An inter-disciplinary approach to understanding and intervening on contextual factors that shape HIV-risk for young women and men in South Africa

Globally, and in South Africa in particular, HIV remains a major public health challenge. In KwaZulu-Natal Province, the functional epicentre of the global HIV-epidemic, young women and girls (18-24) are particularly at risk of acquiring HIV, and young men, are the only group in the country with an rising HIV-incidence. These high rates of HIV-acquisition are driven by harsh social contexts of poverty, inequitable gender norms, and widespread levels of violence, driven by the long legacy of apartheid. This project seems to achieve three aims: 1) to understand how social contexts shape young people's HIV-acquisition risk; 2) to develop an intervention to support young women and men to take control of their lives and HIV-acquisition risk; and 3) assess the feasibility, acceptability and potential impact of this intervention. To achieve aim 1 we will use unique existing quantitative data sets to understand how social contexts shape HIV-acquisition risk in young people and then undertake long-term participatory research with 16 youth peer research associates (YPRAs) hired from two sites in KwaZulu-Natal - urban informal settlements and rural KwaZulu-Natal. Through this we will understand in multiple ways how risk manifests itself. To achieve aim 2 we will work with the YPRAs and the team of researchers to develop an intervention with resonates with young women's and men's live. To achieve aim 3 we will undertake a pilot evaluation of the intervention, assessing quantitative and qualitatively whether the intervention was felt to be feasible and acceptable by young people, and whether it shows any evidence of effect. We will share results with the community through producing plain language summaries of the research we produce, and also a short video at endline, all in collaboration with the YPRAs.