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Understanding the perspectives and preferences of clients eligible for pre-exposure prophylaxis (PrEP) is essential to designing programs that meet clients' needs. To date, most PrEP programs in limited-resource settings have been implemented by partner organizations for specific target populations, but the government of Zimbabwe aims to make PrEP available to the broader population at substantial risk in public sector clinics. However, there is limited information on general population perspectives about PrEP in Zimbabwe. A qualitative study was conducted to explore clients' motivation to take or decline PrEP and continue or discontinue PrEP. Through a PrEP pilot in one urban family planning clinic and one rural youth center in Zimbabwe, 150 HIV-negative clients screened as being at high risk of HIV and were offered PrEP between January and June 2018. Sixty semi-structured interviews were conducted with clients who agreed to follow-up (including 5 decliners, all from the rural youth center, and 55 accepters, with 42 from the rural youth center and 13 from the urban family planning clinic). Interviews were conducted after either the first or second PrEP follow-up appointment or after the client declined PrEP. Interviews were audio recorded, de-identified, transcribed, and coded thematically. PrEP uptake was driven by risk perception for HIV, and in many cases, that risk was introduced by the unsafe behavior or HIV-positive status of a partner. Among sero-discordant couples (SDCs), the desire to safely conceive a child was also cited as a factor in taking PrEP. Clients who opted for PrEP preferred it to other forms of HIV prevention. SDCs reported decreased condom use after PrEP initiation and in some cases were using PrEP while trying to conceive a child. After initiating PrEP, clients had more confidence in their sexual relationships and less stress associated with negotiating condom use. Family and partner support was critical to starting and continuing PrEP, but some clients stopped PrEP or missed appointments due to side effects or logistical challenges such as transportation. Results of this study can be used to provide operational guidance for national public sector roll-out of PrEP as part of combination HIV prevention in Zimbabwe. Based on feedback and experiences of clients, the training materials for health workers can be refined to ensure that health workers are prepared to counsel clients on the decision to start and/or continue PrEP and answer common client questions. Program advertisements should also be targeted with key messages that speak to client experiences. Clinical Trial Registry Number: PACTR201710002651160.

Wprowadzenie i cel: Badania międzynarodowe i krajowe wskazują, że nastoletnia młodzież powszechnie stosuje leki przeciwbólowe. Realizowane dotychczas w Polsce projekty badawcze dotyczące tej problematyki prowadzone były wśród młodzieży uczęszczającej do szkół ogólnodostępnych. Nie dysponujemy natomiast danymi na temat przyjmowania leków przeciwbólowych wśród nastolatków przebywających w placówkach edukacji specjalnej, tj. w młodzieżowych ośrodkach socjoterapii (MOS) i młodzieżowych ośrodkach wychowawczych (MOW). Celem niniejszej pracy była ocena częstości stosowania leków przyjmowanych z powodu dolegliwości bólowych wśród młodzieży przebywającej w MOS/MOW. Materiał i metody: Badanie zrealizowano w 2018 roku wśród młodzieży w wieku 12-19 lat z losowo wybranych placówek MOS/MOW z całej Polski (N = 1730). Dane zebrano z wykorzystaniem audytoryjnych badań ankietowych. Do oceny różnic w częstości przyjmowania leków ze względu na płeć i rodzaj ośrodka zastosowano test chi-kwadrat. Wyniki: W miesiącu przed badaniem leki z powodu bólu głowy przyjmowało przynajmniej 1-2 razy około 60% uczestników badań, z powodu bólu brzucha - 44,5% respondentów. Dziewczęta znacząco częściej niż chłopcy stosują leki zarówno z powodu bólu głowy, jak i bólu brzucha. Rozpowszechnienie używania leków przeciwbólowych wśród wychowanków MOS/MOW jest wyższe niż wśród młodzieży uczącej się w szkołach ogólnodostępnych. Wnioski: Ze względu na zagrożenia związane z przyjmowaniem leków działania profilaktyczne adresowane do młodzieży powinny uwzględniać zajęcia ukierunkowane na doskonalenie wiedzy i umiejętności dotyczących bezpiecznego stosowania farmaceutyków. Wywiad dotyczący przyjmowania leków przeciwbólowych przez nastolatka powinien być elementem diagnozy lekarza rodzinnego.

