Original Research

Empowering parents for human immunodeficiency virus prevention: Health and sex education at home

Taygen Edwards, Ntombizodumo Mkwanazi, Joanie Mitchell, Ruth M. Bland, Tamsen J. Rochat
Southern African Journal of HIV Medicine | Vol 21, No 1 | a970 | DOI: https://doi.org/10.4102/sajhivmed.v21i1.970 | © 2020 Taygen Edwards, Ntombizodumo Mkwanazi, Joanie Mitchell, Ruth M. Bland, Tamsen J. Rochat | This work is licensed under CC Attribution 4.0
Submitted: 19 March 2019 | Published: 29 June 2020

About the author(s)

Taygen Edwards, Africa Health Research Institute, Somkhele, South Africa; and, Liggins Institute, University of Auckland, Auckland, New Zealand
Ntombizodumo Mkwanazi, Human and Social Capabilities Division, Human Sciences Research Council, Durban, South Africa; and, DSI-NRF Centre of Excellence in Human Development, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Joanie Mitchell, Lentegeur Psychiatric Hospital, Department of Health, Government of the Western Cape, Cape Town, South Africa
Ruth M. Bland, Royal Hospital for Sick Children, Glasgow, Scotland; and, Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland; and, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
Tamsen J. Rochat, DSI-NRF Centre of Excellence in Human Development, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, SAMRC Developmental Pathways to Health Research Unit (DPHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa


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Abstract

Background: Improving health literacy amongst human immunodeficiency virus (HIV)-positive mothers could strengthen child and adolescent HIV prevention. The Amagugu intervention included health literacy materials to strengthen maternal communication and has demonstrated success in low-resource HIV-endemic settings.

Objectives: Our aims were to (1) evaluate whether Amagugu materials improved health literacy leading to changes in parental behaviour towards communicating on topics such as HIV, health behaviours and sex education, and (2) explore what additional information and materials mothers would find helpful.

Method: The Amagugu evaluation included 281 HIV-positive mothers and their HIV-uninfected children (6–10 years). Process evaluation data from exit interviews were analysed using content analysis and logistic regression techniques.

Results: Of 281 mothers, 276 (98.0%) requested more educational storybooks: 99 (35.2%) on moral development/future aspirations, 92 (32.7%) on general health, safety and health promotion, and 67 (23.8%) on HIV and disease management. Compared to baseline, mothers reported that the materials increased discussion on the risks of bullying from friends (150; 53.4%), teacher problems (142; 50.5%), physical abuse (147; 52.3%) and sexual abuse (126; 44.8%). Most mothers used the ‘HIV Body Map’ for health (274; 97.5%) and sex education (267; 95.0%). The use of a low-cost doll was reported to enhance mother–child communication by increasing mother–child play (264; 94.3%) and maternal attentiveness to the child’s feelings (262; 93.6%).

Conclusion: Parent-led health education in the home seems feasible, acceptable and effective and should be capitalised on in HIV prevention strategies. Further testing in controlled studies is recommended.


Keywords

health education; sex education; intervention materials; HIV prevention; HIV-uninfected children; parent–child communication

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