A combination sexual and reproductive health (SRH) intervention for adolescent girls and young women (AGYW), implemented in South Africa 2016-2019, included facilitated peer-group clubs designed to build AGYW self-esteem, foster supportive peer networks, and provide SRH education. We conducted qualitative in-depth interviews and focus group discussions with AGYW who had participated in peer-group clubs, club facilitators, teachers and intervention implementers. Perceived benefits of participation in peer-group clubs included increased peer support, self-esteem, and gender empowerment, access to safe spaces, improved ability to access emotional support, and positive role modelling, which in turn contributed to improved well-being and mental health. Findings show that peer-group club interventions can be successful in promoting self-esteem, well-being and perceived social support amongst AGYW in South Africa. Given the protective role that social support and mental health have on positive SRH outcomes for AGYW, it is critical that combination interventions incorporate relevant and effective components.

Parent–adolescent sexuality communication, the process in which parents and their adolescent children discuss sexuality and sexual and reproductive health, is a key component for adolescents’ protective behaviours. Open communication with parents, particularly mothers, enables informed sexual and reproductive health (SRH) decision-making amongst adolescent girls and young women (AGYW). As part of a qualitative study evaluating a South African combination HIV prevention intervention for AGYW, we explored perspectives on SRH communication among AGYW and mothers of AGYW, and the effects of the intervention on sexuality communication as perceived by AGYW, mothers of AGYW, intervention facilitators and implementers, and community leaders. In-depth interviews and focus group discussions were conducted with 185 AGYW aged 15–24 years who had participated in the intervention, seven mothers of AGYW intervention recipients, 14 intervention facilitators, six community leaders, and 12 intervention implementers. Key themes that emerged in analysis were (1) Barriers to Sexuality communication, (2) Implications of Gaps in Sexuality Communication, and (3) Addressing Barriers to Sexuality communication. Barriers to sexuality communication included inability or unwillingness to discuss sex, a generation gap, proscriptive socio-cultural guidelines, and mothers’ discomfort, lack of knowledge and self-efficacy, and fear of encouraging promiscuity. AGYW described making poorly-informed SRH decisions alone, expressing a desire for more open communication with and support from parents/mothers. Framed within the social cognitive theory, these findings can help to guide efforts to address barriers around parent–adolescent sexuality communication, inform interventions aimed at targeting SRH issues amongst AGYW, such as unintended pregnancy and HIV, and support meaningful engagement of parents in supporting AGYW in navigating pathways to achieving their SRH goals.