This document summarizes a study that evaluated the Siyakha Nentsha program, an adolescent HIV prevention program in South Africa that included financial education and social support components. The study found that adolescents living in poverty who lacked social connections were more vulnerable to HIV risk behaviors like early sexual debut. The purpose of the program was to improve adolescents' functional capabilities, well-being, and reduce risks of HIV, early pregnancy, and school dropout. The program provided evidence-based, multi-session lessons on HIV/RH/life skills and financial capabilities. Results showed the program increased knowledge of HIV, condom use, and empowerment, and reduced sexual risk behaviors and number of partners, especially among females.

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 Economic Empowerment and HIV meeting Washington, DC April 22, 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 Not socially connected Orphaned 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 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 Intervention Evidence-based Piloted Multi-sectoral Participatory Intensive – multi-session

10. Randomization HIV, RH, Life Skills HIV, RH, Life Skills + financial capabilities Delayed intervention

11. Research Methods Longitudinal survey Youth-conducted social mapping with presentations back to community Youth, parent, mentor focus groups to assess experience with intervention

13. Description of sample Age Household size Orphaning Sex Pregnancy Economic status Assets—household and personal Friendship networks Participation

14. How powerful do you feel? Males * Females*

15. Awareness of social grants Males * Females*

16. Know can get pregnant if you have sex only once Males females*

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

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

19. Talk to partner about avoiding or delaying sex Males Females

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

21. Partner reduction--% reduced to 1 or 0 Males females

22. This is only the beginning—much more analysis to come More disaggregation Age, orphan status, household poverty, personal assets, etc. More outcomes Gender attitudes, beliefs about partner violence, aspirations and how to achieve, financial beliefs and behaviors, more on empowerment Regressions Round 3?

23. “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

24. 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

25. 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

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