Journal article
Combination social protection for reducing HIV-risk behavior amongst adolescents in South Africa
- Abstract:
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Background: Social protection (i.e. cash transfers, free schools, parental support) has potential for adolescent HIV-prevention. We aimed to identify which social protection interventions are most effective and whether combined social protection has greater effects in South Africa.
Methods: In this prospective longitudinal study, we interviewed 3516 adolescents aged 10-18 between 2009 and 2012. We sampled all homes with a resident adolescent in randomly-selected census areas in four urban and rural sites in two South African provinces. We measured household receipt of fourteen social protection interventions and incidence of HIV-risk behaviors. Using gender-disaggregated multivariate logistic regressio
n and marginal-effects analyses, we assessed respective contributions of interventions and potential combination effects. Results: Child-focused grants, free schooling, school feeding, teacher support, and parental monitoring were independently associated with reduced HIV-risk behavior incidence (OR 0.10-0.69). Strong effects of combination social protection were shown, with cumulative reductions in HIV-risk behaviors. For example, girls’ predicted past-year incidence of economically-driven sex dropped from 11% with no interventions, to 2% amongst those with a child grant, free school and good parental monitoring. Similarly, girls’ incidence of unprotected/casual sex or multiple-partners dropped from 15% with no interventions to 10% with either parental monitoring or school feeding, and to 7% with both interventions.
Conclusion: In real-world, high-epidemic conditions, ‘combination social protection’ shows strong HIV-prevention effects for adolescents and may maximize prevention efforts.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 401.5KB, Terms of use)
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- Publisher copy:
- 10.1097/QAI.0000000000000938
Authors
- Publisher:
- BioMed Central
- Journal:
- Journal of Acquired Immune Deficiency Syndromes More from this journal
- Volume:
- 72
- Issue:
- 1
- Pages:
- 96–104
- Publication date:
- 2016-05-01
- Acceptance date:
- 2015-12-11
- DOI:
- ISSN:
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1758-2652
- Keywords:
- Pubs id:
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pubs:597478
- UUID:
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uuid:518fa529-255d-4792-b753-0249ca611b3b
- Local pid:
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pubs:597478
- Source identifiers:
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597478
- Deposit date:
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2016-01-26
- ARK identifier:
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- Copyright holder:
- Cluver et al
- Copyright date:
- 2016
- Notes:
- © 2016 Cluver et al. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially.
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