Women of Worth: the impact of a cash plus intervention to enhance attendance and reduce sexual health risks for young women in Cape Town, South Africa

Introduction Conditional cash transfers (CTs) augmented with other interventions are promising interventions for reducing HIV risk in adolescent girls and young women. Methods A multi‐phase, quasi‐experimental study assessed the impact of a CT (ZAR300; $22) conditional on attending a skills building...

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Published in:Journal of the International AIDS Society 2022-06, Vol.25 (6), p.e25938-n/a
Main Authors: Naledi, Tracey, Little, Francesca, Pike, Carey, Edwards, Harley, Robbertze, Dante, Wagner, Colleen, London, Leslie, Bekker, Linda‐Gail
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adolescent
Adolescents
AIDS
Biometrics
Cellular telephones
combination HIV interventions
Community
conditional cash transfer
COVID-19
Domestic violence
emerging adult women
Ethics
Female
Health risks
HIV
HIV Infections - epidemiology
HIV Infections - prevention & control
HIV/AIDS
Human immunodeficiency virus
Humans
Intervention
Intimate Partner Violence
Population
Questionnaires
Reproductive health
Retention
Risk factors
Sexual Behavior
Sexual Health
Sexually transmitted diseases
South Africa - epidemiology
STD
Young adults
young woman
youth
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Summary:Introduction Conditional cash transfers (CTs) augmented with other interventions are promising interventions for reducing HIV risk in adolescent girls and young women. Methods A multi‐phase, quasi‐experimental study assessed the impact of a CT (ZAR300; $22) conditional on attending a skills building intervention, Women of Worth (WoW), designed to improve sexual and reproductive health (SRH) outcomes in Cape Town, South Africa from May 2017 to December 2019. The intervention entailed 12 sessions with encouragement to attend adolescent and youth‐friendly health services. Women aged 19–24 years were randomized 1:1 to receive the intervention with a CT (“cash + care” or C+C) or without a CT (“care”). The study included a pilot phase followed by a post‐modification phase with improved uptake and retention without changing programme content or CT. Self‐reported HIV prevalence and SRH/HIV vulnerability were assessed via a self‐administered questionnaire at baseline, after 11 sessions, and 6–30 months’ post‐intervention for a subset. Mixed effect logistic regression models were fitted to estimate within‐subject changes in outcomes. Results Of 5116 participants, 904 (452 participants per arm) were in the pilot and 4212 (2039 “care” participants and 2173 “C+C” participants) were in the post modified phase. There were 1867 (85.9%) and 135 (6,6%) participants in the “C+C” group and the “Care,” respectively, that were WoW completers (≥ 11 sessions/retention). During the pilot phase, 194 (42.9%) and 18 (4.0%) participants in “C+C” and the “care” groups were retained. Receiving a CT sustained participation nearly 60‐fold (OR 60.37; 95% CI: 17.32; 210.50, p
ISSN:1758-2652
1758-2652
DOI:10.1002/jia2.25938