The Young Women's Health CoOp in Cape Town, South Africa: Study protocol for a cluster-randomised trial for adolescent women at risk for HIV

Background: South Africa remains the global epicentre of HIV infection, and adolescent women have the highest incidence of HIV in the country. South Africa also has high rates of alcohol and other drug (AOD) use, violence, and gender inequality. Violence converges with AOD use, gender inequities and...

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Main Authors: Wechsberg, W.M., Browne, F.A., Carney, T., Myers-Franchi, Bronwyn, Minnis, A., MacDonald, R., Ndirangu, J.W., Turner, L.B., Howard, B.N., Rodman, N.
Format: Journal Article
Language:English
Published: BMC 2018
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/85645
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author Wechsberg, W.M.
Browne, F.A.
Carney, T.
Myers-Franchi, Bronwyn
Minnis, A.
MacDonald, R.
Ndirangu, J.W.
Turner, L.B.
Howard, B.N.
Rodman, N.
author_facet Wechsberg, W.M.
Browne, F.A.
Carney, T.
Myers-Franchi, Bronwyn
Minnis, A.
MacDonald, R.
Ndirangu, J.W.
Turner, L.B.
Howard, B.N.
Rodman, N.
author_sort Wechsberg, W.M.
building Curtin Institutional Repository
collection Online Access
description Background: South Africa remains the global epicentre of HIV infection, and adolescent women have the highest incidence of HIV in the country. South Africa also has high rates of alcohol and other drug (AOD) use, violence, and gender inequality. Violence converges with AOD use, gender inequities and other disparities, such as poverty, to increase sexual risk and poor educational attainment for adolescent women. This study seeks to test the efficacy of peer recruitment and cofacilitation of the Young Women's Health CoOp (YWHC), a comprehensive gender-focused intervention to reduce HIV risk behaviours and increase the uptake of HIV counselling and testing (HCT) among out-of-school, adolescent women who use AODs. The YWHC is facilitated by local research staff and supported by peers. Methods: This cluster-randomised trial is enrolling participants into two arms: a control arm that receives standard HCT, and an intervention arm that receives the YWHC. Participants are enrolled from 24 economically disadvantaged communities in Cape Town, South Africa. These geographically distinct communities serve as clusters that are the units of randomisation. This study uses adolescent peer role models and research field staff to recruit marginalised adolescent women. At baseline, participants complete a questionnaire and biological testing for HIV, recent AOD use, and pregnancy. The core intervention is delivered in the month following enrollment, with linkages to health services and educational programmes available to participants throughout the follow-up period. Follow-up interviews and biological testing are conducted at 6 and 12 months post enrollment. Discussion: The study findings will increase knowledge of the efficacy of a comprehensive HCT, gender-focused programme in reducing AOD use, victimisation, and sexual risk behaviour and increase uptake services for out-of-school, adolescent women who use AODs. The trial results could lead to wider implementation of the YWHC for vulnerable adolescent women, a key population often neglected in health services. Trial registration: Trial registration no: NCT02974998, November 29, 2016.
