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Randomized Controlled Trial
. 2020 Jun 26;20(1):1016.
doi: 10.1186/s12889-020-09115-4.

"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

Deborah Baron  1 , Fiona Scorgie  2 , Lethabo Ramskin  1 , Nomhle Khoza  1 , Jennifer Schutzman  3 , Anne Stangl  3 , Sheila Harvey  4   5 , Sinead Delany-Moretlwe  1 ; EMPOWER study team
Affiliations
Randomized Controlled Trial

"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

Deborah Baron et al. BMC Public Health. .

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 , 5 April 2020, retrospectively registered.

Keywords: Africa; Clubs; Empowerment; HIV prevention; PrEP; Young women.

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Conflict of interest statement

The authors declare that they have no competing interests.

References

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