HIV/AIDS and Mental HIV/AIDS and Mental Health Issues for Deaf Health Issues for Deaf and Hard of Hearing and Hard of Hearing Adolescents in South Adolescents in South

AfricaAfrica Sumaya Mall Sumaya Mall

55thth International AIDS Society Conference, International AIDS Society Conference, Cape TownCape Town

20092009

BackgroundBackground

In 2008, prevalence of HIV/AIDS in South In 2008, prevalence of HIV/AIDS in South Africa was 10.6% (HSRC, 2009)Africa was 10.6% (HSRC, 2009)

Co-existing epidemic mental disorders Co-existing epidemic mental disorders Vulnerable populations in this context Vulnerable populations in this context

including adolescents (prevalence is 8.7%, including adolescents (prevalence is 8.7%, HSRC, 2009) and disabled HSRC, 2009) and disabled

Adolescents with a disability may be Adolescents with a disability may be particularly vulnerable (Groce, 2007)particularly vulnerable (Groce, 2007)

Deaf Community (Bisol, 2008)Deaf Community (Bisol, 2008)

Background continued…Background continued…

Communication in the Deaf community Communication in the Deaf community HIV/AIDS education for the Deaf community. HIV/AIDS education for the Deaf community. Global uptake of VCT by the Deaf community is Global uptake of VCT by the Deaf community is

lowlow Deaf communities are closed and sexual behaviour Deaf communities are closed and sexual behaviour

patterns are unknown patterns are unknown Need for HIV/AIDS prevention programmes that Need for HIV/AIDS prevention programmes that

also address mental healthalso address mental health Need for appropriate theoretical frameworks Need for appropriate theoretical frameworks

Aim Aim

Overall AimOverall Aim::

To investigate the associations between To investigate the associations between common mental disorders, knowledge of common mental disorders, knowledge of HIV/AIDS and high risk sexual behaviour HIV/AIDS and high risk sexual behaviour in adolescents who are deaf in South Africa in adolescents who are deaf in South Africa

ObjectivesObjectives

Theory of Planned Behaviour Theory of Planned Behaviour Qualitative research will pre-empt and inform the Qualitative research will pre-empt and inform the

development of an appropriate questionnaire to development of an appropriate questionnaire to answer the aim. answer the aim.

Views of policy makers, parents, educators and Views of policy makers, parents, educators and deaf adolescents themselves will be extracteddeaf adolescents themselves will be extracted

Points of importance to be included in the Points of importance to be included in the questionnairequestionnaire

Differences between the deaf adolescents who sign Differences between the deaf adolescents who sign and those that speak will be extracted. and those that speak will be extracted.

Motivation and ImpactMotivation and Impact

Study will address the role of mental Study will address the role of mental disorders in precipitating high risk sexual disorders in precipitating high risk sexual behaviour amongst deaf and hard of behaviour amongst deaf and hard of hearing adolescents hearing adolescents

Study will inform tailored HIV/AIDS Study will inform tailored HIV/AIDS prevention programmes for the deaf and prevention programmes for the deaf and hard of hearing. hard of hearing.

MethodsMethods

Qualitative research through in Qualitative research through in depth interviews that pre-empts depth interviews that pre-empts the questionnairethe questionnaire

In depth interviews with policy In depth interviews with policy makers, parents, educators and makers, parents, educators and adolescentsadolescents

Open ended, appropriate Open ended, appropriate interview guidesinterview guides

Pre-existing questionnaire based Pre-existing questionnaire based on Theory of Planned Behaviour; on Theory of Planned Behaviour; some additions including mental some additions including mental health measurements from CES-health measurements from CES-D and Beck Depression InventoryD and Beck Depression Inventory

Methods continued…Methods continued…

Measuring instruments will be translated into Measuring instruments will be translated into Xhosa and AfrikaansXhosa and Afrikaans

Assistance of sign language interpreterAssistance of sign language interpreter

Pilot StudyPilot Study

Qualitative interview guidesQualitative interview guides can be pilotedcan be piloted Quantitative measuring instrument can be Quantitative measuring instrument can be

piloted at a school for the deaf in piloted at a school for the deaf in JohannesburgJohannesburg

AnalysisAnalysis

Qualitative research will be analysed by means of Qualitative research will be analysed by means of grounded theory/thematic analysis grounded theory/thematic analysis

Quantitative aspects by STATA Version 8Quantitative aspects by STATA Version 8 Chi Squared Analysis or independent t tests Chi Squared Analysis or independent t tests Level of significance: p = <0.05Level of significance: p = <0.05 Independent variables = TPB constructs Independent variables = TPB constructs Dependent variablesDependent variables Univariate/Bi variate analysis will precede multi Univariate/Bi variate analysis will precede multi

variate analysis variate analysis

CostCost

10 000 USD 10 000 USD Including the cost of the sign language Including the cost of the sign language

interpreter, travel costs, transcription and interpreter, travel costs, transcription and developing the measuring instrument.developing the measuring instrument.

Ethical ConsiderationsEthical Considerations

Potential Benefits and HarmsPotential Benefits and Harms Informed Consent Informed Consent Confidentiality (participants, transcriber, Confidentiality (participants, transcriber,

sign language interpreter) sign language interpreter) Reporting of Results Reporting of Results

AcknowledgementsAcknowledgements

Alan Flisher Alan Flisher Leslie SwartzLeslie Swartz John Joska John Joska Claudia Bisol Claudia Bisol Sharon KleintjiesSharon Kleintjies Ashraf Kagee Ashraf Kagee Lesley HenleyLesley Henley