MOAC0104 - Oral Abstract
Combination social protection halves HIV-risk behavior incidence amongst female and male South African adolescents
Presented by Lucie Cluver (South Africa).
L. Cluver1, M. Orkin2, M. Boyes3, L. Sherr4
1Oxford University & University of Cape Town, Social Policy and Intervention, Cape Town, South Africa, 2University of the Witwatersrand, School of Public and Development Management, Johannesburg, South Africa, 3Curtin University, School of Psychology and Speech Pathology, Perth, Australia, 4University College London, Royal Free and University College Medical School, London, United Kingdom
protection is emerging as a potentially powerful HIV-prevention tool for
adolescents. Evidence to date has focused on conditional or unconditional cash
transfers, with little known about effects of non-cash economic support (such
as food gardens, school feeding), or about combinations of economic and psychosocial
10-18 year-olds (f=56·7%; m=43.3%) were interviewed twice (baseline < 2.5%
refusal, one year follow-up 96.8% retention) in South Africa in a random
prospective observational study. All homes with a resident adolescent were
sampled, within randomly-selected census areas in two urban and two rural
districts in two provinces. Socio-demographic predictors of very high-risk
behavior (i.e. unprotected sex, transactional sex, multiple partners, sex
whilst using substances) were identified. Economic support included
unconditional government cash transfers, school feeding and food gardens.
Psychosocial support included positive parenting and teacher social support. Analyses
used hierarchical regression and log-linear models, controlling for
socio-demographics and prior HIV-risk behavior.
support alone predicted reduced incidence of HIV-risk behaviour for adolescent girls (OR .588, CI
.394-.876, p=.009), but not for boys, in prospective multivariate logistic
regression. Combined economic and psychosocial support predicted halved
incidence of HIV-risk behavior for girls (OR .484 CI.303-.773, p=.002) and also
for boys (OR .495 CI.300-.816, p=.006), compared to no support. Females
experiencing parental AIDS-mortality or morbidity (AIDS-affected) had increased
overall risk behavior. For these, combined economic and psychosocial support
showed amplified impact, with HIV-risk behavior reduced from 51.2% to 19.8%.
[Effects of combination social protection]
unconditional economic and psychosocial protection provision reduces HIV-risk
behavior for female and male adolescents in Southern Africa. Adolescence is a
period of heightened risk, but also of rapid cognitive and social development.
By targeting adolescent needs both for alleviation of severe poverty, and for
adult psychosocial support, social protection has potential for maximized
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