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Background: There is limited understanding of the concept of the digital identity of young children created through engagement on social networking sites. Objective: The objective of this scoping review was to identify key characteristics of the concept of digital identity for children from conception to the age of 8 years on social networking sites. Methods: This scoping review was conducted using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The key databases searched were EBSCO, Web of Science, ProQuest ERIC, and Scopus. Gray literature sources (National Grey Literature Collection, ProQuest Dissertations and Theses, and Google Scholar) were also searched to identify unpublished studies. Articles were selected if they were published in English and reported data on the digital identity of children in relation to social networking sites. Results: The key terms used in the literature were sharenting, followed by digital footprints and children’s identities. Our study revealed 2 approaches to the creation of digital identity: social digital identity and performative digital identity. The articles in this review most commonly used the term sharenting to describe the behavior parents engage in to create digital identities for children on social networking sites. Motivations to post information about children differed among parents; however, the most common reasons were to share with friends and family and create digital archives of childhood photos, termed social digital identity. The second motivation was categorized as performative digital identity. The risk of digital kidnapping and identity theft associated with the creation of digital identities also influenced parents’ behaviors. Conclusions: The creation of a digital identity for children is an emerging concept. Our review develops a deeper understanding of sharenting behaviors that can be used to better support parents and their chil

Background: While triple anti-retroviral therapy (ART) has improved HIV-infected children surviving into adolescence and adulthood, these children remain vulnerable to HIV-related psychological disturbance due to both the direct HIV infection effects on the brain and indirect effects related to coping with a range of medical, psychological and social stresses associated with HIV, which makes it vital to identify their mental health needs. This study assessed the emotional and behavioural challenges of HIV perinatally infected children and adolescents with a completed disclosure process attending “ART teen club” in Malawi. Methods: A cross-sectional descriptive study design was conducted to obtain quantitative descriptive descriptions of emotional and behavioural challenges among HIV-infected children and adolescents between 10 and 22 years of age. They were interviewed on their family socio-demographic characteristics, clinical characteristics as well as emotional, conduct, hyperactivity, peer and prosocial problems using the Chichewa version of the Strengths and Difficulties Questionnaire. Data were analyzed using descriptive analysis and logistic regression. Results: Based on the four-band categorization of the SDQ, higher scores for total difficulties score were observed in 72.9% of the children. According to the subscales of the SDQ, results show that children had higher scores in peer problems (62.8%), emotional (68.2%), conduct (68.6%) and prosocial (57.8%) subscales while lower scores were identified in the hyperactivity (16.6%) subscale. Results show that within each level, males are having lower frequencies as compared to females. Results from multivariate binary logistic regression indicate that those with a single parent or not as well as the WHO HIV clinical stage had an impact on the mental health status of the children. Children who do not have a single parent (AOR 3.404; 95% CI:1.563–7.416, p = 0.002) had 3.404 odds of having abnormal mental health st

Aim: To evaluate hand hygiene knowledge and demonstrated technique before and after implementation of the hand hygiene programme and its sustainability among Malawian kindergarten students. Design: Quasi-experimental design, utilizing a repeated measure at three points, namely, before intervention (T0), soon after intervention (T1) and follow-up (T2). Methods: The hand hygiene programme consisted of integrating hand hygiene protocol into the school health curriculum, setting up proper handwashing facilities, training school teachers, health talks and developing reminders on hand hygiene. Fifty-three kindergarten children aged 3–6 years were enrolled in the programme. Data were collected at 3 months' intervals (T0, T1, and T2). Parents, teachers, school authorities and children were involved in the implementation and evaluation of the intervention, utilizing a multilevel approach. Results: There was a significant difference in knowledge scores across three time points (T0, T1 and T2), Chi-Square (2, n = 53) = 79.02, p < 0.005 and handwashing technique across the three time points, Chi-Square (2, n = 53) = 88.04, p < 0.005. There was a large effect size of 0.62 on the effect of handwashing technique scores from T0 to T1.

