scholarly journals “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

2020 ◽  
Author(s):  
Deborah Baron ◽  
Fiona Scorgie ◽  
Lethabo Ramskin ◽  
Nomhle Khoza ◽  
Jennifer Schutzman ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Young Women ◽  
Gender Based Violence ◽  
Partner Communication ◽  
Adherence Support ◽  
Gender Based ◽  
And Gender ◽  
Exposure Prophylaxis ◽  
Violence Prevalence ◽  
Interactive Exercises

Abstract 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.

scholarly journals “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

2020 ◽  
Author(s):  
Deborah Baron ◽  
Fiona Scorgie ◽  
Lethabo Ramskin ◽  
Nomhle Khoza ◽  
Jennifer Schutzman ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Young Women ◽  
Gender Based Violence ◽  
Partner Communication ◽  
Adherence Support ◽  
Gender Based ◽  
And Gender ◽  
Exposure Prophylaxis ◽  
Violence Prevalence ◽  
As Relationship

Abstract 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.

scholarly journals “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

2020 ◽  
Author(s):  
Deborah Baron ◽  
Fiona Scorgie ◽  
Lethabo Ramskin ◽  
Nomhle Khoza ◽  
Jennifer Schutzman ◽  
...  
Keyword(s):  
South African ◽  
Adolescent Girls ◽  
Young Women ◽  
Gender Based Violence ◽  
Partner Communication ◽  
Adherence Support ◽  
Gender Based ◽  
And Gender ◽  
Exposure Prophylaxis ◽  
As Relationship

Abstract 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.Trial registration: South African Clinical Trial Register 4353, 15 April 2016

scholarly journals “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

2020 ◽  
Author(s):  
Deborah Baron ◽  
Fiona Scorgie ◽  
Lethabo Ramskin ◽  
Nomhle Khoza ◽  
Jennifer Schutzman ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Young Women ◽  
Gender Based Violence ◽  
Partner Communication ◽  
Adherence Support ◽  
Gender Based ◽  
And Gender ◽  
Exposure Prophylaxis ◽  
Clinical Trials Registry ◽  
As Relationship

Abstract 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.Trial registration: Pan African Clinical Trials Registry PACTR202006754762723, 10 June 2020, retrospectively registered

scholarly journals Implementation of Anyaka Makwiri: A Multicomponent Mentoring Program for Adolescent Girls and Young Women in Uganda

2021 ◽  
Vol 16 (2-3) ◽  
pp. 278-286
Author(s):  
Kate F. Plourde ◽  
Geeta Nanda ◽  
Elise Healy ◽  
Dennis Kibwola ◽  
Phoebe Mutonyi ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Young Women ◽  
Social Connectedness ◽  
Qualitative Interviews ◽  
Lessons Learned ◽  
Qualitative Assessment ◽  
Mentoring Program ◽  
Gender Based Violence ◽  
Gender Based ◽  
And Gender

This article describes the development and implementation of the Anyaka Makwiri program and summarizes results from the qualitative assessment of participant experiences. Anyaka Makwiri is a multicomponent mentoring program developed for adolescent girls and young women (AGYW) ages 15 to 24 in Gulu, Uganda. The comprehensive program consisted of a curriculum covering sexual and reproductive health (SRH), financial capabilities, soft skills, and gender-based violence and gender equality; activities designed to improve participants’ social connectedness; optional onsite testing for sexually transmitted infections (STIs), HIV, and pregnancy along with STI treatment; group-based savings; and links to SRH services, including contraceptive and gender-based violence services. The program was implemented over a 6-month period and reached 490 AGYW. Findings are derived from routine program-monitoring data including administrative records, de-identified service statistics, and baseline surveys. In addition, this article summarizes some of the key findings from qualitative interviews with both mentors and AGYW participants, conducted at the conclusion of the program.  Participants generally had a favorable view of the mentoring program, particularly in terms of the curriculum topics they were exposed to, and mentors were also positive about their experiences. Despite the program’s many successes there were some implementation challenges, the most prominent being intermittent participant attendance due to a variety of difficulties. The lessons learned from the implementation of Anyaka Makwiri provide valuable insights for the design and implementation of multicomponent mentoring programs for AGYW.

scholarly journals The Community PrEP Study: a randomized control trial leveraging community-based platforms to improve access and adherence to pre-exposure prophylaxis to prevent HIV among adolescent girls and young women in South Africa—study protocol

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Andrew Medina-Marino ◽  
Dana Bezuidenhout ◽  
Sybil Hosek ◽  
Ruanne V. Barnabas ◽  
Millicent Atujuna ◽  
...  
Keyword(s):  
South Africa ◽  
Adolescent Girls ◽  
Young Women ◽  
Randomized Control Trial ◽  
Community Based ◽  
Adherence Support ◽  
Randomized Control ◽  
Exposure Prophylaxis ◽  
Effective Use ◽  
Improve Access

