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2017 ; 12
(3
): e0173225
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English Wikipedia
Sexual learning among East African adolescents in the context of generalized HIV
epidemics: A systematic qualitative meta-synthesis
#MMPMID28278210
Knopf AS
; McNealy KR
; Al-Khattab H
; Carter-Harris L
; Oruche UM
; Naanyu V
; Draucker CB
PLoS One
2017[]; 12
(3
): e0173225
PMID28278210
show ga
BACKGROUND: AIDS-related illness is the leading cause of mortality for
adolescents in sub-Saharan Africa. Together, Kenya, Tanzania, and Uganda account
for 21% of HIV-infected adolescents in sub-Saharan Africa. The United Nations
framework for addressing the epidemic among adolescents calls for comprehensive
sexual and reproductive health education. These HIV prevention efforts could be
informed by a synthesis of existing research about the formal and informal sexual
education of adolescents in countries experiencing generalized epidemics. The
purpose of this study was to describe the process of sexual learning among East
African adolescents living in the context of generalized HIV epidemics. METHODS:
Qualitative metasynthesis, a systematic procedure for integrating the results of
multiple qualitative studies addressing a similar phenomenon, was used.
Thirty-two research reports met study inclusion criteria. The reports were
assessed in a four-step analytic process: appraisal, classification of findings,
synthesis of findings, and construction of a framework depicting the process of
sexual learning in this population. RESULTS: The framework includes three phases
of sexual learning: 1) being primed for sex, 2) making sense of sex, and 3)
having sexual experiences. Adolescents were primed for sex through gender norms,
cultural practices, and economic structures as well as through conversations and
formal instruction. They made sense of sex by acquiring information about sexual
intercourse, reproduction and pregnancy, sexually transmitted infections, and
relationships and by developing a variety of beliefs and attitudes about these
topics. Some adolescents described having sexual experiences that met wants or
needs, but many experienced sex that was coerced or violent. Whether sex was
wanted, coerced, or violent, adolescents experienced worry about sexually
transmitted infections or premarital pregnancy. CONCLUSIONS: The three phases of
sexual learning interact to shape adolescents' sexual lives and their risk for
HIV infection. This framework will contribute to the development of sexual
education programs that address HIV risk within the broader context of sexual
learning.