Economic Resources and HIV Preventive Behaviors Among School-Enrolled Young Women in Rural South Africa (HPTN 068)

Jennings, Larissa; Pettifor, Audrey; Hamilton, Erica L.; Ritchwood, Tiarney D.; Gómez‐Olivé, F. Xavier; MacPhail, Catherine; Selin, Amanda; Kahn, Kathleen

doi:10.1007/s10461-016-1435-5

Cited by 11 publications

(11 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The findings demonstrate that not only does the hybrid microfinance/productive assets loan program provide economic empowerment for the young adolescent and family, but also improves adolescent health and school attendance in a rural humanitarian setting. This finding is consistent with other evidence that demonstrated benefits beyond economics with asset-based economic interventions such as improved psychosocial outcomes [26,27]. Tangible assets, such as the rabbit and offspring, can influence the adolescent's future outlook and reduce risk behaviors such as leaving school early to work in the local mines.…”

Section: Discussionsupporting

confidence: 89%

Comparative effectiveness of an economic empowerment program on adolescent economic assets, education and health in a humanitarian setting

et al. 2020

View full text Add to dashboard Cite

Background: Adolescence is a critical period of human development, however, limited research on programs to improve health and well-being among younger adolescents living in conflict-affected and humanitarian settings exists. The purpose of this study was to assess the comparative effectiveness of an economic empowerment program on young adolescent outcomes in a complex humanitarian setting. Methods: This longitudinal, mixed methods study examined the relative effectiveness of an integrated parent (Pigs for Peace, PFP) and young adolescent (Rabbits for Resilience, RFR) animal microfinance/asset transfer program (RFR + PFP) on adolescent outcomes of asset building, school attendance, mental health, experienced stigma, and food security compared to RFR only and PFP only over 24 months. A sub-sample of young adolescents completed in-depth qualitative interviews on the benefits and challenges of participating in RFR. Results: Five hundred forty-two young adolescents (10-15 years) participated in three groups: RFR + PFP (N = 178), RFR only (N = 187), PFP only (N = 177). 501 (92.4%) completed baseline surveys, with 81.7% (n = 442) retention at endline. The group by time interaction (24 months) was significant for adolescent asset building (X 2 = 16.54, p = .002), school attendance (X 2 = 12.33, p = .015), and prosocial behavior (X 2 = 10.56, p = .032). RFR + PFP (ES = 0.31, ES = 0.38) and RFR only (ES-0.39, ES = 0.14) adolescents had greater improvement in asset building and prosocial behavior compared to PFP only, respectively. The odds of missing two or more days of school in the past month were 78.4% lower in RFR only and 45.1% lower in RFR + PFP compared to PFP only. No differences between groups in change over time were found for internalizing behaviors, experienced stigma, or food security. Differences by age and gender were observed in asset building, prosocial behavior, school attendance, experienced stigma, and food security. The voices of young adolescents identified the benefits of the RFR program through their ability to pay for school fees, help their families meet basic needs, and the respect they gained from family and community. Challenges included death of rabbits and potential conflict within the household on how to use the rabbit asset. Conclusion: These findings underscore the potential for integrating economic empowerment programs with both parents and young adolescents to improve economic, educational, and health outcomes for young adolescents growing up in rural and complex humanitarian settings. Trial registration: NCT02008695. Retrospectively registered

show abstract

Section: Discussionsupporting

confidence: 89%

Comparative effectiveness of an economic empowerment program on adolescent economic assets, education and health in a humanitarian setting

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The Swa Koteka intervention provided cash payments to both girls and their guardians, conditional on school attendance, and also provided testing and counseling components once a year when girls underwent HIV/HSV-2 testing. Behind this intervention design was the theory that schooling was protective for HIV risk, but also that women’s economic security and empowerment are strongly interconnected, a link that was demonstrated at baseline among young women enrolled in this study (Jennings et al 2017 ). In particular, Jennings et al ( 2017 ) showed that among sexually active young women, having greater economic resources in the form of individual-level resources, like savings and spending money, was associated with safer sexual behaviors (Jennings et al 2017 ).…”

