This document summarizes a study evaluating the Siyakha Nentsha program, an adolescent HIV prevention program in South Africa that provides HIV education, social support, and financial capability training. The program aims to improve well-being and reduce HIV risk among at-risk youth. Early results found that females in the program felt more powerful, participants had greater awareness of social grants and confidence in condom use, and sexual behaviors were less influenced by drugs/alcohol. Male participants also reported a reduction in the number of sexual partners in the last year. Qualitative feedback from participants was positive, finding the program built life skills and confidence to pursue their goals. More analysis of long term outcomes is still needed.

1. Can financial education and social support enhance the effectiveness of an adolescent HIV prevention program?Evidence from the Siyakha Nentsha program in KwaZulu-Natal Kelly Hallman, Eva Roca, Kasthuri Govender, Emmanuel Mbatha, Rob Pattman, DeeviaBhana, Mike Rogan, and Hannah Taboada Countdown to 2015: Challenging orthodoxies related to SRH and HIV London May 17, 2010

2. Setting Semi-rural KwaZulu Natal Poverty and income inequality Unemployment Early pregnancy Early school leaving HIV

3. Formative research: vulnerabilities associated with adolescent HIV risk behaviors Living in poverty Social isolation Orphaning Source: Hallman 2004, 2005, 2008a, 2008b, 2008c

4. Poorer more likely to sexually debut earlier Ever had sex: 14-16 year-olds Poor Non-poor Source: Hallman 2005, 2008a

5. Those with less social capital more likely to experience forced sex Ever forced sex:14-16 year-old females Source: Hallman 2008a, 2008b

6. Orphans have more economically-motivated sexual encounters Ever traded sex: sexually debuted 14-16-year-olds Source: Hallman 2008a, 2008c

7. Possible protective factors Education Hope for the future Access to financial services and social grants Social support

8. Purpose Improve functional capabilities and well-being of adolescents at high risk for: HIV and STIs teenage pregnancy parenthood school dropout loss of one or both parents lack of knowledge of further employment and training opportunities

9. Program Methods and Sample Intervention Evidence-based In-school Multi-sectoral Participatory Intensive – multi-session Accredited

10. Randomization HIV education, social support + financial capabilities HIV education and social support Delayed intervention

11. Some very early results

12. How powerful do you feel? Males Females

13. Awareness of social grants Males Females

14. Very or somewhat confident know how to use a condom correctly Males * Females

15. Have drugs or alcohol affected your sexual decisionmaking in the last 12 months? Males * Females

16. Partner reduction-mean # in last year Males Females

17. Summary Females feel more powerful More awareness of social grants More confidence in condom use Sexual behavior less influenced by drugs/alcohol Partner reduction among males

18. “It’s different, in school we learn mathematics and biology but here we learn things that we can use in the future.” - female age 16

19. Participant views “….. I didn’t understand about HIV and AIDS before but now I do. I didn’t learn that in school.” –female age 20 years “It changed my attitude, because I know how to use a condom and I know how to trust my partner and I know how to advise my partner, when we are sitting together and talking about, how to have sexual intercourse and I know even to advise the community as a whole about HIV/AIDS…”–male age 22 years

20. What the learners say about the program It is good for young people like me because it teaches about things that happen in real life. Respecting and honoring the life you have and people around you and know that you have a precious life. I can express my ideas to others. I can plan for the future Steps necessary to pursue my goals To make a plan and stick to it. It made me realize I had a bright future What happens now determines my future I failed this grade but didn’t give up It builds my self-esteem I am confident Isihlanguprlogramme is teaching us a lot. We as young people need to be familiar with what is going on in our lives. It is a very good programme. How important it is to plan for everything you intend to do I have now decided to study and finish school first, rather than planning for family although I have on baby already To be prepared for any challenges or circumstances that may ever come In order to have a brighter future it starts now and plan what you are going to do with your life Knowing everything made me become more assertive I am planning high and also work hard to achieve my goals

21. Selected resources Hallman, K. 2008a.“Researching the determinants of vulnerability to HIV amongst adolescents,” IDS Bulletin, 39(5), November 2008. Hallman, K. 2008b, in press. “Social exclusion: The gendering of adolescent HIV risks in KwaZulu-Natal, South Africa,” in J. Klot and V. Nguyen eds., The Fourth Wave: An Assault on Women - Gender, Culture and HIV in the 21st Century. Social Science Research Council and UNESCO. Hallman, K. 2008c, under review. "Orphanhood Type and Sexual Debut: A panel study from KwaZulu-Natal, South Africa," Economic Development and Cultural Change. Bruce, J. and Hallman, K. 2008. “Reaching the girls left behind,” Gender & Development, 16(2): 227-245. Hallman, K. 2007. “Nonconsensual sex, school enrollment and educational outcomes in South Africa,” Africa Insight (special issue on Youth in Africa), 37(3): 454-472. Hallman, K. Genderedsocioeconomic conditions and HIV riskbehavioursamongyoung people in South Africa. 2005. African Journal of AIDS Research 4(1): 37–50.Abstract: http://www.popcouncil.org/projects/abstracts/AJAR_4_1.html

22. Much more analysis to come Some promising indications already More disaggregation Age, orphan status, household poverty, personal assets, etc. More outcomes Aspirations, financial beliefs and behaviors, gender attitudes, partner violence, empowerment Regressions Round 3?

23. Thank you! Our funders: DFID via the ABBA RPC & ESRC/Hewlett Joint Scheme