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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Public Health | doi: 10.3389/fpubh.2019.00336

How does the HIV prevention landscape look and change with diverse HIV prevention interventions for adolescents and young adults in rural KwaZulu-Natal?

 Thembelihle Zuma1*,  Janet Seeley1, 2,  Lindiwe O. Sibiya1, Natsayi Chimbindi1, Isolde Birdthistle2, Lorraine Sherr3 and Maryam Shahmanesh1, 3
  • 1Africa Health Research Institute (AHRI), South Africa
  • 2London School of Hygiene and Tropical Medicine, University of London, United Kingdom
  • 3University College London, United Kingdom

In sub-Saharan Africa, adolescents and young adults aged 15-24 years constitute 36% of an estimated 1.3 million new HIV infections. Complex biological, social, behavioural and structural factors, as well as cultural norms contribute to whether and how young people perceive, are aware of and experience diverse HIV interventions. This qualitative study explored experiences and perceptions of intervention types among adolescents and young adults, and how different interventions could hinder or facilitate HIV treatment and prevention for adolescents and young adults in rural KwaZulu-Natal, South Africa.
Data were collected as part of a DREAMS impact evaluation at the Africa Health Research Institute, KwaZulu-Natal between May 2017 – January 2018. We used a combination of rapid community mapping and participant observation in 4 communities, 58 individual interviews, and 10 group discussions with 61 participants, conducted with both adolescent girls and young women and adolescent boys and young men. Thematic analysis focused on the changing HIV prevention landscape as experienced by adolescents and young adults.
Participants reported a mix of new and old biomedical, behavioural, traditional and locally-developed HIV prevention approaches. The appeal of the newer approaches depended on the extent to which they resonated with existing traditional and longstanding HIV prevention methods and the extent to which they engaged with adolescents and young adults’ sexual experiences and with the social and structural factors including gender-related issues. These data demonstrate that in this context, newer methods and approaches can and should synergise with existing methods and beliefs.
The HIV prevention landscape is evolving rapidly. Good community links and engagement offer an alternative support structure that could embrace both locally-developed approaches and traditional practices This structure could potentially support feasibility and acceptability of new and old HIV prevention approaches, without creating an impression that new approaches always need to replace the old.

Keywords: HIV interventions, HIV Prevention Landscape, adolescents, Rural kwaZulu-Natal, South Africa

Received: 18 Jul 2019; Accepted: 25 Oct 2019.

Copyright: © 2019 Zuma, Seeley, Sibiya, Chimbindi, Birdthistle, Sherr and Shahmanesh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Thembelihle Zuma, Africa Health Research Institute (AHRI), Durban, South Africa, thembelihle.zuma@ahri.org