Social Protection and HIV risk Factors among Youth in Southern Africa: An Analysis of Cross-sectional Population-based HIV Impact Assessment Surveys.

Journal: AIDS and behavior

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Affiliated Institutions:  United Nations Population Fund, West and Central African Regional Office, Immeuble Wolle Ndiaye, Almadies, Dakar, Senegal. Division of Infectious Diseases, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, USA. Makerere University Lung Institute, Division of Pulmonology at Kiruddu National Referral Hospital, Kampala, Uganda. Adolescent Accelerate Research Hub, Centre for Social Science Research, University of Cape Town, Cape Town, South Africa. spdzumbunu@outlook.com. Centre for Addiction and Mental Health, Toronto, Canada. Joint United Nations Programme on HIV/AIDS, Windhoek, Namibia. Curtin School of Population Health, Curtin University, Curtin, Australia.

Abstract summary 

Poverty fuels risky sexual behaviors associated with HIV infection among youth. Interventions like cash transfers may mitigate HIV risk. We explored the role of broader social protection (including food, educational, and social transfers) in reducing HIV risk among 15-24-year-olds in Southern Africa. We analyzed Population-based HIV Impact Assessment surveys data from 31,317 youth in eSwatini, Lesotho, Malawi, Namibia, Zambia, and Zimbabwe (2015-2017). Using inverse probability-weighted multivariable logistic regression, we examined associations between types of social protection and condomless sex, multiple partnerships, and high-risk sexual behaviors. Food support was associated with reduced odds of condomless sex (OR 0.71 [95% CI 0.61-0.82]), multiple partnerships (0.77 [0.63-0.95]), and high-risk sex (0.70 [0.60-0.82]). Educational support was associated with reduced odds of condomless sex (0.57 [0.46-0.59]) and high-risk sex (0.59 [0.47-0.73]). Social transfers were associated with reduced odds of condomless sex (0.62 [0.54-0.70]) and high-risk sex (0.50 [0.44-0.56]). The benefits of social protection varied across countries. Educational support was associated with reduced odds of any HIV risk factors in eSwatini, Zambia, and Zimbabwe. However, the protective effect of social transfers was only observed in eSwatini, and the benefit of food support was only significant in Namibia. Furthermore, protective associations were more pronounced among females than males. This study underscores the potential of social protection to strengthen HIV prevention efforts by mitigating poverty-related risk factors, particularly for adolescent girls and young women in Southern Africa. The impact of specific programs appears context-dependent, highlighting the need for tailored interventions.

Authors & Co-authors:  Banougnin Boladé Hamed BH Castor Delivette D Baluku Joseph Baruch JB Dzumbunu Silinganisiwe Padline SP Somefun Oluwaseyi Dolapo OD Sene Waly W Chipanta David D Hertzog Lucas L

Study Outcome 

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Citations :  Karim SSA, Baxter C. HIV incidence rates in adolescent girls and young women in sub-saharan Africa. Lancet Glob Health. 2019;7(11):e1470–1.
Authors :  8
Identifiers
Doi : 10.1007/s10461-025-04638-6
SSN : 1573-3254
Study Population
Women,Girls,Females
Mesh Terms
Other Terms
Adolescents and young people;HIV risk;Social protection;Southern african countries
Study Design
Cross Sectional Study
Study Approach
Country of Study
Namibia
Publication Country
United States