The province of KwaZulu Natal in South Africa is the hardest hit with HIV, with HIV prevalence rates at antenatal clinics estimated to be over 40 percent - about twice as high as the national prevalence. When combined with high rates of teenage pregnancy – about one-third of 18 and 19 year olds have already given birth - it is critical to address the social and economic factors that are contributing to this alarming situation. Data collected by the New York-based Population Council have shown that factors such as poverty, orphanhood, and social isolation can influence sexual behaviors, and therefore HIV risk.
I’ve come to KwaZulu Natal to visit a school-based program called Siyakha Nentsha, a Zulu phrase meaning “working with young people,” run by the Population Council with a local NGO called Isihlangu. The program is designed as a randomized experiment to provide vulnerable, high school students living in poor, peri-urban, HIV-affected communities with protective strategies against HIV and early pregnancy, and to build economic assets. By enhancing their financial skills – including how to budget, save, access social benefits, and plan for the future – and their knowledge about HIV/AIDS, especially by providing accurate information about HIV transmission and teaching skills for avoiding infection, the program works to address the real-life economic, social, and health challenges these young people face.
I have been speaking to students participating in the program, as well as the young people in their early 20s who come from the same communities and have been trained to implement the program as “facilitators.” One of the facilitators told me how the linkages between financial literacy and HIV are especially important for the girls: “Knowing how to save and invest, their money can grow, and they can sustain their way of living, as opposed to depending on many boyfriends [for money] and getting HIV.” Changes in outcomes, such as knowledge, attitudes, skills, and behavior, will be assessed in the coming months.
These young people face enormous challenges - in one school I visited, the principal said that approximately 30 percent of the teachers and the students were HIV-positive, and many girls in 11th and 12th grades have already had babies. I hope to come back again to see how these skills and messages have helped the students – as well as the facilitators - to keep themselves safe and healthy, and to build independent and productive futures.
Photos courtesy Kelly Hallman et al.