Combination Social Protection Programme as an HIV Prevention Mechanism: Experiences of Youths in Resource-Constrained Settings of Gauteng Province, South Africa
DOI:
https://doi.org/10.25159/2708-9355/13412Keywords:
combination social protection, youths, HIV prevention, agency, empowermentAbstract
Regardless of the tremendous growth of combination social protection as a human immunodeficiency virus prevention mechanism in South Africa, little is known about the ways in which combination social protection improves prevention outcomes for youths. In this article, we report on the experiences of youths participating in the combination social protection. In the study, which was conducted among Black African youths in the City of Johannesburg township settings of Soweto, Alexandra, and Orange Farm, we adopted a qualitative approach. The aim of the study was to explore the experiences of youths participating in the combination social protection and their views on how the programme changed their risk behaviour and sexual practices. We used a purposively selected sample to identify participants for semi-structured qualitative interviews. In-depth individual interviews were conducted with thirty youths and focus group discussions with six non-governmental organisations practitioners and five Department of Social Development officials. The data were analysed by implementing Creswell and Creswell’s strategy of qualitative thematic analysis. The findings show that when youths are equipped with prevention informational resources, economic capabilities, and social assets, they are empowered with agency and purposefulness that may alter their intentions to engage in risky sexual behaviour. It is also revealed that, by providing space for youths to engage on issues of gender and differential access to health and economic opportunities, the programme advanced the empowerment of female youths. Thus, combination social protection could be part of the country’s comprehensive social work package for empowering youths in poor localities.
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References
Alsop, R., and N. Heinsohn. 2005. “Measuring Empowerment in Practice: Structuring Analysis and Framing Indicators.” World Bank Policy Research Working Paper 3510. Accessed January 7, 2022. https://doi.org/10.1596/1813-9450-3510 DOI: https://doi.org/10.1596/1813-9450-3510
Austrian, K., and E. Muthengi. 2014. “Can Economic Assets Increase Girls’ Risk of Sexual Harassment? Evaluation Results from a Social, Health and Economic Asset-Building Intervention for Vulnerable Adolescent Girls in Uganda.” Children and Youth Services Review 47 (1): 168–175. https://doi.org/10.1016/j.childyouth.2014.08.012 DOI: https://doi.org/10.1016/j.childyouth.2014.08.012
Burke, H. M., M. Chen, K. Murray, C. Bezuidenhout, P. Ngwepe, A. Bernholc, and A. Medina-Marino. 2020. “The Effects of the Integration of an Economic Strengthening and HIV Prevention Education Programme on the Prevalence of Sexually Transmitted Infections and Savings Behaviours among Adolescents: A Full-factorial Randomised Controlled Trial in South Africa.” BMJ Global Health 5 (4): 1–16. http://dx.doi.org/10.1136/bmjgh-2019-002029 DOI: https://doi.org/10.1136/bmjgh-2019-002029
Bermudez, L. G., D. Mulenga, M. Musheke, and S. Mathur. 2022. “Intersections of Financial Agency, Gender Dynamics, and HIV Risk: A Qualitative Study with Adolescent Girls and Young Women in Zambia.” Global Public Health 17 (8): 1638–1651. https://doi.org/10.1080/17441692.2021.1951800 DOI: https://doi.org/10.1080/17441692.2021.1951800
Chauke, T., and O. S. Obadire. 2020. “Using Gender Differential Motivation for Youth Entrepreneurship as an Economic Survival Strategy in South Africa.” Gender & Behaviour 18 (1): 1–15. https://hdl.handle.net/10520/ejc-genbeh-v18-n1-a45.
Cluver, L., M. Orkin, A. Yakubovich, and L. Sherr. 2016. “Combination Social Protection for Reducing HIV–Risk Behaviour amongst Adolescents in South Africa.” Journal of Acquired Immune Deficiency Syndromes 72 (1): 96–104. https://doi.org/10.1097/QAI.0000000000000938 DOI: https://doi.org/10.1097/QAI.0000000000000938
Creswell, J. W., and D. J. Creswell. 2018. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. London: SAGE.
Department of Welfare. 1997. White Paper for Social Welfare. Government Gazette, Vol. 386. No. 18166. Pretoria: Government Printer.
