NRS433 Adolescents Living with HIV Paper

Write a critical appraisal that demonstrates comprehension of two quantitative research studies. Use the “Research Critique Guidelines – Part II” document to organize your essay. Successful completion of this assignment requires that you provide a rationale, include examples, and reference content from the study in your responses.

Use the practice problem and two quantitative, peer-reviewed research articles you identified in the Topic 1 assignment to complete this assignment.

In a 1,000–1,250 word essay, summarize two quantitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

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Research Critique Guidelines – Part II Use this document to organize your essay. Successful completion of this assignment requires that you provide a rationale, include examples, and reference content from the studies in your responses. Quantitative Studies Background 1. Summary of studies. Include problem, significance to nursing, purpose, objective, and research question. How do these two articles support the nurse practice issue you chose? 1. Discuss how these two articles will be used to answer your PICOT question. 2. Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question. Method of Study: 1. State the methods of the two articles you are comparing and describe how they are different. 2. Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method. Results of Study 1. Summarize the key findings of each study in one or two comprehensive paragraphs. 2. NRS433 Adolescents Living with HIV Paper

What are the implications of the two studies you chose in nursing practice? Outcomes Comparison 1. What are the anticipated outcomes for your PICOT question? 2. How do the outcomes of your chosen articles compare to your anticipated outcomes? © 2019. Grand Canyon University. All Rights Reserved. Literature Evaluation Table Student Name: Summary of Clinical Issue (200-250 words): The number of HIV-positive adults has become a burgeoning issue due to their increasing number. According to UNICEF, 1.8 million adolescents are living with HIV worldwide, and more than 1.5million of this number live in sub-Saharan Africa. Further analysis of this number revealed HIV-positive adolescent girls accounted for two-thirds of new adolescent infections. Young adults between the ages of 15-19 made up 16% of new adult infections worldwide. In sub-Saharan Africa, adolescent girls are the most prone adolescents to be infected with the virus. As compared to boys, adolescent girls were twice as likely to get HIV. The main mode of infection among adolescents is unprotected sex. In sub-Saharan Africa, 85% of all new infections were as a result of having unprotected sex. Adolescents don’t use contraceptive control, and other preventative measures due to fear of being perceived as deviant, especially in Africa, where culture is still rife. These perceptions make adolescents unwilling to reveal their HIV serostatus making it difficult to treat and contain it’s spread. Also, the general lack of HIV and sexual health knowledge among adolescent, especially in Africa, is responsible for the rising numbers of new infections. The financial and technological status of most states in Africa and Asia is responsible for the poor living conditions of HIV positive adolescents. NRS433 Adolescents Living with HIV Paper

