School, Supervision and Adolescent-Sensitive Clinic Care: Combination Social Protection and Reduced Unprotected Sex Among HIV-Positive Adolescents in South Africa

November 2016 - Structural Prevention

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Toska, T., Cluver, L.D., Boyes, M.E., Isaacsohn, M., Hodes, R., and Sherr, L. AIDS and Behavior (September 2016), doi:10.1007/s10461-016-1539-y.

The study examined the impact of social protection provisions on unprotected sex among 1,060 HIV-positive adolescents eligible for treatment. Nine different types of social protection provisions were included. Cash/cash in-kind provisions comprised social cash transfers, past-week food security, free education, free food in school, and free clothing. Psychosocial provisions comprised positive parenting, strong parental supervision, support groups, and adolescent-sensitive care. Results showed that 18 percent of adolescents reported condomless sex at last intercourse; girls reported significantly higher rates of condomless sex than boys did. Among adolescents who provided a viral load, it was found that viral failure was strongly associated with condomless sex, indicating high risk of HIV transmission. Adolescents who received free education, strong parental supervision, and (particularly for girls) adolescent-sensitive care were less likely to have unprotected sex. The findings also indicated that adolescents exposed to free school, strong parental supervision, and adolescent-sensitive care were least likely to have condomless sex when exposed to all three of these interventions, and were incrementally more likely to have condomless sex when exposed to fewer social protection provisions.

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