Young, Disabled and LGBT+ brings together the work of an international team interested in exploring the intersection of sexuality, gender identity, and disability in the lives of young people and aims to further develop this area as a distinct area of study. This volume features original research and writing into lives that are often misunderstood, marginalised and under-represented in research. It is framed with artwork, poetry and writing from young disabled LGBT+ people and centralises the voices and lives of young disabled LGBT+ people throughout. Drawing from disciplines including sociology, psychology, disability and youth studies, and with contributions from practitioners, it examines experiences and research from a number of perspectives, such as education, personal lives and activism. Featuring work from the UK, Canada, United States, India and Australia, it is a timely and topical book which will appeal to scholars particularly interested in sexuality, gender, disability and youth studies; professionals within health, education, social work and youth work who aim to understand and support young disabled LGBT+ people; and young people themselves.

Background: Being exposed to violence is a global health problem, increasing the risk of suffering from ill health. The main aim of this study was to estimate the prevalence of emotional, physical and sexual violence victimisation and its association to self-rated health among youths. The second aim was to investigate whether the youths had disclosed to healthcare professionals at a Youth Centre or others about being exposed. Methods: The cross-sectional study includes data from a web survey of youths, aged 15–25 (n=500), collected in Sweden. Descriptive statistics and univariate analyses were used for the analyses. Results: In all, emotional, physical or sexual violence during their lifetime was reported by 43.2% and 22.8% of youths during the last year. In total, 88% of the respondents assessed their self-rated health as good, very good or excellent. Those who had been exposed to emotional, physical or sexual violence during their lifetime reported statistically significant lower self-rated health (fair and poor) than those who were not victimised. When healthcare professionals at the Youth Centre asked youths about exposure during their lifetime, one-fifth disclosed having been exposed. Conclusions: Youths who reported any type of violence during their lifetime showed lower self-rated health compared to those who were not exposed. Youth Centres have an important role in identifying youths who are exposed to violence and/or self-report their health as low. Still, only a minority of youths who have been exposed to violence told health professionals at a Youth Centre about it when asked. It is necessary to further investigate how the issues can be best addressed.

Who are the young people reached by peer education programs and/or by youth centers? The present study intends to better know about the activities of the peer educators who are involved in organizations that promote reproductive health information and services in three West African countries. A special research tool was created to collect data to evaluate the composition and characteristics of the populations that such programs reach; therefore, to evaluate the populations left behind. We found that the typical profile of individuals in contact with peer educators or attending youth centers tended to be males aged 15 and more, schooled or highly educated, never married, and living in urban areas. We also found a relationship between peer educators' and peers' socio-demographic characteristics in rural Burkina Faso and urban Guinea Bissau. Finally, the main topics discussed included HIV/AIDS and Sexually Transmitted Infections, but omitting other aspects of sexual and reproductive health Quels sont les jeunes que les programmes d'éducation par les pairs et/ou les maisons de jeunes réussissent à atteindre ? La présente étude vise à mieux connaître les activités des pairs éducateurs impliqués dans les organisations qui font la promotion de l'information et des services en santé reproductive dans trois pays d'Afrique de l'Ouest. Nous avons créé un outil de recherche original qui nous a permis de collecter les données destinées à l'évaluation de la composition et des caractéristiques des populations qui participent à ces programmes, et par déduction de celles des populations qui sont laissées pour compte. Nous trouvons que le profil le plus commun des individus qui sont en contact avec les pairs éducateurs ou qui fréquentent les maisons de jeunes sont des garçons âgés de 15 ans et plus, scolarisés ou de niveau scolaire primaire ou plus, jamais mariés, et résidant en milieu urbain. De plus, nos résultats révèlent l'existence d'une relation entre les caractéristiques socio-démographiques des pairs éducateurs et des jeunes en milieu rural burkinabè et en milieu urbain en Guinée-Bissau. Enfin, les principaux sujets de discussion concernent le VIH/Sida et les maladies sexuellement transmissibles, mais les autres aspects de la santé sexuelle et reproductive sont souvent omis.

