Pregnancy and STI/HIV prevention intervention preferences of South African adolescent girls: findings from a cultural consensus modelling qualitative study

Abstract

South African adolescent girls experience high rates of unintended pregnancy and sexually transmitted infections including HIV. To inform culturally-tailored dual protection interventions to prevent both unintended pregnancy and STIs/HIV, this study qualitatively examined girls’ sexual health intervention preferences. Participants were aged 14–17 years old and Sesotho-speaking (N = 25). To elucidate shared cultural beliefs, individual interviews examined participants’ perceptions about other adolescent girls’ pregnancy and STI/HIV prevention intervention preferences. Interviews were conducted in Sesotho and translated into English. Two independent coders identified key themes in the data using a conventional content analysis approach with discrepancies resolved by a third coder. Participants indicated that intervention content should include efficacious pregnancy and STI/HIV prevention methods and ways to navigate peer pressure. Interventions should be accessible, avoid criticism and provide high-quality information. Preferred intervention formats included online, SMS/text, or delivery by social workers or older, knowledgeable peers, with mixed acceptability for delivery by parents or same-age peers. Schools, youth centres and sexual health clinics were preferred intervention settings. Results highlight the importance of cultural context in tailoring dual protection interventions to address the reproductive health disparities among adolescent girls in South Africa.

Keywords:

• Culture
• health disparities
• intervention
• sexual health
• dual method use

Acknowledgements

We are grateful to participants for sharing their experiences with us. We thank school partners and the research staff for their critical contributions.

Disclosure statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Additional information

Funding

This study was funded by the Bill & Melinda Gates Foundation (OPP1161907; principal investigator: Jennifer L. Brown). The project described was also supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (Award Number UL1TR000077).