Cultural Consensus Modeling to Understand South African Adolescent Girls' Attitudes, Awareness, and Uptake of Dual Protection Strategies.
PURPOSE
This study used cultural consensus modeling to elucidate culturally relevant factors associated with dual protection use (strategies to prevent both pregnancy and sexually transmitted infection [STI]/HIV) among South African adolescent girls aged 14-17 years.


METHODS
In Phase 1, participants (N = 50) completed a free-listing survey assessing pregnancy and STI/HIV methods used by peers. In Phase 2, participants (N = 100) completed a rating survey to examine perceived peer acceptability of Phase 1 pregnancy and STI/HIV prevention methods. In Phase 3, qualitative individual interviews (N = 25) gathered in-depth information regarding the cultural acceptability of pregnancy and STI/HIV prevention strategies. In Phase 4, participants (N = 300) completed the Phase 2 rating survey for individual beliefs regarding the acceptability of pregnancy and STI/HIV prevention methods.


RESULTS
In Phase 1, 41 pregnancy and 29 STI/HIV prevention strategies, along with 16 factors influencing pregnancy prevention method acceptability were endorsed; male condoms were the most commonly endorsed pregnancy and STI/HIV prevention method. In Phase 2, using cultural consensus analysis, participants were consistent in the perceived acceptability of pregnancy and STI/HIV prevention methods (73.4% variance accounted for in single cultural model). In Phase 3, qualitative findings provided in-depth information regarding factors influencing commonly used pregnancy (e.g., injectable contraception) and STI/HIV (e.g., condoms) prevention methods. In Phase 4, a single cultural model was identified (56.3% variance accounted for), with similar acceptability ratings as Phase 2.


CONCLUSIONS
A singular cultural model of pregnancy and STI/HIV prevention method acceptability was observed, with little awareness of dual protection. The findings highlight cultural factors for future culturally tailored dual protection interventions for South African adolescent girls.
['Brown|Jennifer L|JL|', 'Marais|Lochner|L|', 'Sharp|Carla|C|', 'Cloete|Jan|J|', 'Lenka|Molefi|M|', 'Rani|Kholisa|K|', 'Marime|Philile|P|', 'Ditlhare|Irene|I|', 'Moqolo|Refuwe|R|', 'Peterson|Disebo|D|', 'Sales|Jessica M|JM|']
D000293:Adolescent D001290:Attitude D017280:Condoms D032921:Consensus D003267:Contraception D005260:Female D015658:HIV Infections D007722:Health Knowledge, Attitudes, Practice D006801:Humans D008297:Male D011247:Pregnancy D012749:Sexually Transmitted Diseases
Cultural consensus modeling South African adolescents Dual protection STI/HIV prevention Pregnancy prevention