Market segmentation of South African adolescent girls and young women to inform HIV prevention product marketing strategy: A mixed methods study

Abstract Background South African adolescent girls and young women (AGYW) report significant mental distress and sexual and reproductive health concerns. Mental health problems and trauma symptoms are consistently associated with sexual and reproductive health behavior. Despite their intersection, few interventions address them simultaneously or engage female caregivers (FC) as collaborators. This study presents findings from a pilot test of an empirically supported culturally adapted family-based HIV-prevention program, Informed Motivated Aware and Responsible Adolescents and Adults- South Africa (IMARA-SA), on AGYW anxiety, depression, and trauma. Methods Sixty 15–19-year-old AGYW (mean age = 17.1 years) and their FC from outside Cape Town were randomized to IMARA-SA or a health promotion control program. AGYW reported their anxiety using the GAD-7, depression using the PHQ-9, and trauma using the PC-PTSD-5 at baseline and follow-up (6–10 months post). Both interventions were delivered by Xhosa-speaking Black South African women in groups over 2 days for approximately 10 h. We examined intervention effects using zero-inflated negative binomial regression for anxiety, multinomial logistic regression for depression, and logistic regression for trauma. Results At baseline, groups did not differ in demographic characteristics but AGYW randomized to IMARA-SA had higher depression scores than controls (p = 0.04) and a greater proportion screened positive for PTSD (p = .07). Controlling for baseline mental health scores, AGYW who received IMARA-SA compared to controls had significantly fewer anxiety symptoms at follow-up (adjusted incidence rate ratio for count model = 0.54, 95% CI = 0.29–0.99, p = 0.05), were less likely to report at least one depressive symptom relative to no symptoms (relative risk ratio = 0.22, 95% CI = 0.05, 0.95, p = 0.04), and were less likely to report symptoms of PTSD relative to no symptoms, but this difference was not statistically significant. Conclusions Mental health is implicated in risky sexual behavior, and reducing emotional distress can mitigate exposure to poor sexual and reproductive health outcomes. This pilot study yielded promising findings for the mental health impact of IMARA-SA, justifying replication in a larger randomized trial. Trial registration ClinicalTrials.gov Number NCT04758390, accepted 17/02/2021.

Download Full-text

Consumer Journeys of Adolescent Girls and Young Women in South Africa: Implications for Marketing HIV Prevention Products

Social Marketing Quarterly ◽

10.1177/15245004211030965 ◽

2021 ◽

pp. 152450042110309

Author(s):

Michelle Dugas ◽

Kenyon Crowley ◽

Guodong (Gordon) Gao ◽

Lorcan McHarry ◽

Louise Kenmuir ◽

...

Keyword(s):

South Africa ◽

Hiv Prevention ◽

South African ◽

Health Beliefs ◽

Adolescent Girls ◽

Young Women ◽

Low Income ◽

Sexual Experience ◽

Personal Hygiene ◽

Consumer Journeys

Background: Female-initiated prevention products could reduce HIV infection rates in contexts with pronounced gender inequality like South Africa, but uptake and adherence remain low when available. Insights into the behavior of target consumers are needed to effectively promote these products; however, perceptions of stigma may discourage honest reporting. Focus of the Article: To address this need, we examined differences among the consumer journeys of six segments of South African adolescent girls and young women (AGYW), who vary on sexual health beliefs, sexual experience, and self-enhancement, when buying hygiene products. Research Question: We hypothesized that segments would differ in what motivated their purchases and in engagement with different touchpoints, reflecting a need for targeted outreach strategies. Methods: 1,500 low-income, Black South African AGYW (14–25 years of age) were surveyed face-to-face in their homes about their consumer journeys when purchasing deodorant and sanitary products, with the aim of extending the insights obtained to HIV prevention. Results: We found notable similarities across segments but also several important differences underscoring the potential for tailored marketing of HIV prevention products. Among some of the segments, differences were found in prepurchase mindsets and touchpoints, retail and brand drivers, and postpurchase feelings. Recommendations for Research or Practice: These findings highlight the need for tailored outreach among AGYW and may inform the design of effective, personalized marketing strategies that enhance the appeal of HIV prevention products. Limitations: To circumvent potential stigma associated with HIV, survey questions were anchored on personal hygiene products. While this may encourage greater honesty, findings may not fully generalize to HIV prevention products.

