Tackling HIV by empowering adolescent girls and young women: a multisectoral, government led campaign in South Africa

Subedar, Hasina; Barnett, Sarah A.; Chaka, Tsakani; Dladla, Sibongile; Hagerman, Ellen; Jenkins, Sarah; Matshimane, Gertrude; Mangold, Kerry; Msimanga, Busi; Pooe, R.I.D.; Schultz, Lebogang; Pillay, Yogan

doi:10.1136/bmj.k4585

Cited by 22 publications

(21 citation statements)

References 1 publication

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“…Already, PrEP programs in South Africa designed for young women are establishing partnerships with college campus clinics to provide PrEP to AGYW [50]. These partnerships may provide convenient venues on campuses for university students to attend peer clubs around their class schedule.…”

Section: Discussionmentioning

confidence: 99%

“You talk about problems until you feel free”: South African adolescent girls' and young women’s narratives on the value of HIV prevention peer support clubs

Baron¹,

Scorgie²,

Ramskin³

et al. 2020

Preprint

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Background: Daily oral pre-exposure prophylaxis (PrEP) can reduce HIV infection in adolescent girls and young women if used consistently during periods of risk. The EMPOWER study evaluated peer-based clubs incorporating an empowerment curriculum offered to adolescent girls and young women (16-24 years) in South Africa and Tanzania for adherence support. Methods: Using serial in-depth interviews (n=33), we assessed the benefits and challenges of club attendance among 13 EMPOWER participants in the Johannesburg site who were randomised to clubs. We used a summary matrix of coded data to support a narrative, case-based analysis. Four case studies are presented. Results: Club participants reported benefits such as increased self-esteem and self-efficacy, reduced isolation, and greater insight into gender-based violence and strategies to address it. Day-to-day PrEP adherence was not the only topic discussed in clubs; participants also appreciated the safe space for sharing problems (such as relationship conflict and PrEP stigma) and found interactive exercises helpful in improving partner communication.Conclusions: Findings support the use of peer-based clubs using a structured empowerment approach, which may offer valuable PrEP initiation support to adolescent girls and young women in settings with high HIV and gender-based violence prevalence.

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Section: Discussionmentioning

confidence: 99%

“You talk about problems until you feel free”: South African adolescent girls' and young women’s narratives on the value of HIV prevention peer support clubs

Baron¹,

Scorgie²,

Ramskin³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Already, PrEP programs in South Africa designed for young women are establishing partnerships with college campus clinics to provide PrEP to AGYW [48]. These partnerships may provide convenient venues on campuses for university students to attend peer clubs around their class schedule.…”

Section: Discussionmentioning

confidence: 99%

“You talk about problems until you feel free”: South African adolescent and young women’s narratives on the value of HIV prevention peer support clubs

Baron¹,

Scorgie²,

Ramskin³

et al. 2020

Preprint

View full text Add to dashboard Cite

Daily oral pre-exposure prophylaxis (PrEP) can reduce HIV infection in adolescent girls and young women if used consistently during periods of risk. The EMPOWER study evaluated peer-based clubs incorporating an empowerment curriculum offered to adolescent girls and young women (16-24 years) in South Africa and Tanzania for adherence support. Using serial in-depth interviews (n=33), we assessed the benefits and challenges of club attendance among 13 EMPOWER participants in the Johannesburg site who were randomised to clubs. We used a summary matrix of coded data to support a narrative, case-based analysis. Four case studies are presented. Club participants reported benefits such as increased self-esteem and self-efficacy, reduced isolation, and greater insight into gender-based violence and strategies to address it. Day-to-day PrEP adherence was not the only topic discussed in clubs; participants also appreciated the safe space for sharing problems and found interactive exercises helpful in improving partner communication. Findings support the use of peer-based clubs using a structured empowerment approach, which may offer valuable PrEP initiation support to adolescent girls and young women in settings with high HIV and gender-based violence prevalence.

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“…For women, the speci c socio-demographic characteristics, which together with healthcare decision making capacity in uence HIV testing include age, education, wealth, employment, residence and parity [8,15]. In SSA, literature on women decision-making capacity and HIV testing are limited to speci c countries such as Tanzania [8], Ethiopia [16] and South Africa [17] and mostly among women who are accessing health care services at health facilities [18,19]. This suggests the paucity of studies on women's decision-making and HIV testing in SSA.…”

Section: Introductionmentioning

confidence: 99%

Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

Seidu

Oduro

Budu

et al. 2020

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Background Global commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment as these efforts play major roles in mother-to-child transmission. We explored the association between women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa (SSA). Methods We used data from the current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 28 countries in SSA. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression to explore the likelihood of HIV testing by women’s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios(AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value <0.05. Results We found that prevalence of HIV testing in the 28 SSA countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare-decisions alone [COR=3.183, CI=2.880-3.519] or with their partners [COR=2.577, CI=2.335-2.844] were more likely to test for HIV compared to those whose healthcare-decisions were taken by others and this persisted after controlling for significant covariates [AOR=1.507, CI=1.321-1.720] and [AOR=1.518, CI=1.334-1.728], respectively. Conclusion SSA countries intending to improve HIV testing need to incorporate women’s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with their decision to test for their HIV status.

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Tackling HIV by empowering adolescent girls and young women: a multisectoral, government led campaign in South Africa

Abstract: Hasina Subedar and colleagues describe the intersectoral collaboration enabling She Conquers, a three year national campaign rolled out across South Africa, to tackle the multiple drivers of the high rates of HIV infection among adolescent girls and young women

Cited by 22 publications

References 1 publication

“You talk about problems until you feel free”: South African adolescent girls' and young women’s narratives on the value of HIV prevention peer support clubs

“You talk about problems until you feel free”: South African adolescent girls' and young women’s narratives on the value of HIV prevention peer support clubs

“You talk about problems until you feel free”: South African adolescent and young women’s narratives on the value of HIV prevention peer support clubs

Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

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