Abstract Background HIV incidence among South African adolescent girls and young women (AGYW) remains high, but could be reduced by highly effective pre-exposure prophylaxis (PrEP). Unfortunately, AGYW report significant barriers to clinic-based sexual and reproductive health services. Even when AGYW access PrEP as an HIV prevention method, poor prevention-effective use was a serious barrier to achieving its optimal HIV prevention benefits. Determining the acceptability and feasibility of community-based platforms to increase AGYW’s access to PrEP, and evaluating behavioural interventions to improve prevention-effective use of PrEP are needed. Methods We propose a mixed-methods study among AGYW aged 16–25 years in Eastern Cape Province, South Africa. In the first component, a cross-sectional study will assess the acceptability and feasibility of leveraging community-based HIV counselling and testing (CBCT) platforms to refer HIV-negative, at-risk AGYW to non-clinic-based, same-day PrEP initiation services. In the second component, we will enrol 480 AGYW initiating PrEP via our CBCT platforms into a three-armed (1:1:1) randomized control trial (RCT) that will evaluate the effectiveness of adherence support interventions to improve the prevention-effective use of PrEP. Adherence will be measured over 24 months via tenofovir-diphosphate blood concentration levels. Qualitative investigations will explore participant, staff, and community experiences associated with community-based PrEP services, adherence support activities, study implementation, and community awareness. Costs and scalability of service platforms and interventions will be evaluated. Discussion This will be the first study to assess the acceptability and feasibility of leveraging CBCT platforms to identify and refer at-risk AGYW to community-based, same-day PrEP initiation services. It will also provide quantitative and qualitative results to inform adherence support activities and services that promote the prevention-effective use of PrEP among AGYW. By applying principles of implementation science, behavioural science, and health economics research, we aim to inform strategies to improve access to and prevention-effective use of PrEP by AGYW. Trial registration ClinicalTrials.govNCT03977181. Registered on 6 June 2019—retrospectively registered.

scholarly journals Gender-Based Violence as A Driver of HIV Infections Among Adolescent Girls and Young Women in Kisumu, Kenya

2019 ◽  
pp. 665-678
Author(s):  
Anthony Wainaina Ndungu
Keyword(s):  
Hiv Prevention ◽  
Data Collection ◽  
Violence Prevention ◽  
Adolescent Girls ◽  
Young Women ◽  
Group Discussion ◽  
Sampling Technique ◽  
Monitoring And Evaluation ◽  
Gender Based Violence ◽  
Gender Based

Gender Based Violence is a universal catastrophe affecting global health, and thus development and is a major human rights concern. This study’s major objective was to establish what extent gender-based violence prevention influence performance of HIV prevention projects for young women and teenagers in Kisumu County. The study population constituted of teenage girls, and young women enrolled in HIV prevention projects implemented in Kisumu County for at least two years. Interviews were also conducted with key project implementers including project managers and monitoring and evaluation managers. Data collection for the study was done by utilizing data collection tools which included focused group discussion, structured questionnaires and an interview guide. 364 respondents were taken from 89,611 adolescents enrolled in HIV prevention projects using stratified random sampling technique. For descriptive data the study employed percentages, frequencies Arithmetic Mean as analytical tools of analysis. The Pearson’s value and Linear Regression were manipulated as statistical tools for inferential statistics. To test the hypotheses, the Fisher (F) test utilized. Descriptive statistics showed that gender-based violence prevention has a noteworthy effect on the production of HIV prevention projects for young women and adolescent girls in Kisumu County. The value of r2 was 0.452, indicating that gender-based violence prevention explained 45.2% of the change in the effectiveness of HIV prevention projects in Kisumu. The beta coefficient was 0.623, implying that gender-based violence had a noteworthy statistical impact on the performance of HIV prevention projects (β=0.623, t=10.928, p=0.000<0.05).

scholarly journals Prevalence and patterns of gender-based violence across adolescent girls and young women in Mombasa, Kenya

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Parinita Bhattacharjee ◽  
Huiting Ma ◽  
Helgar Musyoki ◽  
Eve Cheuk ◽  
Shajy Isac ◽  
...  
Keyword(s):  
Sexual Violence ◽  
Sex Work ◽  
Adolescent Girls ◽  
Young Women ◽  
Casual Sex ◽  
First Episode ◽  
Intimate Partners ◽  
Gender Based Violence ◽  
Police Violence ◽  
Gender Based

Abstract Background We sought to estimate the prevalence and describe heterogeneity in experiences of gender-based violence (GBV) across subgroups of adolescent girls and young women (AGYW). Methods We used data from a cross-sectional bio-behavioural survey among 1299 AGYW aged 14–24 in Mombasa, Kenya in 2015. Respondents were recruited from hotspots associated with sex work, and self-selected into one of three subgroups: young women engaged in casual sex (YCS), young women engaged in transactional sex (YTS), and young women engaged in sex work (YSW). We compared overall and across subgroups: prevalence of lifetime and recent (within previous year) self-reported experience of physical, sexual, and police violence; patterns and perpetrators of first and most recent episode of physical and sexual violence; and factors associated with physical and sexual violence. Results The prevalences of lifetime and recent physical violence were 18.0 and 10.7% respectively. Lifetime and recent sexual violence respectively were reported by 20.5 and 9.8% of respondents. Prevalence of lifetime and recent experience of police violence were 34.7 and 25.8% respectively. All forms of violence were most frequently reported by YSW, followed by YTS and then YCS. 62%/81% of respondents reported having sex during the first episode of physical/sexual violence, and 48%/62% of those sex acts at first episode of physical/sexual violence were condomless. In the most recent episode of violence when sex took place levels of condom use remained low at 53–61%. The main perpetrators of violence were intimate partners for YCS, and both intimate partners and regular non-client partners for YTS. For YSW, first-time and regular paying clients were the main perpetrators of physical and sexual violence. Alcohol use, ever being pregnant and regular source of income were associated with physical and sexual violence though it differed by subgroup and type of violence. Conclusions AGYW in these settings experience high vulnerability to physical, sexual and police violence. However, AGYW are not a homogeneous group, and there are heterogeneities in prevalence and predictors of violence between subgroups of AGYW that need to be understood to design effective programmes to address violence.

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