INTRODUCTION: Human immunodeficiency virus (HIV) prevention interventions focused at reducing risky sexual behaviours are an important strategy for preventing HIV infection among youth (15-24 years) who continue to be vulnerable to the disease. This systematic review aims to synthesise current global evidence on the effectiveness of HIV prevention interventions for reducing risky sexual behaviour among youth in the last decade. METHODS AND ANALYSIS: MEDLINE/PubMed, EMBASE, PsychINFO, ProQuest Central, CINAHL and Web of Science databases, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform and reference lists of included studies and systematic reviews on effectiveness of HIV prevention interventions for reducing risky sexual behaviour among youth will be searched for articles published from August 2011 to August 2021. Eligible studies will be longitudinal studies including randomised controlled trials and quasi-experimental studies that examined the effectiveness of HIV prevention interventions among youth populations (15-24 years) with risky sexual behaviour as a primary or secondary outcome. Study selection and quality assessment will be undertaken independently by three reviewers and disagreements will be resolved through consensus. Data analysis will be undertaken using RevMan software V.5.3.3. A random effects meta-analysis will be conducted to report heterogeneous data where statistical pooling is achievable. We will use I2 statistics to test for heterogeneity. Where appropriate, a funnel plot will be generated to assess publication bias. Where statistical pooling is unachievable, the findings will be reported in a narrative form, together with tables and figures to assist in data presentation if required. Reporting of the systematic review will be informed by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. ETHICS AND DISSEMINATION: Ethical approval is not required. Findings of the systematic re

Purpose Interventions focused on promoting resilience or protective factors of youth have been proposed as a strategy for reducing risky behaviours associated with HIV infection among youth; however few studies have explored their effectiveness. This study assessed the impact of a resilience-based HIV prevention intervention (You Only Live Once) on risky sexual behaviours, resilience and protective factors of youth. Methods A one-group pretest-posttest design was used. One hundred and ninety-seven youth aged 15–24 years were conveniently recruited from a non-profit organisation in Maluti-a-Phofung Local Municipality, South Africa and participated in a 12-session, resilience-based HIV intervention delivered over a 1-week period by trained adult facilitators. Outcomes of interest were assessed at baseline and 3-month follow-up using validated risky sexual behaviour measures, and Child and Youth Resilience Measure. Mixed effect logistic and linear regression models were formulated to assess the impact of the intervention on risky sexual behaviours; resilience and protective factors respectively. Results Compared to baseline, participants at 3-month follow-up were 68 % less likely to have unprotected sex, 22 % less likely to regret their decision to engage in sexual activity and 0.4 % less likely to be pregnant or made someone pregnant. Conversely, participants at the 3-month follow-up had a higher propensity to engage in multiple sexual partnerships, transactional sex and intergenerational sex than baseline. Participants at 3-month follow-up had significant improvements in their scores of resilience, individual capacities and contextual factors that facilitate a sense of belonging (p < 0.05). Conclusion You Only Live Once intervention appeared to have mitigated some risky sexual behaviours, and improved resilience and protective factors over a 3-month period. These findings suggest that the intervention has ability to reduce risky sexual behaviours associated with HIV

Background: Although several programs have been initiated to increase the uptake of health services amongst youth living with human immunodeficiency virus in the world, disparities in access to these care services still exist. Aim: This study aimed to explore the experiences of young people as they attend the human immunodeficiency virus clinic and to identify factors affecting their uptake of health services in southern Malawi. Methods: A focused ethnography was conducted to collect data from 20 youths living with human immunodeficiency virus and aged between 15 and 24 years through one-on-one in-depth interviews and casual observations. The interviews data were analysed thematically following transcriptions. Findings: Two themes emerged to describe the factors that facilitated or hindered the uptake of HIV-health services. The first theme: Facilitators to the accessibility and utilization of HIV services consisted subthemes of Health personnel-related factors and Innovative healthcare delivery approach. The second theme: Barriers to utilization and accessibility of HIV service comprised of the following subthemes: Ignorance of health services available, Clinic-related factors and Consumer-related factors. Conclusion: Efforts to support health services that are youth-friendly and easily accessible are needed to increase uptake, decrease mortality, prevent disability and promote the wellbeing of youth living with human immunodeficiency virus. Implications for nursing practice and policy: Approaches used with this population should be youth-centred and multifaceted, recognizing both the psychosocial challenges and the vulnerability that many youths in Malawi experience.

