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Research article
Tracy McClinton Appollis
Health Systems Research Unit, South African Medical Research Council, PO Box 19070, Tygerberg, Cape Town, 7505, South Africa. 2 Adolescent Health Research Unit, Division of Child & Adolescent Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700, South Africa.
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3982-4555
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: For interventions to reach those they are intended for, an understanding of the factors that influence their participation, as well as the facilitators and barriers of participation are needed. This study explores factors associated with participation in a combination HIV prevention intervention targeting adolescent girls and young women (AGYW) aged 15–24-years-old, as well as the experiences of AGYW, intervention implementers, and facilitators who participated in this intervention.
Methods: This study used mixed-methods approach with quantitative household survey data from 4399 AGYW aged 15-24-years-old in six of the ten districts in which the intervention was implemented. In addition, qualitative methods included semi-structured in-depth interviews and focus group discussions in five of the ten intervention districts with 185 AGYW who participated in one or more of the key components of the intervention, and 13 intervention implementers and 13 facilitators.
Results: Findings reveal that almost half of AGYW (48.4%) living in the districts where the intervention took place, participated in at least one of the components of the intervention. For both 15-19-year-olds and 20-24-year-olds, factors associated with increased participation in the intervention included being HIV negative, in school, never been pregnant, and having had a boyfriend. Experiencing intimate partner violence (IPV) and/or sexual violence in the past 12 months was associated with increased levels of participation in the intervention for 20-24-year-olds only. In our analysis of the qualitative data, facilitators to participation included motivating participants to join the interventions through explaining the benefits of the programme. Barriers included misguided expectations about financial rewards or job opportunities; competing responsibilities, interests or activities; family responsibilities including childcare; inappropriate incentives; inability to disrupt the school curriculum and difficulties with conducting interventions after school hours due to safety concerns; miscommunication about meetings; as well as struggles to reach out-of-school AGYW.
Conclusion: Designers of combination HIV prevention interventions need to address the structural barriers to participation so that AGYW can attend without risking their safety and compromising their family, childcare and schooling responsibilities. Strategies to create demand need to include clear communication about the nature and potential benefits of such interventions, and the inclusion of valued incentives.
Keywords
participation, intervention, recruitment, retention, girls, women, South Africa, HIV
This is a list of supplementary files associated with this preprint. Click to download.
- Additionalfile2.pdf
• File name: Additional file 2 • Title of data: HERStory Survey for YWG aged 15-24 (English) • Description of data: The full questionnaire for the quantitative HERStory study for AGYW aged 15-24 years
- Additionalfile1.pdf
• File name: Additional file 1 • Title of data: COREQ template • Description of data: Consolidated criteria for reporting qualitative studies (COREQ): 32-item checklist
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CURRENT STATUS: Published
View the published article at BMC Public Health.
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Editorial decision: Accept
On 16 Feb, 2021
Editor assigned
On 09 Dec, 2020
Submission checks complete
On 09 Dec, 2020
Editor invited
On 09 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 06 Dec, 2020
Editor assigned
On 21 Nov, 2020
Submission checks complete
On 21 Nov, 2020
Editor invited
On 21 Nov, 2020
No comments provided
Editor assigned
On 27 Oct, 2020
Editorial decision: Major revision
On 27 Oct, 2020
Submission checks complete
On 26 Oct, 2020
Editor invited
On 26 Oct, 2020
No comments provided
Editorial decision: Major revision
On 25 Oct, 2020
Editor assigned
On 14 Oct, 2020
Submission checks complete
On 13 Oct, 2020
Editor invited
On 13 Oct, 2020
Version 1
Posted 25 Aug, 2020
No comments provided
Editorial decision: Major revision
On 02 Oct, 2020
Review #2 received
Received 29 Sep, 2020
Review #1 received
Received 19 Sep, 2020
Reviewer #1 agreed
On 28 Aug, 2020
Reviewer #2 agreed
On 28 Aug, 2020
Reviewers invited
Invitations sent on 27 Aug, 2020
First submitted
On 12 Aug, 2020
Editor assigned
On 12 Aug, 2020
Submission checks complete
On 11 Aug, 2020
Editor invited
On 11 Aug, 2020
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A new preprint design is coming!
