Lesley Gittings

Western Caspian University · Health Studies

Virtual reality (VR) for mental health promotion remains understudied in low-income humanitarian settings. We examined the effectiveness of VR in reducing depression with urban refugee youth in Kampala, Uganda. This randomized controlled trial assessed VR alone (Arm 1), VR followed by Group Problem Management Plus (GPM+) (Arm 2) and a control group...

Water justice—equitable, reliable access to clean, sufficient water, and the knowledge and mechanisms related to its management—is a key global social justice and environmental issue. Cape Town, South Africa, is an important context to explore water justice due to its 2018 water crisis. Water scarcity intersects with other issues, including health...

This report details a qualitative methodological approach of developing an Augmented Reality (AR) tool which integrates digital storytelling for context-specific, accessible, scalable participatory research knowledge translation on climate-related sexual health experiences among youth (aged 16-25 years) in Kenya. AR, which engages audiences through...

In Jamaica, stigma experiences of sex workers (SW), gay men and other men who have sex with men (MSM), and transgender women living with HIV remain understudied. To address this gap, we explored experiences of stigma and linkages with the HIV care cascade among key populations living with HIV in Jamaica, including cisgender women SW, MSM, and trans...

Background Nurses have a critical role to play in the delivery of sexual and reproductive health (SRH) services to adolescents and young people. Nurses’ interactions with adolescents and young people can shape sexual and reproductive behaviours and outcomes, including willingness to access and engage with healthcare services. However, little resear...

The Northwest Territories (NWT), Canada has high rates of sexually transmitted infections (STI) that elevate HIV acquisition risks. We conducted a mixed-methods study to explore the potential of land-based peer leader retreats (PLR) in building HIV prevention enabling environments among Northern and Indigenous youth in the NWT. PLRs are grounded in...

Sex workers experience elevated risks of sexual and gender-based violence (SGBV) from intimate partners, clients, and community members that harms health and human rights. While SGBV contributes to poorer sexual and reproductive health (SRH) outcomes among sex workers, including elevated human immunodeficiency virus (HIV) vulnerabilities, stigma ta...

Indigenous and Northern women in Canada experience high rates of intimate partner violence (IPV), and this is particularly true in the Northwest Territories (NWT). Adolescents are also at increased risk of IPV, which has far-reaching, lifelong effects. Indigenous youth are particularly vulnerable to IPV due to ongoing effects of intergenerational t...

Children and adolescents living with HIV in Africa experience poor outcomes across the HIV cascade of care. Paediatric and adolescent-friendly services are crucial to their well-being, and recent years have seen a call for urgent service improvements. While frontline health workers are responsible for these services, less attention has been given t...

This paper highlights the pressing need to address the HIV epidemic among adolescent boys and young men (ABYM) in sub-Saharan Africa. Despite progress in HIV prevention, ABYM still experience low diagnosis rates, treatment adherence, and linkage to care. The paper emphasizes ABYM's vulnerability due to societal norms, limited healthcare access, and...

Background Intimate partner violence (IPV) is rising in Canada and disproportionately affects Indigenous communities in the Northwest Territories largely due to the harmful, ongoing effects of settler colonialisation. Youth are known to be at high risk for IPV, but scant evidence exists about the scale of IPV and strategies for its prevention among...

Adolescents and men are two populations that perform poorly within the HIV cascade of care, having worse AIDS-related health outcomes, and experiencing higher levels of HIV-related stigma. This paper explores institutional health system discrimination as experienced by adolescent boys with perinatally-acquired HIV, situating them within the social...

Adolescent perspectives are crucially important for developing sustainable solutions to address climate change yet remain overlooked in the literature, particularly in low and middle-income contexts. Kenya is an important context to explore youth climate solutions, as youth constitute the fastest growing population facing climate change-related cha...

p>Background: Although mental health challenges disproportionately affect people in humanitarian contexts, most refugee youth do not receive the mental health support needed. Uganda is the largest refugee-hosting nation in Africa, hosting over 1.58 million refugees in 2022, with more than 111,000 living in the city of Kampala. There is limited info...

p>Background: Although mental health challenges disproportionately affect people in humanitarian contexts, most refugee youth do not receive the mental health support needed. Uganda is the largest refugee-hosting nation in Africa, hosting over 1.58 million refugees in 2022, with more than 111,000 living in the city of Kampala. There is limited info...

