Iringa among four ngoma groups of young people: Lumumba, Hayahaya, Alamano and Tanangozi. Theatre stakeholders were involved to seek their perceptions of the global impact on ngoma. In-depth interviews, participant-performer research, and group discussions were the methods employed, focussing on the content, costumes, musical instruments and the make-up used, to explore how and why cultures from around the world influence the way this traditional dance form is performed by young people. It emerged that a range of factors drive innovation in this dance form, including the dancers’ quest for recognition, their individual creativity, the performers’ desire to discover and display unique identities. The findings suggest that in this age of globalisation, international influences upon aesthetic sense and expression are inevitable. But in the case of Tanzania’s ngoma, which has been preserved conscientiously for decades, protective responses to such influences should be maintained vigilantly, in order to shield this valued intangible heritage from fading away.

scholarly journals Care-seeking during fatal childhood illness in rural South Africa: a qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043652
Author(s):  
Jessica Price ◽  
Merlin Willcox ◽  
Vuyiswa Dlamini ◽  
Audrey Khosa ◽  
Phindile Khanyile ◽  
...  
Keyword(s):  
South Africa ◽  
Decision Making ◽  
Focus Group ◽  
Childhood Illness ◽  
Care Seeking ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Rural South ◽  
Depth Interviews ◽  
Rural South Africa

ObjectivesThis study aimed to better understand reasons why children in South Africa die at home, including caregivers’ care-seeking experiences, decision-making, choice of treatment provider and barriers to accessing care during a child’s final illness.DesignThis qualitative study included semi-structured in-depth interviews and focus group discussions with caregivers of children who died below the age of 5 years. Data were thematically analysed, and key findings compared with the Pathways to Survival Framework—a model frequently used in the study of child mortality. An adapted model was developed.SettingTwo rural health and demographic surveillance system (HDSS) sites in South Africa—the Agincourt HDSS and the Africa Health Research Institute.ParticipantsThirty-eight caregivers of deceased children (29 participated in in-depth interviews and 9 were participants in two focus group discussions). Caregivers were purposively sampled to ensure maximum variation across place of death, child age at death, household socioeconomic status, maternal migration status and maternal HIV status.FindingsAlthough caregivers faced barriers in providing care to children (including insufficient knowledge and poor transport), almost all did seek care from the formal health system. Negative experiences in health facilities did not deter care-seeking, but most respondents still received poor quality care and were not given adequate safety-netting advice. Traditional healers were only consulted as a last resort when other approaches had failed.ConclusionBarriers to accessing healthcare disrupt the workings of previously accepted care-seeking models. The adapted model presented in this paper more realistically reflects care-seeking experiences and decision-making during severe childhood illness in rural South Africa and helps explain both the persistence of home deaths despite seeking healthcare, and the impact of a child’s death on care-seeking in future childhood illness. This model can be used as the basis for developing interventions to reduce under-5 mortality.

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