Department of Women, Youth and Persons with Disabilities (DWYPD). 2021. “National Youth Policy for 2020–2030.” South African Government. Accessed January 24, 2022. https://www.gov.za/sites/default/files/gcis_document/202103/nationalyouthpolicy.pdf
Jewkes, R., K. Dunkle, M. Nduna, and N. Shai. 2010. “Intimate Partner Violence, Relationship Power Inequity, and Incidence of HIV Infection in Young Women in South Africa: A Cohort Study.” The Lancet 376 (9734): 41–48. https://doi.org/10.1016/S0140-6736(10)60548-X DOI: https://doi.org/10.1016/S0140-6736(10)60548-X
Johnson, L. F., C. Chiu, L. Myer, M. A. Davies, R. E. Dorrington, L. G. Bekker, A. Boulle, and G. M. Rath. 2016. “Prospects for HIV Control in South Africa: A Model-Based Analysis.” Global Health Action 9 (30314): 1–12. https://doi.org/10.1016/S0140-6736(10)60548-X DOI: https://doi.org/10.3402/gha.v9.30314
Kabeer, N. 2001. “Resources, Agency, Achievements: Reflections on the Measurement of Women’s Empowerment.” In Discussing Women’s Empowerment—Theory and Practice, edited by A. Sisask, 17–54. Sweden: SIDA. https://doi.org/10.1111/1467-7660.00125 DOI: https://doi.org/10.1111/1467-7660.00125
Kim, J., P. Pronyk, T. Barnett, and C. Watts. 2008. “Exploring the Role of Economic Empowerment in HIV Prevention.” AIDS 22 (4): 57–71. https://doi.org/10.1097/01.aids.0000341777.78876.40 DOI: https://doi.org/10.1097/01.aids.0000341777.78876.40
Lee, N., S. B. Stücklin, P. L. Rodriguez, M. Faris, and I. Mukaka. 2019. “Financial Education for HIV-Vulnerable Youth, Orphans, and Vulnerable Children: A Systematic Review of Outcome Evidence.” Vulnerable Children and Youth Studies 14 (30): 191–218. https://doi.org/10.1080/17450128.2019.1612128 DOI: https://doi.org/10.1080/17450128.2019.1612128
Mkumba, L. S., M. Nassali, J. Benner, and T. D. Ritchwood. 2021. “Sexual and Reproductive Health Needs of Young People Living with HIV in Low-and-Middle-Income Countries: A Scoping Review.” Reproductive Health 18 (219): 1–14. https://doi.org/10.1186/s12978-021-01269-7 DOI: https://doi.org/10.1186/s12978-021-01269-7
Naidoo, I., M. Mabaso, and N. Zungu. 2021. “Being ALHIV and Staying Alive: What Do We Know about Adolescents Living with HIV in South Africa?” HSRC Review 19 (1): 42–45. http://hdl.handle.net/20.500.11910/16012
National Planning Commission. 2012. “National Development Plan 2030.” Accessed September 2, 2022. https://www.gov.za/issues/national-development-plan-2030
Nieuwenhuis, J. 2019. “Qualitative Research Designs and Data-Gathering Techniques.” In First Steps in Research, edited by K. Maree, 72–100. Pretoria: Van Schaik.