Sex education within the formal bounds of school curricula or clinic consultation is traditionally conceived as age-appropriate and accurate information, delivered by a sanctioned adult such as a nurse or teacher. This article explores another kind of curriculum – taught and learned among young men themselves in the kasi (township) in which they li...

Long-acting injectable anti-retroviral therapy (LAART) may overcome barriers to long-term adherence and improve the survival of adolescents and young people living with HIV (AYLHIV). Research on the acceptability of LAART for this age-group is limited. We asked 953 AYLHIV about their preferred (theoretical) ART mode of delivery (pill, injectable, o...

Men are less vulnerable to HIV acquisition than women, but have poorer HIV-related health outcomes. They access HIV services less, and are more likely to die on antiretroviral therapy. The adolescent epidemic presents further challenges, and AIDS-related illness is the leading cause of death among adolescents in sub-Saharan Africa. We explored the...

Background Although mental health challenges disproportionately affect people in humanitarian contexts, most refugee youth do not receive the mental health support needed. Uganda is the largest refugee-hosting nation in Africa, hosting over 1.58 million refugees in 2022, with more than 111,000 living in the city of Kampala. There is limited informa...

Janani Vijayaraghavan and colleagues argue that agency and health are intimately connected; achieving best health outcomes for adolescents will require strengthening their agency

Growing evidence documents the effects of the COVID-19 pandemic on adolescents in East and Southern Africa. We present and explore the longitudinal health and development-related priorities and challenges of adolescent advisors in South Africa and Kenya, including prior to, and during the COVID-19 pandemic. Findings were co-generated with adolescen...

Indigenous adolescents in Canada are among those shouldering the impacts of colonialism and racism. Peer approaches and art-and-land-based programming have demonstrated promise to support empowerment and well-being, yet little is known about their efficacy with Northern and Indigenous adolescents in Canada or of how this group conceptualises empowe...

Objective: The objective of this review is to characterize the state of literature regarding forcibly displaced persons' sexual and reproductive health in urban areas in low- and middle-income countries. Specific objectives include describing the sexual and reproductive health outcomes among forcibly displaced persons relocating in urban environme...

While substantial research has emerged from the frontlines of the COVID-19 pandemic, as well as from studies with adolescent populations, there has been a dearth of research focused in South Africa on the context-specific experiences of healthcare workers (HCWs) and the adolescents and young people (AYP) to whom they provide services. This article...

Acceptability has become a key consideration in the development, evaluation and implementation of health and social interventions. This commentary paper advances key learnings and recommendations for future intervention acceptability research with young people in Africa, aimed at supporting the achievement of developmental goals. It relates finding...

This paper presents empirical and methodological findings from an art-based, participatory process with a group (n = 16) of adolescent and young advisors in the Western Cape Province of South Africa. In a weekend workshop, participants reflected on their participation in 12 years of health and development-related research through theatre, song, vis...

Limited research has evaluated sexual health promotion projects with adolescents living in Arctic regions. The study objective was to examine changes in STI knowledge and safer sex efficacy among youth in the Northwest Territories (NWT), Canada who participated in arts-based sexual health workshops. We used a pre/post-test design with a convenience...

The COVID-19 pandemic has complicated healthcare service provision and access, yet little is known about experiences of public healthcare nurses during the COVID-19 pandemic in the Eastern Cape Province of South Africa, particularly relating to health services for young people living with HIV. This study qualitatively explores the experiences, chal...

Vaccines are an essential public health intervention in response to global emerging infectious diseases such as COVID-19. South Africa aims to vaccinate 67% of its population in 2021 to contain the transmission and effects of COVID-19. While evidence suggests that younger South African adults may be less likely to accept vaccines than older adults,...

Critical hope centres optimism and possibilities for change in the midst of struggles for social justice. It was a central tenet of early participatory pedagogy and HIV research. However, critical hope has been overlooked in contemporary HIV research that largely focuses on risk and biomedical interventions in ways that obscure collective agency an...

