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    School, Supervision and Adolescent-Sensitive Clinic Care: Combination Social Protection and Reduced Unprotected Sex Among HIV-Positive Adolescents in South Africa

    245734_245734.pdf (524.6Kb)
    Access Status
    Open access
    Authors
    Toska, E.
    Cluver, L.
    Boyes, Mark
    Isaacsohn, M.
    Hodes, R.
    Sherr, L.
    Date
    2016
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Toska, E. and Cluver, L. and Boyes, M. and Isaacsohn, M. and Hodes, R. and Sherr, L. 2016. School, Supervision and Adolescent-Sensitive Clinic Care: Combination Social Protection and Reduced Unprotected Sex Among HIV-Positive Adolescents in South Africa. AIDS and Behavior. 2016: pp. 1-14.
    Source Title
    AIDS and Behavior
    DOI
    10.1007/s10461-016-1539-y
    ISSN
    1090-7165
    School
    School of Psychology and Speech Pathology
    Remarks

    This open access article is distributed under the Creative Commons license http://creativecommons.org/licenses/by/4.0/

    URI
    http://hdl.handle.net/20.500.11937/29341
    Collection
    • Curtin Research Publications
    Abstract

    © 2016 The Author(s). Social protection can reduce HIV-risk behavior in general adolescent populations, but evidence among HIV-positive adolescents is limited. This study quantitatively tests whether social protection is associated with reduced unprotected sex among 1060 ART-eligible adolescents from 53 government facilities in South Africa. Potential social protection included nine ‘cash/cash-in-kind’ and ‘care’ provisions. Analyses tested interactive/additive effects using logistic regressions and marginal effects models, controlling for covariates. 18 % of all HIV-positive adolescents and 28 % of girls reported unprotected sex. Lower rates of unprotected sex were associated with access to school (OR 0.52 95 % CI 0.33–0.82 p = 0.005), parental supervision (OR 0.54 95 % CI 0.33–0.90 p = 0.019), and adolescent-sensitive clinic care (OR 0.43 95 % CI 0.25–0.73 p = 0.002). Gender moderated the effect of adolescent-sensitive clinic care. Combination social protection had additive effects amongst girls: without any provisions 49 % reported unprotected sex; with 1–2 provisions 13–38 %; and with all provisions 9 %. Combination social protection has the potential to promote safer sex among HIV-positive adolescents, particularly girls.

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