The lack of proper technology in healthcare institutions is responsible for medical gaps which make planning, treatment, and distribution of antiretroviral drugs difficult. Most African states such as Somalia and Sudan lack an adequate budget for purchase and distribution of antiretroviral drugs © 2019. Grand CanyonUniversity. All Rights Reserved. leaving HIV positive adolescents to purchase the drugs themselves. Also, the poor living standards and low income of adults lead them to resort to using sex to purchase drugs and fend for themselves as seen in Kisumu by fishermen soliciting sex from adolescents in exchange for food. In order to meet the global aims of an HIV free generation by 2030, there needs to be intensive sensitization of youth on sexual health and HIV. The poor financial conditions of most regions in sub-Saharan Africa need to be addressed to cater to medical gaps and to enhance the provision of antiretroviral drugs among infected youths. This paper analyzes six articles to find out the HIV perceptions, social support and protection, and medical gaps which exist in adolescents over the last decade. PICOT Question: How do adolescents diagnosed with HIV perceive social support, protection, and medical gaps during the last decade? Criteria Article 1 Article 2 Article 3 APA- Okawa, S., Mwanza-Kabaghe, S., Bloch, S., (2018). HIV in Ukraine: Li, R. J., Jaspan, H. B., O’Brien, V., Rabie, H., Formatted Mwiya, M., Kikuchi, K., Jimba, M., An Everlasting Epidemic? Cotton, M. F., &Nattrass, N. (2010). Positive Article Kankasa, C., & Ishikawa, N. (2017). Assessment of knowledge, behaviour futures: a qualitative study on the needs of Citation Adolescents’ experiences and their change, tolerance towards people adolescents on antiretroviral therapy in South with suggestions for HIV serostatus living with HIV, and accessibility of Africa. AIDS Care, 22(6), 751-758.Retrieved Permalink Disclosure in Zambia: a Mixed-Methods healthcare services for HIV among from study. Frontiers in public health, 5, 326 adolescent girls and young women in https://www.tandfonline.com/doi/abs/10.1080/ Retrieved from Ukraine. Retrieved from 09540120903431363 https://www.ncbi.nlm.nih.gov/pmc/artic https://academic.oup.com/her/article/ les/PMC5736526/ 14/4/473/693716 2 How the Does The article analyzes the setting of HIV The article studies the knowledge and This article analyzes the needs of HIV infected Article Serostatus and its impacts on the perceptions of adolescents on HIV adolescents in getting antiretroviral therapy Relate to the perception of HIV-infected adolescents infection and infected persons and the social support measures put in place PICOT Question? Quantitative Quantitative because the study gives the Quantitative because it uses the Qualitative analysis because , result of the study in forms of measures of frequency to analyze and participant’s perceptions Qualitative( percentages conclude data. it explores How do you know?)NRS433 Adolescents Living with HIV Paper

Purpose This study aims to determine the setting This study aims to determine the This study aims to identify the needs of Statement for HIV serostatus and its effect on knowledge adolescents and opinions of adolescents on antiretroviral therapy and social adolescents on HIV infection and support infected persons Research How does the setting for HIV serostatus To determine the knowledge of To establish the basic needs required for HIV- Question affect young adolescent and what adolescents on HIV infection and infected adolescents in South Africa recommendations of the most suitable opinions on HIV-infected persons To explore the current antiretroviral therapy HIV disclosure practice? and support initiatives in South Africa and how it impacts HIV-infected adolescents Outcome HIV serostatus disclosure though The adolescents showed a general All the participants viewed their status emotionally distressful at first improved concern for contracting HIV and had negatively with social issues such as violence adolescent motivation and self-care. adequate information concerning the and poverty hampering the antiretroviral modes of infection. therapy in South Africa. 70% of the participants remained positive about their 3 present and future despite the social stressors Setting The study took place at the University Finland Cape Town, South Africa (Where did Teaching Hospital, Zambia the study take place?) Sample The sample was 190 adolescents 1183 adolescents aged 15 years 26 adolescents between 15-19 Method The study was a mixed methods study Focus groups Focus groups which mainly collected data through structured and two-open ended questionnaires Key 73.2% of the sample had mixed feelings 96% of the participants 100% of all participants viewed their status Findings of about HIV serostatus disclosure, while acknowledged HIV could be negatively with social issues such as violence the Study 86.2% saw the disclosure as beneficial. prevented by contraceptives use, and and poverty hampering the antiretroviral 84.7% showed adherence to treatment, 90% acknowledged having multiple therapy in South Africa. 70% of the while 81.1% showed limited self- sexual partners increased risk of participants remained positive about their disclosure to others. infection. 47% of boys and 56% of present and future despite the social stressors girl participants were concerned about the possibility of getting AIDS. Recommend Health workers should provide adequate NRS433 Adolescents Living with HIV Paper