Download Full-text

Youth Relationships in the Era of COVID-19: A Mixed-Methods Study Among Adolescent Girls and Young Women in Kenya

Journal of Adolescent Health ◽

10.1016/j.jadohealth.2021.07.017 ◽

2021 ◽

Author(s):

Celia Karp ◽

Caroline Moreau ◽

Grace Sheehy ◽

Selena Anjur-Dietrich ◽

Faith Mbushi ◽

...

Keyword(s):

Mixed Methods ◽

Adolescent Girls ◽

Young Women ◽

Mixed Methods Study

Download Full-text

Using soccer to build confidence and increase HCT uptake among adolescent girls: a mixed-methods study of an HIV prevention programme in South Africa

Sport in Society ◽

10.1080/17430437.2014.997586 ◽

2015 ◽

Vol 18 (8) ◽

pp. 1009-1022 ◽

Cited By ~ 12

Author(s):

Rebecca Beth Hershow ◽

Katherine Gannett ◽

Jamison Merrill ◽

Elise Braunschweig Kaufman ◽

Chris Barkley ◽

...

Keyword(s):

South Africa ◽

Mixed Methods ◽

Hiv Prevention ◽

Adolescent Girls ◽

Mixed Methods Study ◽

Prevention Programme

Download Full-text

Availability and advertising of sugar sweetened beverages in South African public primary schools following a voluntary pledge by a major beverage company: a mixed methods study

Global Health Action ◽

10.1080/16549716.2021.1898130 ◽

2021 ◽

Vol 14 (1) ◽

pp. 1898130

Author(s):

Agnes Erzse ◽

Nicola Christofides ◽

Nicholas Stacey ◽

Kelsey Lebard ◽

Louise Foley ◽

...

Keyword(s):

Mixed Methods ◽

South African ◽

Primary Schools ◽

Mixed Methods Study ◽

Sugar Sweetened Beverages ◽

Sweetened Beverages

Download Full-text

Prevalence and factors associated with intimate partner violence among the adolescent girls and young women in South Africa: findings the 2017 population based cross-sectional survey

BMC Public Health ◽

10.1186/s12889-021-11183-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jacqueline Mthembu ◽

Musawenkosi Mabaso ◽

Sarah Reis ◽

Khangelani Zuma ◽

Nompumelelo Zungu

Keyword(s):

South African ◽

Adolescent Girls ◽

Young Women ◽

Partner Violence ◽

Urban Areas ◽

Population Based ◽

Intimate Partner ◽

Low Ses ◽

Cross Sectional ◽

Factors Associated

Abstract Background Evidence indicate that intimate partner violence (IPV) is disturbingly high among South African adolescent girls and young women (AGYW). Understanding prevalence and risk factors for IPV among these emerging adults is critical for developing appropriate interventions to prevent adverse health outcomes later in life. This study investigates the prevalence and factors associated with lifetime physical IPV experience among AGYW, aged 15–24 years, using the South African national HIV prevalence, incidence, behaviour and communication survey conducted in 2017. Methods The data used in this secondary analysis was obtained from a cross-sectional, population-based household survey data, conducted using a multi-stage stratified random cluster sampling approach. Multivariate stepwise backward logistic regression modelling was used to determine factors associated with IPV. Results Of 716 AGYW that responded to the two commonly answered questions on IPV, 13.1% (95% CI: 9.6–17.6) indicated that they experienced IPV. The odds of reporting experiences of IPV were significantly lower among AGYW residing in high SES households [AOR = 0.09 (95% CI: 0.02–0.47), p = 0.004] than low SES households, and those residing in rural informal/tribal areas [AOR = 0.01 (95% CI: 0.00–0.22), p = 0.004] than urban areas. AGYW experiencing IPV had higher odds of reporting psychological distress compared to their counterparts [AOR = 4.37 (95% CI, 0.97–19.72), p = 0.054]. Conclusion The findings highlight the need for targeted structural and psychosocial interventions in low SES households and especially in urban areas.