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spelling curtin-20.500.11937-856452021-10-21T05:38:43Z The Young Women's Health CoOp in Cape Town, South Africa: Study protocol for a cluster-randomised trial for adolescent women at risk for HIV Wechsberg, W.M. Browne, F.A. Carney, T. Myers-Franchi, Bronwyn Minnis, A. MacDonald, R. Ndirangu, J.W. Turner, L.B. Howard, B.N. Rodman, N. Science & Technology Life Sciences & Biomedicine Public, Environmental & Occupational Health Adolescent women Alcohol and other drug use HIV prevention Gender-based violence School dropouts South Africa WOMAN-FOCUSED INTERVENTION HIGH-SCHOOL DROPOUT SUBSTANCE USE SEXUAL RISK CONDOM USE VIOLENCE PREVENTION STUDENTS ALCOHOL COUPLES Background: South Africa remains the global epicentre of HIV infection, and adolescent women have the highest incidence of HIV in the country. South Africa also has high rates of alcohol and other drug (AOD) use, violence, and gender inequality. Violence converges with AOD use, gender inequities and other disparities, such as poverty, to increase sexual risk and poor educational attainment for adolescent women. This study seeks to test the efficacy of peer recruitment and cofacilitation of the Young Women's Health CoOp (YWHC), a comprehensive gender-focused intervention to reduce HIV risk behaviours and increase the uptake of HIV counselling and testing (HCT) among out-of-school, adolescent women who use AODs. The YWHC is facilitated by local research staff and supported by peers. Methods: This cluster-randomised trial is enrolling participants into two arms: a control arm that receives standard HCT, and an intervention arm that receives the YWHC. Participants are enrolled from 24 economically disadvantaged communities in Cape Town, South Africa. These geographically distinct communities serve as clusters that are the units of randomisation. This study uses adolescent peer role models and research field staff to recruit marginalised adolescent women. At baseline, participants complete a questionnaire and biological testing for HIV, recent AOD use, and pregnancy. The core intervention is delivered in the month following enrollment, with linkages to health services and educational programmes available to participants throughout the follow-up period. Follow-up interviews and biological testing are conducted at 6 and 12 months post enrollment. Discussion: The study findings will increase knowledge of the efficacy of a comprehensive HCT, gender-focused programme in reducing AOD use, victimisation, and sexual risk behaviour and increase uptake services for out-of-school, adolescent women who use AODs. The trial results could lead to wider implementation of the YWHC for vulnerable adolescent women, a key population often neglected in health services. Trial registration: Trial registration no: NCT02974998, November 29, 2016. 2018 Journal Article http://hdl.handle.net/20.500.11937/85645 10.1186/s12889-018-5665-5 English http://creativecommons.org/licenses/by/4.0/ BMC fulltext
spellingShingle Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Adolescent women
Alcohol and other drug use
HIV prevention
Gender-based violence
School dropouts
South Africa
WOMAN-FOCUSED INTERVENTION
HIGH-SCHOOL DROPOUT
SUBSTANCE USE
SEXUAL RISK
CONDOM USE
VIOLENCE
PREVENTION
STUDENTS
ALCOHOL
COUPLES
Wechsberg, W.M.
Browne, F.A.
Carney, T.
Myers-Franchi, Bronwyn
Minnis, A.
MacDonald, R.
Ndirangu, J.W.
Turner, L.B.
Howard, B.N.
Rodman, N.
The Young Women's Health CoOp in Cape Town, South Africa: Study protocol for a cluster-randomised trial for adolescent women at risk for HIV
title The Young Women's Health CoOp in Cape Town, South Africa: Study protocol for a cluster-randomised trial for adolescent women at risk for HIV
title_full The Young Women's Health CoOp in Cape Town, South Africa: Study protocol for a cluster-randomised trial for adolescent women at risk for HIV
title_fullStr The Young Women's Health CoOp in Cape Town, South Africa: Study protocol for a cluster-randomised trial for adolescent women at risk for HIV
title_full_unstemmed The Young Women's Health CoOp in Cape Town, South Africa: Study protocol for a cluster-randomised trial for adolescent women at risk for HIV
title_short The Young Women's Health CoOp in Cape Town, South Africa: Study protocol for a cluster-randomised trial for adolescent women at risk for HIV
title_sort young women's health coop in cape town, south africa: study protocol for a cluster-randomised trial for adolescent women at risk for hiv
topic Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Adolescent women
Alcohol and other drug use
HIV prevention
Gender-based violence
School dropouts
South Africa
WOMAN-FOCUSED INTERVENTION
HIGH-SCHOOL DROPOUT
SUBSTANCE USE
SEXUAL RISK
CONDOM USE
VIOLENCE
PREVENTION
STUDENTS
ALCOHOL
COUPLES
url http://hdl.handle.net/20.500.11937/85645