There should be more incentives The government of South Africa should ations of the information on the risks and benefits of aimed at sensitizing young enhance the effectiveness of antiretroviral Researcher disclosure to caregivers. adolescents on the dangers of HIV therapy in the state by subsidizing the cost of infection. anti-retroviral drugs. Police should use deescalation techniques to minimize police based 4 violence, and adequate deployment should be done to improve security. Criteria Article 4 Article 5 APA- Toth, G., Mburu, G., Tuot, S., Khol, V., Ngin, C., Format Wong, V. J., Murray, K. R., Phelps, B. R., Chhoun, P., & Yi, S. (2018). Social-support needs ted among adolescents living with HIV in the transition Vermund, S. H., &McCarraher, D. R. (2017). Article Adolescents, young people, and the 90–90–90 Article 6 from pediatric to adult care in Cambodia: findings from Citation goals: a call to improve HIV testing and linkage a cross-sectional study.AIDS research and therapy, with to treatment. AIDS (London, England), 31 15(1), 8 Retrieved from Permali (Suppl 3), S191. Retrieved from https://aidsrestherapy.biomedcentral.com/articles/10.118 nk 6/s12981-018-0195-x www.aidsmap.com/Study-identifies-serious- Armstrong, A., Nagata, J. M., Vicari, M., Irvine, C., Cluver, L., Sohn, A. H., … & Ross, D. (2018). A global research agenda for adolescents living with HIV. Journal of acquired immune deficiency syndromes (1999), 78(1), S16. Retrieved from https://journals.lww.com/jaids/FullText/2018/0815 1/A_Global_Research_Agenda_for_Adolescents_L gaps-in-treatment-and-care-of-HIV-positive- iving.4.aspx adolescents-in-sub-SaharanAfrica/page/3151096/ How The article analyzes the gaps in healthcare The research article investigates the importance of social Does facilities that formulate perceptions of HIV support and protection in producing positive health the infected adolescents results Article This article identifies the social support and Relate protection priorities needed to the PICOT Questio 5 n? Quantit Quantitative because descriptive statistics was Quantitative study because descriptive statistics are used ative, used to analyze and summarize the data to analyze and summarize data. Qualita coded using thematic coding to allow for further tive(Ho w Quantitative because data from questionnaires were analysis using descriptive statistics do you know?) Purpose This study aims to identify the gaps in healthcare This study aims to determine if social support and This article aims to identify the priority themes Stateme facilities in Sub-Saharan Africa. protection is important in achieving positive health needed to attain an AIDS-free generation by 2030 nt outcome in HIV-infected adolescents Researc To identify and determine if there are any To determine if social support and protection are h treatment gaps in the care of HIV-positive important in achieving positive health outcome in HIV- Questio adolescents in Sub-Saharan Africa infected adolescents. To investigate the priority themes needed to attain an AIDS-free generation by 2030 n Outcom The major service limitations were lack of Social support and protection was deemed as important HIV testing priorities were outlined as access e mechanisms to support retention and adherence in positive outcomes among HIV-infected adolescents improvement, linkage to healthcare and self-testing in care, poor integration of sexual reproductive while those for treatment included monitoring and health services, inadequate desegregation of novel drug delivery systems health outcomes based on age and service gaps. NRS433 Adolescents Living with HIV Paper

