Access to Tuberculosis testing among adolescents living with Human Immunodeficiency Virus in the Eastern Cape, South Africa: social factors and theoretical considerations
type: CreativeWork
description: Background: Addressing adolescent tuberculosis (TB) is a critical step towards eliminating TB in high burden countries, especially in HIV endemic communities. South Africa has the highest rates of TB/HIV co-infection and the largest population of adolescents living with HIV (ALHIV) in the world – contributing substantial risk to TB-related morbidity and mortality in this already vulnerable cohort. Previous research on TB has largely overlooked adolescents and ALHIV which has left knowledge – and potential service provision – gaps, but also opportunities for important research. TB among ALHIV is a complex public health challenge, needing to be understood in the context of the unique socio-emotional life stage of adolescence. This dissertation aims to provide insights into the critical first step in the ALHIV TB care cascade: access to TB testing. Through quantitative analysis, I explore the social factors that promote or prevent ALHIV from accessing TB testing in South Africa. Methods: In this longitudinal study, I analysed the Mzantsi Wakho cohort data from n=1046 ALHIV (10-19 years old) from 53 health facilities across the Amathole district of the Eastern Cape. N= 933 (89%) ALHIV – those who participated in the second and third cohort waves – were included in this analysis. Data were collected through self-reported questionnaires, assisted by trained and experienced researchers three times between 2014/2015 to 2017/2018. The selection of social factors that influence access to the outcome of TB testing was informed by an extensive scoping literature review. These factors were initially categorised using WHO's social determinants of health framework, which applies the Ecological Model. Thereafter, factors were filtered through the People Centred Model of TB care – to draw focus to the factors pertaining to the individual (both inter- and intrapersonal) rather than factors imbedded in health systems and services. Analysis was conducted in four steps: First descriptiv…
abstract: Background: Addressing adolescent tuberculosis (TB) is a critical step towards eliminating TB in high burden countries, especially in HIV endemic communities. South Africa has the highest rates of TB/HIV co-infection and the largest population of adolescents living with HIV (ALHIV) in the world – contributing substantial risk to TB-related morbidity and mortality in this already vulnerable cohort. Previous research on TB has largely overlooked adolescents and ALHIV which has left knowledge – and potential service provision – gaps, but also opportunities for important research. TB among ALHIV is a complex public health challenge, needing to be understood in the context of the unique socio-emotional life stage of adolescence. This dissertation aims to provide insights into the critical first step in the ALHIV TB care cascade: access to TB testing. Through quantitative analysis, I explore the social factors that promote or prevent ALHIV from accessing TB testing in South Africa. Methods: In this longitudinal study, I analysed the Mzantsi Wakho cohort data from n=1046 ALHIV (10-19 years old) from 53 health facilities across the Amathole district of the Eastern Cape. N= 933 (89%) ALHIV – those who participated in the second and third cohort waves – were included in this analysis. Data were collected through self-reported questionnaires, assisted by trained and experienced researchers three times between 2014/2015 to 2017/2018. The selection of social factors that influence access to the outcome of TB testing was informed by an extensive scoping literature review. These factors were initially categorised using WHO's social determinants of health framework, which applies the Ecological Model. Thereafter, factors were filtered through the People Centred Model of TB care – to draw focus to the factors pertaining to the individual (both inter- and intrapersonal) rather than factors imbedded in health systems and services. Analysis was conducted in four steps: First descriptiv…
author: van Staden, Quintin
keywords: Sociology
date published: 2022
date modified: 2026-07-22T22:22:46Z
provider: University of Cape Town
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Department of Sociology

PropertyValue
property ID: Handle
value: http://hdl.handle.net/11427/37192