Obiezu-Umeh, C., U. Nwaozuru, S. Mason, T. Gbaja-Biamila, D. Oladele, O. Ezechi, and J. Iwelunmor. 2021. “Implementation Strategies to Enhance Youth-Friendly Sexual and Reproductive Health Services in Sub-Saharan Africa: A Systematic Review.” Frontiers in Reproductive Health 3 (684081): 1–13. https://doi.org/10.3389/frph.2021.684081 DOI: https://doi.org/10.3389/frph.2021.684081
Pettifor, A., S. Marie, P. Carey, and L. G. Bekker. 2018. “Adolescent Lives Matter, Preventing HIV in Adolescents.” Current Opinion in HIV and AIDS 13 (3): 265–273. https://doi.org/10.1097/COH.0000000000000453 DOI: https://doi.org/10.1097/COH.0000000000000453
President’s Emergency Plan for AIDS Relief (PEPFAR). 2017. “South Africa Country Operational Plan 2017 (COP17).” Accessed August 6, 2022. https://www.state.gov/wp-content/uploads/2019/08/South-Africa-19.pdf
Republic of South Africa. 1996. Constitution of the Republic of South Africa, Act 108 of 1996. Government Gazette, Vol. 378, No. 17678. Accessed September 4, 2023. https://www.gov.za/sites/default/files/images/a108-96.pdf
Pulerwitz, J., S. Mathur, D. Woznica, and M. Carael. 2018. “How Empowered are Girls/Young Women in Their Sexual Relationships? Relationship Power, HIV Risk, and Partner Violence in Kenya.” PLoS One 13 (7): 1–14. https://doi.org/10.1371/journal.pone.0199733 DOI: https://doi.org/10.1371/journal.pone.0199733
Richards-Schuster, K., S. Pritzker, and A. Rodriguez-Newhall. 2018. “Youth Empowerment.” In Encyclopaedia of Social Work, edited by C. Franklin, 301–318. New York: Oxford University Press. https://doi.org/10.1093/acrefore/9780199975839.013.1077 DOI: https://doi.org/10.1093/acrefore/9780199975839.013.1077
Saul, J., G. Bachman, S. Allen, N. F. Toiv, C. Cooney, and T. Beamon. 2018. “The DREAMS Core Package of Interventions: A Comprehensive Approach to Preventing HIV among Adolescent Girls and Young Women.” PLoS ONE 13 (12): 1–18. https://doi.org/10.1371/journal.pone.0208167 DOI: https://doi.org/10.1371/journal.pone.0208167
Statistics South Africa (StatsSA). 2023. “Quarterly Labour Force Survey—Q2:2023.” Accessed October 27, 2023. https://www.statssa.gov.za/publications/P0211/Presentation%20QLFS%20Q2%202023.pdf
Simbayi, L. C., K. Zuma, N. Zungu, S. Moyo, E. Marinda, S. Jooste, M. Mabaso, S. Ramlagan, A. North, J. van Zyl, N. Mohlabane, C. Dietrich, and I. Naidoo. 2019. “South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2017: Towards Achieving the UNAIDS 90-90-90 Targets.” Cape Town: HSRC. Accessed March 15, 2023. http://hdl.handle.net/20.500.11910/15052
Tolmay, J., L. Knight, L. Muvhango, T. Polzer-Ngwato, H. Stöckl, and M. Ranganathan. 2022. “Women’s Economic Contribution, Relationship Status and Risky Sexual Behaviours: A Cross-Sectional Analysis from a Microfinance-Plus Programme in Rural South Africa.” AIDS Behaviour 26 (7): 2349–2362. https://doi.org/10.1007/s10461-021-03566-5 DOI: https://doi.org/10.1007/s10461-021-03566-5
United Nations Programme on HIV/AIDS (UNAIDS). 2022. “In Danger: UNAIDS Global AIDS Update.” Accessed April 28, 2023. https://www.unaids.org/en/resources/documents/2022/in-danger-global-aids-update
Zuma, T., J. Seeley, S. Hlongwane, N. Chimbindi, L. Sherr, S. Floyd, I. Birdthistle, and M. Shahmanesh. 2022. “A Socio-Ecological Approach to Understanding Experiences and Perceptions of a Multilevel HIV Prevention Intervention: The Determined, Resilient, Empowered, AIDS-Free, Mentored, and Safe (DREAMS) Partnership in uMkhanyakude, KwaZulu-Natal, South Africa.” SSM – Qualitative Research in Health 2 (100138): 1–8. https://doi.org/10.1016/j.ssmqr.2022.100138 DOI: https://doi.org/10.1016/j.ssmqr.2022.100138
Zungu, N., I. Naidoo, R. Hodes, A. North, M. Mabaso, D. Skinner, L. Gittings, R. Sewpaul, S. Takatshana, S. Jooste, S. Moyo, S. Ramlagan, A. Cloete, E. Toska, and ALHIV Team. 2021 “Adolescents Living with HIV in South Africa.” Pretoria: Human Sciences Research Council. Accessed April 27, 2023. http://hdl.handle.net/20.500.11910/16404
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Accepted 2023-11-13
Published 2024-02-20