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通过东非和南部非洲的自我护理干预措施预防意外怀孕和艾滋病毒:结构化综述的结果

Preventing Unintended Pregnancies and HIV Through Self-Care Interventions in East and Southern Africa: Findings From a Structured Review.

作者信息

Castro Lopes Sofia, Martin Hilber Adriane, Secula Florence, Nyoni Yemurai, Shankar Tewari Jyoti, Bakaroudis Maria, Tallarico Renata

机构信息

Independent Consultant, Cape Town, South Africa.

Swiss Centre for International Health, Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.

出版信息

Public Health Rev. 2025 Mar 4;46:1607481. doi: 10.3389/phrs.2025.1607481. eCollection 2025.

Abstract

OBJECTIVE

To identify promising interventions targeting young people in East and Southern Africa through self-care practices, with a focus on prevention of unintended pregnancies and HIV and develop four evidence-based self-care models.

METHODS

A structured literature review was conducted followed by a consultation with key stakeholders and youth networks from Malawi, South Africa, Zambia and Zimbabwe. Of the 2,890 published articles identified, 464 were fully reviewed and 59 were included in the final analysis along with 48 pieces of grey literature. A total of 31 youths participated in the consultation sessions.

RESULTS

Self-care interventions with high levels of feasibility, acceptability, and scalability included HIV self-testing, self-management of contraceptives, and self-awareness for improved and safer sex behaviours and sexual health. Key features of these interventions included the use of non-clinical environments, regular follow ups to reinforce practice, use of digital solutions, linkage to in person care, and participatory approaches involving young people from ideation to implementation.

CONCLUSION

Self-care models that promote distribution, access, support through multiple mechanisms in non-clinical environments are more acceptable and more effective in reaching young people.

摘要

目的

通过自我保健实践确定针对东非和南部非洲年轻人的有前景的干预措施,重点是预防意外怀孕和艾滋病毒,并开发四种基于证据的自我保健模式。

方法

进行了结构化文献综述,随后与来自马拉维、南非、赞比亚和津巴布韦的关键利益相关者和青年网络进行了磋商。在识别出的2890篇已发表文章中,对464篇进行了全面审查,最终分析纳入了59篇,另有48篇灰色文献。共有31名青年参加了磋商会。

结果

具有高度可行性、可接受性和可扩展性的自我保健干预措施包括艾滋病毒自我检测、避孕药具自我管理以及提高安全性行为和性健康的自我意识。这些干预措施的关键特征包括使用非临床环境、定期随访以强化实践、使用数字解决方案、与面对面护理相联系以及采用从构思到实施让年轻人参与的参与式方法。

结论

在非临床环境中通过多种机制促进分发、获取和支持的自我保健模式在接触年轻人方面更可接受且更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c91/11913615/35ae8fc7311c/phrs-46-1607481-g001.jpg

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