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See the published version of this preprint at BMC Public Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Tracy McClinton Appollis
Health Systems Research Unit, South African Medical Research Council, PO Box 19070, Tygerberg, Cape Town, 7505, South Africa. 2 Adolescent Health Research Unit, Division of Child & Adolescent Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700, South Africa.
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3982-4555
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Public Health.
No community comments so far
Editorial decision: Accept
On 16 Feb, 2021
Editor assigned
On 09 Dec, 2020
Submission checks complete
On 09 Dec, 2020
Editor invited
On 09 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 06 Dec, 2020
Editor assigned
On 21 Nov, 2020
Submission checks complete
On 21 Nov, 2020
Editor invited
On 21 Nov, 2020
No comments provided
Editor assigned
On 27 Oct, 2020
Editorial decision: Major revision
On 27 Oct, 2020
Submission checks complete
On 26 Oct, 2020
Editor invited
On 26 Oct, 2020
No comments provided
Editorial decision: Major revision
On 25 Oct, 2020
Editor assigned
On 14 Oct, 2020
Submission checks complete
On 13 Oct, 2020
Editor invited
On 13 Oct, 2020
Version 1
Posted 25 Aug, 2020
No comments provided
Editorial decision: Major revision
On 02 Oct, 2020
Review #2 received
Received 29 Sep, 2020
Review #1 received
Received 19 Sep, 2020
Reviewer #1 agreed
On 28 Aug, 2020
Reviewer #2 agreed
On 28 Aug, 2020
Reviewers invited
Invitations sent on 27 Aug, 2020
First submitted
On 12 Aug, 2020
Editor assigned
On 12 Aug, 2020
Submission checks complete
On 11 Aug, 2020
Editor invited
On 11 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
Background: For interventions to reach those they are intended for, an understanding of the factors that influence their participation, as well as the facilitators and barriers of participation are needed. This study explores factors associated with participation in a combination HIV prevention intervention targeting adolescent girls and young women (AGYW) aged 15–24-years-old, as well as the experiences of AGYW, intervention implementers, and facilitators who participated in this intervention.
Methods: This study used mixed-methods approach with quantitative household survey data from 4399 AGYW aged 15-24-years-old in six of the ten districts in which the intervention was implemented. In addition, qualitative methods included semi-structured in-depth interviews and focus group discussions in five of the ten intervention districts with 185 AGYW who participated in one or more of the key components of the intervention, and 13 intervention implementers and 13 facilitators.
Results: Findings reveal that almost half of AGYW (48.4%) living in the districts where the intervention took place, participated in at least one of the components of the intervention. For both 15-19-year-olds and 20-24-year-olds, factors associated with increased participation in the intervention included being HIV negative, in school, never been pregnant, and having had a boyfriend. Experiencing intimate partner violence (IPV) and/or sexual violence in the past 12 months was associated with increased levels of participation in the intervention for 20-24-year-olds only. In our analysis of the qualitative data, facilitators to participation included motivating participants to join the interventions through explaining the benefits of the programme. Barriers included misguided expectations about financial rewards or job opportunities; competing responsibilities, interests or activities; family responsibilities including childcare; inappropriate incentives; inability to disrupt the school curriculum and difficulties with conducting interventions after school hours due to safety concerns; miscommunication about meetings; as well as struggles to reach out-of-school AGYW.
Conclusion: Designers of combination HIV prevention interventions need to address the structural barriers to participation so that AGYW can attend without risking their safety and compromising their family, childcare and schooling responsibilities. Strategies to create demand need to include clear communication about the nature and potential benefits of such interventions, and the inclusion of valued incentives.
This is a list of supplementary files associated with this preprint. Click to download.
- Additionalfile2.pdf
• File name: Additional file 2 • Title of data: HERStory Survey for YWG aged 15-24 (English) • Description of data: The full questionnaire for the quantitative HERStory study for AGYW aged 15-24 years
- Additionalfile1.pdf
• File name: Additional file 1 • Title of data: COREQ template • Description of data: Consolidated criteria for reporting qualitative studies (COREQ): 32-item checklist
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