A qualitative investigation of facilitators and barriers to DREAMS uptake among adolescents with grandparent caregivers in rural KwaZulu-Natal, South Africa

Datos Bibliográficos

ID19593762
AutoresDumile Gumede (0000-0001-8739-6033, Durban University of Technology, autor de correspondencia), Anna Meyer-Weitz (0000-0002-1874-0803, University of KwaZulu-Natal), Thembelihle Zuma (0000-0002-8374-2354, Africa Health Research Institute), M Shahmanesh (0000-0001-7129-8535, Africa Health Research Institute), Janet Seeley (0000-0002-0583-5272, London School of Hygiene & Tropical Medicine)
EditoresAri Probandari (0000-0003-3171-5271)
Año2022
Volumen2
Número9
Páginase0000369
Fecha de publicación2022-09-22
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaPLOS Global Public Health (JOURNAL)
Identificadores de la revistaISSN: 2767-3375 • E-ISSN: 2767-3375
EditorialPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0000369
PMID36962500
OpenAlexW4296741138
IdiomaEN
Citas recibidas1
Referencias citadas47

Adolescents with grandparent caregivers have experienced challenges including the death of one or both parents due to HIV in sub-Saharan Africa. They may be left out of existing HIV prevention interventions targeting parents and children. We investigated the facilitators and barriers to DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) programme uptake among adolescents with grandparent caregivers across different levels of the socio-ecological model in rural South Africa. Data were collected in three phases (October 2017 to September 2018). Adolescents (13–19 years old) and their grandparent caregivers (≥50 years old) (n = 12) contributed to repeat in-depth interviews to share their perceptions and experiences regarding adolescents’ participation in DREAMS. Data were triangulated using key informant interviews with DREAMS intervention facilitators (n = 2) to give insights into their experiences of delivering DREAMS interventions. Written informed consent or child assent was obtained from all individuals before participation. All data were collected in isiZulu and audio-recorded, transcribed verbatim and translated into English. Thematic and dyadic analysis approaches were conducted guided by the socio-ecological model. Participation in DREAMS was most effective when DREAMS messaging reinforced existing norms around sex and sexuality and when the interventions improved care relationships between the adolescents and their older caregivers. DREAMS was less acceptable when it deviated from the norms, raised SRH information that conflicts with abstinence and virginity, and when youth empowerment was perceived as a potential threat to intergenerational power dynamics. While DREAMS was able to engage these complex families, there were failures, about factors uniquely critical to these families, such as in engaging children and carers with disabilities and failure to include adolescent boys in some interventions. There is a need to adapt HIV prevention interventions to tackle care relationships specific to adolescent-grandparent caregiver communication

Developmental psychology · Empowerment · Grandparent · Political science · Psychiatry · Psychological intervention · Qualitative research · Sociology · Thematic analysis · Adolescent Sexual and Reproductive Health · HIV/AIDS Research and Interventions · Medicine · Poverty, Education, and Child Welfare · Psychology