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 ◽  
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):  
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 “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 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.

THE SINS OF THE FATHER: GENDER- BASED VIOLENCE IN POST-APARTHEID SOUTH AFRICA

2017 ◽  
Vol 14 (2) ◽  
pp. 57-70 ◽  
Author(s):  
Lyn Snodgrass
Keyword(s):  
South Africa ◽  
Black Women ◽  
South African ◽  
African Women ◽  
Gender Based Violence ◽  
Political Issues ◽  
Race And Gender ◽  
Gender Based ◽  
And Gender ◽  
South African Women

This article explores the complexities of gender-based violence in post-apartheid South Africa and interrogates the socio-political issues at the intersection of class, ‘race’ and gender, which impact South African women. Gender equality is up against a powerful enemy in societies with strong patriarchal traditions such as South Africa, where women of all ‘races’ and cultures have been oppressed, exploited and kept in positions of subservience for generations. In South Africa, where sexism and racism intersect, black women as a group have suffered the major brunt of this discrimination and are at the receiving end of extreme violence. South Africa’s gender-based violence is fuelled historically by the ideologies of apartheid (racism) and patriarchy (sexism), which are symbiotically premised on systemic humiliation that devalues and debases whole groups of people and renders them inferior. It is further argued that the current neo-patriarchal backlash in South Africa foments and sustains the subjugation of women and casts them as both victims and perpetuators of pervasive patriarchal values.

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.

Navigating agency: adolescents’ challenging dating violence towards gender equitable relationships in a South African township

2020 ◽  
Vol 50 (4) ◽  
pp. 540-552
Author(s):  
Benita Moolman ◽  
Roshin Essop ◽  
Tshidiso Tolla
Keyword(s):  
Intimate Partner Violence ◽  
South African ◽  
Dating Violence ◽  
Adolescent Girls ◽  
Partner Violence ◽  
Intimate Partner ◽  
Gender Based Violence ◽  
High Prevalence ◽  
Gender Based ◽  
South African Township

Intimate partner violence among adolescents is a result of gender and sexual inequitable norms. South African studies note the high prevalence of intimate partner violence in adolescent relationships with adolescent girls and women bearing the high costs. This article examines adolescent girls’ attempts to challenge dating violence and exit violent relationships. It reports the results of a gender empowerment programme linked to girls’ soccer in a South African township. The results indicate the complexities experienced by girls moving towards more gender equitable relationships, some strategies they adopt, and some challenges they still face. The programme facilitated by Grassroots Soccer (Soweto) is located in a Black, urban, low socio-economic context with high rates of gender-based violence. While it appears promising, further curriculum development is needed in the programme, particularly in relation to changing gendered and sexualized social norms that prescribe conventional and patriarchal femininities.

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