Section: Discussionmentioning

confidence: 99%

The Impact of a Conditional Cash Transfer on Multidimensional Deprivation of Young Women: Evidence from South Africa’s HTPN 068

et al. 2020

Self Cite

View full text Add to dashboard Cite

Despite the growing popularity of multidimensional poverty measurement and analysis, its use to measure the impact of social protection programs remains scarce. Using primary data collected for the evaluation of HIV Prevention Trials Network (HPTN) 068, a randomized, conditional cash transfer intervention for young girls in South Africa that ran from 2011 to 2015, we construct an individual-level measure of multidimensional poverty, a major departure from standard indices that use the household as the unit of analysis. We construct our measure by aggregating multiple deprivation indicators across six dimensions and using a system of nested weights where each domain is weighted equally. Our findings show that the cash transfer consistently reduces deprivations among girls, in particular through the domains of economic agency, violence, and relationships. These results show how social protection interventions can improve the lives of young women beyond single domains and demonstrate the potential for social protection to simultaneously address multiple targets of the SDGs.

show abstract

“…While there was no effect of the CCT intervention on HIV incidence, there were some improved sexual behaviors and a large reduction in the risk of intimate partner violence [39]. An analysis of baseline data also showed that individual economic resources among the study sample were associated with a number of HIV preventive practices including periodic sexual abstinence, having fewer sexual partners, and consistent condom use [31]. Further, a qualitative analysis by MacPhail et al (2017), found young women in the treatment group experienced a number of benefits due to the cash itself, including enhanced status with peers and feelings of independence, which may have consequently affected their sexual risk-taking behavior and psychosocial well-being [40].…”

Section: Introductionmentioning

confidence: 92%

“…One recent study found more positive associations between individual economic resources and protective sexual behaviors among sexually active young women in South Africa [31] while others have been more mixed [29,30]. In Cameroon, women (aged with greater economic resources displayed more protective factors such as greater HIV knowledge and more condom use but were also more likely to test positive for HIV and to engage in riskier sexual behaviors such as having multiple partners in the past 12 months [30].…”

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Cash Transfers, Young Women’s Economic Well-Being, and HIV Risk: Evidence from HPTN 068

et al. 2018

Self Cite

View full text Add to dashboard Cite

Despite the large interest in economic interventions to reduce HIV risk, little research has been done to show whether there are economic gains of these interventions for younger women and what intermediary role economic resources play in changing participants' sexual behavior. This paper contributes to this gap by examining the impacts of a conditional cash transfer (CCT) for young women in South Africa on young women's economic resources and the extent to which they play a role in young women's health and behavior. We used data from HIV Prevention Trials Network 068 study, which provided transfers to young women (in addition to their parents) conditional on the young woman attending at least 80% of school days in the previous month. We found that the CCT increased young women's economic wellbeing in terms of having savings, spending money, being unindebted, and food secure. We also investigated heterogeneous effects of the program by household economic status at baseline because the program was not specifically poverty targeted and found that the results were driven by young women from the poorest families. From these results, we examined heterogeneity by baseline poverty for other outcomes related to HIV risk including sexual behavior and psychosocial well-being. We found psychosocial well-being benefits in young women from the poorest families and that economic wellbeing gains explained much these impacts.

show abstract

Economic Resources and HIV Preventive Behaviors Among School-Enrolled Young Women in Rural South Africa (HPTN 068)

Cited by 11 publications

References 55 publications

Comparative effectiveness of an economic empowerment program on adolescent economic assets, education and health in a humanitarian setting

Comparative effectiveness of an economic empowerment program on adolescent economic assets, education and health in a humanitarian setting

The Impact of a Conditional Cash Transfer on Multidimensional Deprivation of Young Women: Evidence from South Africa’s HTPN 068

Cash Transfers, Young Women’s Economic Well-Being, and HIV Risk: Evidence from HPTN 068

Contact Info

Product

Resources

About