Gender-focused HIV and pregnancy prevention for school-going adolescents: TheMpondombilipilot intervention in KwaZulu-Natal, South Africa

Abstract

This pilot study evaluated a 15 session classroom intervention for HIV and pregnancy prevention among grade 8–10 boys and girls (ages 14–17) in rural South Africa, guided by gender-empowerment theory and implemented by teachers, nurses, and youth peer educators. Pre- and post-intervention surveys included 933 male and female students in two intervention and two comparison schools. Main outcome: condom use at last sex; secondary outcomes: partner communication; gender beliefs and values; perceived peer behaviors; self-efficacy for safer sex. At five months post-intervention, change in condom use did not differ between intervention and comparison schools. Intervention school youth had greater increases in self-efficacy for unsafe sex refusal [OR=1.61; 95% CI=1.01, 2.57] and condom use [OR=1.76; 95% CI=1.07, 2.89], partner communication [OR=2.42; 95% CI=1.27, 4.23], and knowledge of HIV testing opportunities [OR=1.76; 95% CI=1.08, 2.87]. This gender-focused pilot intervention increased adolescents’ self-efficacy and partner communication, and has potential to improve preventive behaviors.

Directed and target focused multi‐sectoral adolescent HIV prevention: Insights from implementation of the ‘DREAMS Partnership’ in rural South Africa

“…Community leaders saw DREAMS multi-sectoral approach as a lost opportunity to include young men who faced similar youth development challenges [26]. While young men have sexual reproductive health (SRH) needs and are partners of AGYW [26] in our community this ambivalence mirrored the well-described barriers to shifting gender-norms in South Africa [27][28][29]. DREAMS implemented a package that addressed gender-based violence explicitly and gender dynamics implicitly (contraception education and access, stepping stones and cash transfers).…”

“Motherhood Is Hard”: Exploring the Complexities of Unplanned Motherhood Among HIV-Positive Adolescents in South Africa

“…To uncover the dynamics surrounding adolescent sexuality, reproduction, and parenting, it is important to also explore the complex and intersecting issues of emotions, reason, pragmatism, and impulse that are linked with social economics and domestic backgrounds-and how they shape the present and future (Harrison et al, 2016;Mantell et al, 2006;K. Naidoo, 2015;P.…”

‘Behaving well’: the transition to respectable womanhood in rural South Africa

“…Recent studies aimed at understanding these experiences, for example, have focused on sexual risk because of HIV, a disease disproportionately affecting young South African women (e.g., Idele et al 2014; Ruark et al 2016; Shisana et al 2014). The risk of unintended pregnancy and the lack of contraception are also common subjects of concern (e.g., Christofides et al 2014; Harrison et al 2016; Mchunu et al 2012), as is the culture of sexual- and gender-based violence in South Africa (e.g., Jewkes et al 2010; Russell et al 2014; Waxman et al 2016). Although collectively these areas of research provide a wealth of important information about the challenging environments in which girls become women, the focus on risk sometimes obscures girls’ everyday ‘non-risky’ lived experiences.…”