Tailor Lauren S, Angell Jonathan, Hasan Syeda, Low Sharon, Willis Nicola, Mutsinze Abigail, Chitiyo Vivian, Kuchocha Peggy, Logie Carmen H
University of Toronto, Toronto, Ontario, Canada.
Child Health Evaluative Sciences Program, The Hospital for Sick Children, Toronto, ON, Canada.
Health Promot Pract. 2024 Sep 30;26(4):15248399241278974. doi: 10.1177/15248399241278974.
HIV disproportionately affects adolescent girls and young women living in Southern Africa. Rates of perinatal HIV transmission are high in this population, emphasizing the need for targeted health promotion and public health programming to improve the health of young mothers living with HIV. Zvandiri, a non-profit organization in Zimbabwe, created the Young Mentor Mother (YMM) program in response to this issue. This health promotion program uses peer-led service delivery conducted by trained young mothers living with HIV, called YMMs. We conducted semi-structured virtual interviews (N = 29) among Zvandiri staff and YMMs to identify benefits and challenges, and to inform future program scaling. We applied thematic analyses to the transcriptions. Participant narratives revealed several themes, including three key benefits from the YMM program: (1) peer support, (2) holistic care, and (3) women's empowerment. Participants also shared barriers to the success of the program, reflecting two overarching dimensions: (1) barriers related to scaling up the YMM program and (2) challenges related to addressing socio-structural factors. Barriers to scale-up included limited funds and resources, and food insecurity. Socio-structural challenges included HIV-related stigma, cultural and geographic differences, and intimate partner violence (IPV). These challenges align with the social-ecological model, whereby structural factors (lack of funding, food insecurity), community factors (HIV-related stigma, socio-cultural differences in accepting HIV care), and interpersonal factors (IPV) affect the implementation and scale-up of the program. We recommend future adopters of the YMM program to tailor the model for their community, prioritize peer supporter's well-being, foster women's empowerment, and adopt a holistic care approach.
艾滋病毒对生活在南部非洲的少女和年轻女性影响尤为严重。该人群中围产期艾滋病毒传播率很高，这凸显了针对性健康促进和公共卫生规划的必要性，以改善感染艾滋病毒的年轻母亲的健康状况。津巴布韦的一个非营利组织“兹万迪里”针对这一问题创建了“年轻导师母亲”（YMM）项目。这个健康促进项目采用由受过培训的感染艾滋病毒的年轻母亲（即YMM）主导的同伴服务模式。我们对兹万迪里的工作人员和YMM进行了半结构化的虚拟访谈（N = 29），以确定益处和挑战，并为未来项目的扩大提供参考。我们对访谈记录进行了主题分析。参与者的叙述揭示了几个主题，包括YMM项目的三个关键益处：（1）同伴支持，（2）全面护理，以及（3）妇女赋权。参与者还分享了项目成功的障碍，反映在两个总体方面：（1）与扩大YMM项目相关的障碍，以及（2）与应对社会结构因素相关的挑战。扩大规模的障碍包括资金和资源有限以及粮食不安全。社会结构方面的挑战包括与艾滋病毒相关的耻辱感、文化和地理差异以及亲密伴侣暴力（IPV）。这些挑战与社会生态模型相符，即结构因素（资金不足、粮食不安全）、社区因素（与艾滋病毒相关的耻辱感、接受艾滋病毒护理方面的社会文化差异）和人际因素（IPV）会影响该项目的实施和扩大。我们建议未来采用YMM项目的机构根据其社区情况调整该模式，优先考虑同伴支持者的福祉，促进妇女赋权，并采用全面护理方法。