Introduction Recent empirical evidence suggests that youth living with HIV are likely to engage in sexual risk behaviours and report antiretroviral therapy non-adherence, both of which are critical in controlling the risk of HIV transmission. Malawian youth living with HIV have a role to play in controlling the transmission, however, their perceptions and comprehension of this role are not well understood. Therefore, this study explores the social-cultural contexts of HIV risk and sexual behaviours among Malawian youth living with HIV. Methods From January to May 2019, 20 participants living with HIV, aged between 15 to 24 years and who had voluntarily given consent to participate were enrolled in this study. All were recruited through an HIV treatment program at a public referral hospital in Mwanza District, Malawi. Using focused ethnography, in-depth interviews were conducted using a developed and piloted interview guide, casual observations were recorded, and fields notes were taken. Interviews were digitally recorded and transcribed verbatim. A thematic analysis was carried out to synthesize data. Findings From the thematic analysis, four themes emerged: 1. HIV knowledge and health risk behaviours - sources of HIV knowledge included the clinic, peers, parents, church and community leaders, however, knowledge from community sources was not always accurate. Inadequate HIV knowledge coupled with traditional initiation ceremonies, religious affairs and beliefs, facilitated sexual risk behaviours and antiretroviral non-adherence or stoppage. The interplay between both sexual risk behaviours and antiretroviral therapy non-adherence with poverty and personal characteristics of shyness and forgetfulness were prominent in this theme. 2. Perspectives of HIV status disclosure - participants struggled with HIV status disclosure to sexual partners out of fear of either stigma or discrimination based on cultural perceptions of HIV in the community and past negative experience

Background: Tippy-taps are locally made devices for washing hands with running water. They are simple and low-cost, enabling technology that provides adequate water sources, handwashing stations and motivation for people to prioritise handwashing. This systematic review aimed to establish the use, benefits, adoption and effectiveness of enabling technology; tippy-tap handwashing station, in resource-limited settings. Methods: We systematically searched for articles in the PubMed, EMBASE, PsycINFO, AMED, CINAHL, DOAJ and Google Scholar databases guided by the acceptable best practice developed by the PROSPERO and COCHRANE for systematic search and selection of articles. Search terms such as tippy-taps, enabling technology, hand-washing station, hand-washing behaviour, diarrhoea, respiratory infection, increase handwashing behaviour were used. In addition, a PRISMA flow diagram was used to elaborate on the number of articles retrieved, retained, excluded and reasons for every action. Studies that used tippy-tap hand washing station as a handwashing facility regardless of the design were included in this review. A mixed method appraisal tool was used to appraise studies. Results: Twenty articles met the eligibility criteria. The use of tippy-taps for handwashing by household members or school children was reported by authors of 16 studies, and it ranged from 2.7 to 80%. The availability of tippy-taps increased handwashing and use of soap among participants. Furthermore, the majority of people who were oriented to tippy-taps or recruited to tippy-tap studies built their tippy-tap stations even after the promotional activities or programs had ended. In one study, tippy-taps were reported by participant to be effective in preventing episodes of stomach pain among participants. Conclusion: Tippy-tap handwashing station could help in promoting handwashing practice in resource constraint settings. Future studies are needed to evaluate the effectiveness of tippy-tap hand wash