Setting West and Central Africa 11ART clinics in Cambodia (Where A global case study in 67 countries did the 6 study take place?) Sample 80,000 adolescents between 10-19 years 328 adolescents 323 individuals from 67 countries Method Cross-sectional method The Child Health and Nutrition Research Initiative methodology Key The most prevalent challenges to treatment was 55% of health expenses are state funded. 13.7% of Finding therapy appearance with 40%, socioeconomic adolescents report early to hospitals, 2.7% purchase their Overall mean RPS was 83-87 while AEA was 69s of the barriers with 25% and non-disclosure with 30%. drugs, 32.0% are experiencing HIV stigma, 16.8% lack 75 indicating a consensus on priority questions Study Only 63% of clinics provided support and education due to HIV and 8.2% lack food or housing counselling to HIV-infected individuals because of the virus. Recom New initiatives to address the needs of the Social protection mechanisms should encompass multimendati infected ons adolescent population should be sectorial interventions of formulated and put in place in order to reach the adolescents in transition. the global treatment targets to improve coverage for To attain global targets of AIDS-free generation by 2030 the ALHIV agenda needs to be implemented faster to fill knowledge gaps Researc her 7 Literature Evaluation Table Student Name: Summary of Clinical Issue (200-250 words): The number of HIV-positive adults has become a burgeoning issue due to their increasing number. According to UNICEF, 1.8 million adolescents are living with HIV worldwide, and more than 1.5million of this number live in sub-Saharan Africa. Further analysis of this number revealed HIV-positive adolescent girls accounted for two-thirds of new adolescent infections. Young adults between the ages of 15-19 made up 16% of new adult infections worldwide. In sub-Saharan Africa, adolescent girls are the most prone adolescents to be infected with the virus. As compared to boys, adolescent girls were twice as likely to get HIV. The main mode of infection among adolescents is unprotected sex. In sub-Saharan Africa, 85% of all new infections were as a result of having unprotected sex. Adolescents don’t use contraceptive control, and other preventative measures due to fear of being perceived as deviant, especially in Africa, where culture is still rife. These perceptions make adolescents unwilling to reveal their HIV serostatus making it difficult to treat and contain it’s spread. Also, the general lack of HIV and sexual health knowledge among adolescent, especially in Africa, is responsible for the rising numbers of new infections. The financial and technological status of most states in Africa and Asia is responsible for the poor living conditions of HIV positive adolescents.NRS433 Adolescents Living with HIV Paper

Quantitative Quantitative because the study gives the Quantitative because it uses the Qualitative analysis because , result of the study in forms of measures of frequency to analyze and participant’s perceptions Qualitative( percentages conclude data. it explores How do you know?) Purpose This study aims to determine the setting This study aims to determine the This study aims to identify the needs of Statement for HIV serostatus and its effect on knowledge adolescents and opinions of adolescents on antiretroviral therapy and social adolescents on HIV infection and support infected persons Research How does the setting for HIV serostatus To determine the knowledge of To establish the basic needs required for HIV- Question affect young adolescent and what adolescents on HIV infection and infected adolescents in South Africa recommendations of the most suitable opinions on HIV-infected persons To explore the current antiretroviral therapy HIV disclosure practice? and support initiatives in South Africa and how it impacts HIV-infected adolescents Outcome HIV serostatus disclosure though The adolescents showed a general All the participants viewed their status emotionally distressful at first improved concern for contracting HIV and had negatively with social issues such as violence adolescent motivation and self-care. adequate information concerning the and poverty hampering the antiretroviral modes of infection. therapy in South Africa. 70% of the participants remained positive about their 3 present and future despite the social stressors Setting The study took place at the University Finland Cape Town, South Africa (Where did Teaching Hospital, Zambia the study take place?) Sample The sample was 190 adolescents 1183 adolescents aged 15 years 26 adolescents between 15-19 Method The study was a mixed methods study Focus groups Focus groups which mainly collected data through structured and two-open ended questionnaires Key 73.2% of the sample had mixed feelings 96% of the participants 100% of all participants viewed their status Findings of about HIV serostatus disclosure, while acknowledged HIV could be negatively with social issues such as violence the Study 86.2% saw the disclosure as beneficial. prevented by contraceptives use, and and poverty hampering the antiretroviral 84.7% showed adherence to treatment, 90% acknowledged having multiple therapy in South Africa. 70% of the while 81.1% showed limited self- sexual partners increased risk of participants remained positive about their disclosure to others. infection. 47% of boys and 56% of present and future despite the social stressors girl participants were concerned about the possibility of getting AIDS. Recommend Health workers should provide adequate There should be more incentives The government of South Africa should ations of the information on the risks and benefits of aimed at sensitizing young enhance the effectiveness of antiretroviral Researcher disclosure to caregivers. adolescents on the dangers of HIV therapy in the state by subsidizing the cost of infection. anti-retroviral drugs. Police should use deescalation techniques to minimize police based 4 violence, and adequate deployment should be done to improve security. Criteria Article 4 Article 5 APA- Toth, G., Mburu, G., Tuot, S., Khol, V., Ngin, C., Format Wong, V. J., Murray, K. R., Phelps, B. R., Chhoun, P., & Yi, S. (2018). Social-support needs ted among adolescents living with HIV in the transition Vermund, S. H., &McCarraher, D. R. (2017). Article Adolescents, young people, and the 90–90–90 Article 6 from pediatric to adult care in Cambodia: findings from Citation goals: a call to improve HIV testing and linkage a cross-sectional study.AIDS research and therapy, with to treatment. AIDS (London, England), 31 15(1), 8 Retrieved from Permali (Suppl 3), S191. Retrieved from https://aidsrestherapy.biomedcentral.com/articles/10.118 nk 6/s12981-018-0195-x www.aidsmap.com/Study-identifies-serious- Armstrong, A., Nagata, J. M., Vicari, M., Irvine, C., Cluver, L., Sohn, A. H., … & Ross, D. (2018). A global research agenda for adolescents living with HIV. Journal of acquired immune deficiency syndromes (1999), 78(1), S16. Retrieved from https://journals.lww.com/jaids/FullText/2018/0815 1/A_Global_Research_Agenda_for_Adolescents_L gaps-in-treatment-and-care-of-HIV-positive- iving.4.aspx adolescents-in-sub-SaharanAfrica/page/3151096/ NRS433 Adolescents Living with HIV Paper