Download Full-text

Strengthening Human Immunodeficiency Virus and Tuberculosis Prevention Capacity among South African Healthcare Workers: A Mixed Methods Study of a Collaborative Occupational Health Program

Safety and Health at Work ◽

10.1016/j.shaw.2017.08.004 ◽

2018 ◽

Vol 9 (2) ◽

pp. 172-179 ◽

Cited By ~ 2

Author(s):

Alexandre Liautaud ◽

Prince A. Adu ◽

Annalee Yassi ◽

Muzimkhulu Zungu ◽

Jerry M. Spiegel ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Mixed Methods ◽

Occupational Health ◽

South African ◽

Healthcare Workers ◽

Health Program ◽

Mixed Methods Study ◽

Tuberculosis Prevention ◽

Immunodeficiency Virus

Download Full-text

HIV prevention and HIV care among transgender and gender diverse youth: design and implementation of a multisite mixed-methods study protocol in the U.S.

BMC Public Health ◽

10.1186/s12889-019-7605-4 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Laura Jadwin-Cakmak ◽

Sari L. Reisner ◽

Jaclyn M. W. Hughto ◽

Liz Salomon ◽

Miguel Martinez ◽

...

Keyword(s):

Mixed Methods ◽

Informed Consent ◽

Hiv Prevention ◽

Study Protocol ◽

Qualitative Interview ◽

Lessons Learned ◽

Mixed Methods Study ◽

Gender Diverse ◽

And Gender ◽

The U.S

Abstract Background In the U.S., transgender and gender diverse (TGD) populations face structural, interpersonal, and individual barriers to healthcare. Less is known, however, about the HIV prevention and treatment experiences of TGD youth in the U.S. The current study was developed to fill this research gap. Methods This article describes the research protocol for a multi-site, U.S.-based mixed-methods study that sought to identify the multi-level facilitators and barriers that influence participation of TGD youth in various stages of the HIV prevention (e.g., pre-exposure prophylaxis uptake) and care continua. A sample of diverse TGD youth ages 16–24 was recruited from 14 U.S. sites. TGD youth participants completed a one-time, in-person visit that included an informed consent process, computer-based quantitative survey, and in-depth qualitative interview assessing experiences accessing HIV prevention and/or care services. Providers serving TGD youth were recruited from the same 14 sites and completed a one-time visit via phone that included informed consent, demographic questionnaire, and in-depth qualitative interview assessing their experiences providing HIV prevention or treatment services to TGD youth. Results Overall, 186 TGD youth ages 16–24 and 59 providers serving TGD youth were recruited and enrolled from across the 14 U.S. sites. TGD youth participants had a mean age of 20.69; 77.3% youth of color; 59.7% trans-feminine; 15.5% trans-masculine; 24.9% non-binary; 53.6% family income under poverty level. Providers included medical and mental health providers as well as case manager/care coordinators, HIV test counselors, and health educators/outreach workers. Providers were 81.3% cisgender and 30.5% people of color. Successes with community-engagement strategies and gender-affirming research methods are reported. Conclusions This study addresses critical gaps in current knowledge about the HIV prevention and care experiences of TGD youth. Findings have implications for the development of HIV interventions across levels to support the health and well-being of TGD youth. Future research is warranted to replicate and expand on lessons learned regarding recruitment and engagement of communities of TGD youth, including longitudinal designs to assess engagement across their developmental stages. Lessons learned working with TGD youth through developing and implementing the study protocol are shared. Trial registration Registered on ClinicalTrials.gov on 05/20/2015 (NCT02449629).

Download Full-text