Adolescents living with perinatally acquired HIV are among the first generation in South Africa to grow up with anti-retroviral therapy and democratic freedoms. In this article, we explore the biosocial lives of adolescent boys and young men living with HIV in the Eastern Cape Province of South Africa. We conducted qualitative research with 36 adol...

This paper explores how HIV-positive abakhwetha (young male initiates) undergoing ulwaluko (traditional Xhosa initiation and circumcision) engage with HIV-related biomedical care and treatment. Health-focused life history narratives (n = 36), semi-structured interviews (n = 32) and analysis of health facility files (n = 41) with adolescent boys and...

To further our understanding of the context and lived experiences of adolescents aged 10 – 19 years living with HIV in South Africa.

Consequences of COVID-19 pandemic responses have included exacerbated poverty, food insecurity and state and domestic violence. Such effects may be particularly pronounced amongst adolescents and young people living in contexts of precarity and constraint, including in South Africa. However, there are evidence gaps on the lived experiences of this...

Introduction: HIV-related risks may be exacerbated in humanitarian contexts. Uganda hosts 1.3 million refugees, of which60% are aged under 18. There are knowledge gaps regarding HIV testing facilitators and barriers, including HIV and intersecting stigmas, among urban refugee youth. In response, we explored experiences and perspectives towards HIV...

‘BEING ALHIV’ WHAT DO WE KNOW ABOUT ADOLESCENTS LIVING WITH HIV IN SOUTH AFRICA? Presenters: Dr N Zungu (HSRC), Ms A Davids (HSRC), Dr I Naidoo (HSRC), Dr R Hodes (UCT) & the ALHIV project team Chair: Prof. Khangelani Zuma, Divisional Executive: Human and Social Capabilities, HSRC Date: Tuesday, 24th November 2020 Time: 10H00 - 12H00 This was a...

Whilst the HIV response has made significant progress in increasing representation of adults affected by HIV, the meaningful inclusion of children and adolescents has lagged. But this may be a pivotal moment of change. We report on a decade of conducting adolescent advisory groups in South Africa, to reflect on youth advisory processes. Data was co...

The HIV epidemic is strongly gendered. Women and girls are more likely to contract HIV for biological and social reasons in Sub-Saharan Africa and men living with HIV are more likely to be lost to follow-up and die on antiretroviral therapy (ART) than women. Care work is also gendered, with women shouldering the burden of HIV care-related work. Thi...

Sex education within the formal bounds of school curricula or clinic consultation is traditionally conceived as age-appropriate and accurate information, delivered by a sanctioned adult such as a nurse or teacher. This article explores another kind of curriculum – taught and learned among young men themselves in the kasi (township) in which they li...

Community health workers (CHWs) play a central role in the provision of HIV care in South Africa, and people receiving such community-based adherence support have considerably better health outcomes. As with other forms of care work, the majority of CHWs are women. HIV vulnerability is also gendered, with women being more likely to contract HIV, wh...

Adolescents are the only age group with growing AIDS-related morbidity and mortality in Eastern and Southern Africa, making HIV prevention research among this population an urgent priority. Structural deprivations are key drivers of adolescent HIV infection in this region. Biomedical interventions must be combined with behavioural and social interv...

This is a story that is often told: a young woman from a poor family has had a baby so that she can access the child support grant. Then, instead of spending the money on her family, she dumps the baby with her mother or aunt. She uses the grant to buy trendy clothes, beauty treatments and booze. The state has provided this young mother with money...

This report was commissioned by the Eastern and Southern Africa Regional Inter-agency Task Team on Children Affected by AIDS (RIATT-ESA) to inform the strategic direction of RIATT-ESA’s advocacy programme on the viability of child-sensitive social protection mechanisms in the region. It provides a comprehensive literature and policy review on child...

Caring is typically constructed as a feminised practice, resulting in women shouldering the burden of care-related work. Health-seeking behaviours are also constructed as feminine and men have poorer health outcomes globally. Employing men as carers may not only improve the health of the men they assist but also be transformative with regards to ge...