Introduction
Advances in biomedical
technologies provide potential for adolescent HIV prevention and HIV-positive
survival. The UNAIDS 90–90–90 treatment targets provide a new roadmap for
ending the HIV epidemic, principally through antiretroviral treatment, HIV
testing and viral suppression among people with HIV. However, while imperative,
HIV treatment and testing will not be sufficient to address the epidemic among
adolescents in Southern and Eastern Africa. In particular, use of condoms and
adherence to antiretroviral therapy (ART) remain haphazard, with evidence that
social and structural deprivation is negatively impacting adolescents’ capacity
to protect themselves and others. This paper examines the evidence for and
potential of interventions addressing these structural deprivations.
Discussion
New evidence is emerging
around social protection interventions, including cash transfers, parenting
support and educational support (“cash, care and classroom”). These
interventions have the potential to reduce the social and economic drivers of
HIV risk, improve utilization of prevention technologies and improve adherence
to ART for adolescent populations in the hyper-endemic settings of Southern and
Eastern Africa. Studies show that the integration of social and economic
interventions has high acceptability and reach and that it holds powerful
potential for improved HIV, health and development outcomes.
Conclusions
Social protection is a
largely untapped means of reducing HIV-risk behaviours and increasing uptake of
and adherence to biomedical prevention and treatment technologies. There is now
sufficient evidence to include social protection programming as a key strategy
not only to mitigate the negative impacts of the HIV epidemic among families,
but also to contribute to HIV prevention among adolescents and potentially to
remove social and economic barriers to accessing treatment. We urge a further
research and programming agenda: to actively combine programmes that increase
availability of biomedical solutions with social protection policies that can
boost their utilization.
Below: Impacts of cash and care provision on HIV-risk behaviour among adolescents in South Africa (marginal effects models, controlling for covariates)
Full article at: http://goo.gl/6TM8hV
By: Lucie D Cluver,§,1,2 Rebecca J Hodes,3,4 Lorraine Sherr,5 F Mark Orkin,6 Franziska Meinck,1 Patricia Lim Ah Ken,7Natalia E Winder-Rossi,8 Jason Wolfe,9 and Marissa Vicari10
1Centre for Evidence-Based Intervention,
Department of Social Policy & Intervention, University of Oxford, Oxford,
UK
2Department of Psychiatry and Mental
Health, University of Cape Town, Cape Town, South Africa
3AIDS and Society Research Unit, Centre for
Social Science Research, University of Cape Town, Cape Town, South Africa
4Department of Historical Studies,
University of Cape Town, Cape Town, South Africa
5Health Psychology Unit, Department of
Infection & Population Health, University College London, London, UK
6School of Clinical Medicine and DST-NRF
Centre of Excellence in Human Development, University of the Witwatersrand,
Johannesburg, South Africa
7HIV and AIDS Section, UNICEF, New York,
USA
8UNICEF Regional Office for Eastern and
Southern Africa, Nairobi, Kenya
9Office of HIV/AIDS, Bureau for Global
Health, US Agency for International Development, Washington, DC, USA
10Collaborative Initiative for Paediatric
HIV Education and Research (CIPHER), International AIDS Society, Geneva,
Switzerland
§Corresponding author: Lucie D Cluver, Centre for Evidence-Based
Interventions, Department of Social Policy and Intervention, University of
Oxford, Barnett House, 32 Wellington Square, Oxford OX1 2ER, UK. Tel:
+44(0)1865 270325. (Email: ku.ca.xo.ips@revulC.eicuL)
More at: https://twitter.com/hiv_insight
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