Dorais and Lajeunesse analyse the adverse ways being stigmatized as homosexual affects personality and behaviour, discerning four types of reaction: the 'perfect boy,' whose perfectionism and asexuality are an attempt to minimize the difference between how he is perceived and what he is supposed to be; the 'chameleon,' who attempts to keep everyone from suspecting his secret but constantly feels like an impostor; the 'token fag,' who serves as a scapegoat to his peers, especially at school, and suffers a consequent rejection and lack of self-esteem; and the 'rebel,' who actively rejects any stigma based on his sexual orientation and non-conformity. They show that those who are heterosexual but suspected of being homosexual are most at risk of suicide and make recommendations for suicide prevention.

Ethiopia is addressing these and other major challenges in the health sector through its health extension programme, which has expanded health service coverage, particularly for the rural poor.8 The government has started Grand Challenges Ethiopia to introduce proven innovations for maternal, newborn health and early childhood development into its health system.9 Ethiopian adolescents and young people are engaged through health programmes in schools, universities and youth centres.10 The importance of a highly-skilled and well-resourced health workforce is recognized and the necessity for monitoring systems to generate data on which to base health decisions, is understood.

ObjectivesWHO recommended strengthening the linkages between various HIV prevention programmes and adolescent sexual reproductive health (ASRH) services. The Smart-LyncAges project piloted in Bulawayo city and Mt Darwin district of Zimbabwe established a referral system to link the voluntary medical male circumcision (VMMC) clients to ASRH services provided at youth centres. Since its inception in 2016, there has been no assessment of the performance of the referral system. Thus, we aimed to assess the proportion of young (10–24 years) VMMC clients getting ‘successfully linked’ to ASRH services and factors associated with ‘not being linked’.DesignThis was a cohort study using routinely collected secondary data.SettingAll three VMMC clinics of Mt Darwin district and Bulawayo province.Primary outcome measuresThe proportion of ‘successfully linked’ was summarised as the percentage with a 95% CI. Adjusted relative risks (aRR) using a generalised linear model was calculated as a measure of association between client characteristics and ‘not being linked’.ResultsOf 1773 young people registered for VMMC services, 1478 (83%) were referred for ASRH services as they had not registered for ASRH previously. Of those referred for ASRH services, the mean (SD) age of study participants was 13.7 (4.3) years and 427 (28.9%) were out of school. Of the referred, 463 (31.3%, 95% CI: 30.0 to 33.8) were ‘successfully linked’ to ASRH services and the median (IQR) duration for linkage was 6 (0–56) days. On adjusted analysis, receiving referral from Bulawayo circumcision clinic (aRR: 1.5 (95% CI: 1.3 to 1.7)) and undergoing circumcision at outreach sites (aRR: 1.2 (95% CI: 1.1 to 1.3)) were associated with ‘not being linked’ to ASRH services.ConclusionLinkage to ASRH services from VMMC is feasible as one-third VMMC clients were successfully linked. However, there is need to explore reasons for not accessing ASRH services and take corrective actions to improve the linkages.

Dieser Artikel analysiert, wie das Jugendheim von Tokombéré in Nordkamerun, eine säkulare Einrichtung der römisch-katholischen Kirche, die politische Bildung der Jugendlichen in Tokombéré gefördert hat. Es handelt sich um einen Ort der Sozialisierung, der von der Arbeit der Missionare inspiriert wurde und seit dem Jahr 1974 die politische Betreuung von Jugendlichen ermöglicht, insbesondere durch die Arbeit zur Bewusstseinsbildung auf der Grundlage von Selbstermächtigung und Verantwortungsbewusstsein. Durch die Organisation seiner Anhänger um eine \"Regierung\" herum hat das Heim dazu beigetragen, die Staatsbürgerschaft der Jugendlichen durch Aktivitäten wie Jugendwochen, Kirditude-Tage, amateurhaftes journalistisches Schreiben in der Kudumbar und Filmvorführungen zu entfalten. Diese Substitution des Staates war mitunter eine Quelle von Konflikten sowie Koexistenz. This paper studies how the Tokombéré Youth Centre, a secular place attached to the Roman Catholic Church, has led to the political formation of young people in Tokombéré, northern Cameroon. This is a place of socialisation that grew from the missionaries' work, and which has politically guided youth since 1974 through an awakening based on empowerment and self-reliance. The Centre, with its members structured within a \"government,\" has helped foster the values of citizenship through activities like Youth Weeks, Kirditude days, amateur journalistic writing in the newspaper Kudumbar, and film screenings. This substitution for the state has sometimes been a source of conflict, sometimes of co-existence.