Executive Summary

The Global Fund invested in a South African combination HIV prevention intervention for AGYW aged 10 to 24 years in ten priority districts in South Africa. The intervention was an intensive, comprehensive HIV prevention intervention that aims to use a combination prevention approach to reduce new HIV infections amongst AGYW. The HERStory Study, is an evaluation of the South African combination HIV-prevention intervention for Adolescent girls and young women (AGYW) conducted by the South African Medical Research Council (SAMRC) and partners. The primary objective of the HERStory Study was to determine the intervention impact on HIV incidence over a two-year period. Secondary objectives include assessing the intervention impact on the prevention of HIV risk behaviour and other sexually transmitted infections (STIs) and on the cognitions, behaviour, and social environments of AGYW.

The qualitative component of the HERStory study explored the lives, experiences and social contexts of adolescent girls and young women (AGYW) between the ages of 15 and 24 years, in relation to their sexual and reproductive health (SRH) and education. In addition, the qualitative component examined the impact of a South African combination HIV intervention on the cognitions, behaviour, and social environments of AGYW, perceived enablers and constraints of the intervention, as well as the perceptions of its impact. Qualitative methods complemented a larger quantitative evaluation1 by providing in-depth insight into perceived successes and failures of the intervention package components on target outcomes, the facilitators and barriers to uptake of the different intervention components, and perceptions of the way in which the intervention affected the lives of AGYW, and the communities in which they live. The narratives of AGYW described in the HERStory qualitative evaluation provide insight into aspects of the social environment that influence decision-making around sexuality, condom and contraceptive use, and other sexual and reproductive health issues, as well as school attendance and completion, amongst AGYW in South Africa, and can help to inform the design of future interventions.

The qualitative study sample included AGYW recipients of the intervention, as well as AGYW in the intervention communities who were not engaged in intervention activities. In addition, the sample included other key informants such as parents/caregivers, male peers, teachers, club facilitators, and community leaders in the intervention communities. A sample of programme implementers were also interviewed about implementation challenges and successes.

Key findings presented in this report have been arranged into two main thematic areas: 1) Understanding the context of AGYW SRH and lives; 2) Impact of the Intervention.

View the complete HERStory: An evaluation of a South African combination HIV prevention intervention for adolescent girls and young women report