How The article analyzes the gaps in healthcare The research article investigates the importance of social Does facilities that formulate perceptions of HIV support and protection in producing positive health the infected adolescents results Article This article identifies the social support and Relate protection priorities needed to the PICOT Questio 5 n? Quantit Quantitative because descriptive statistics was Quantitative study because descriptive statistics are used ative, used to analyze and summarize the data to analyze and summarize data. Qualita coded using thematic coding to allow for further tive(Ho w Quantitative because data from questionnaires were analysis using descriptive statistics do you know?) Purpose This study aims to identify the gaps in healthcare This study aims to determine if social support and This article aims to identify the priority themes Stateme facilities in Sub-Saharan Africa. protection is important in achieving positive health needed to attain an AIDS-free generation by 2030 nt outcome in HIV-infected adolescents Researc To identify and determine if there are any To determine if social support and protection are h treatment gaps in the care of HIV-positive important in achieving positive health outcome in HIV- Questio adolescents in Sub-Saharan Africa infected adolescents. To investigate the priority themes needed to attain an AIDS-free generation by 2030 n Outcom The major service limitations were lack of Social support and protection was deemed as important HIV testing priorities were outlined as access e mechanisms to support retention and adherence in positive outcomes among HIV-infected adolescents improvement, linkage to healthcare and self-testing in care, poor integration of sexual reproductive while those for treatment included monitoring and health services, inadequate desegregation of novel drug delivery systems health outcomes based on age and service gaps. Setting West and Central Africa 11ART clinics in Cambodia (Where A global case study in 67 countries did the 6 study take place?) Sample 80,000 adolescents between 10-19 years 328 adolescents 323 individuals from 67 countries Method Cross-sectional method The Child Health and Nutrition Research Initiative methodology Key The most prevalent challenges to treatment was 55% of health expenses are state funded. 13.7% of Finding therapy appearance with 40%, socioeconomic adolescents report early to hospitals, 2.7% purchase their Overall mean RPS was 83-87 while AEA was 69s of the barriers with 25% and non-disclosure with 30%. drugs, 32.0% are experiencing HIV stigma, 16.8% lack 75 indicating a consensus on priority questions Study Only 63% of clinics provided support and education due to HIV and 8.2% lack food or housing counselling to HIV-infected individuals because of the virus. Recom New initiatives to address the needs of the Social protection mechanisms should encompass multimendati infected ons adolescent population should be sectorial interventions of formulated and put in place in order to reach the adolescents in transition NRS433 Adolescents Living with HIV Paper