Effects of Cash Transfer and Community Mobilization in Young South African Women

描述（由申请人提供）：我们提议确定一种创新的、多层次的艾滋病预防干预措施的效果，该干预措施将共同解决导致年轻女性更易感染艾滋病的结构性和社会因素。我们建议向年轻妇女的家庭提供现金转移，条件是年轻妇女上学，目的是通过改善其家庭经济资源（结构性因素）使其继续上学，从而降低年轻妇女感染艾滋病毒的风险。结构层面的干预将辅以社区层面的动员干预，重点是让青年男子参与性别规范和艾滋病毒风险问题，并鼓励他们采取行动保护青年妇女，减少其社区中的艾滋病毒风险。这项研究将在南非姆普马兰加省农村Bushbuckridge的Agincourt分区进行。大约有84,000人居住在阿金库尔的25个村庄，该地区是一个家庭人口监测点（阿金库尔HDSS）。我们将使用AHDSS作为平台，从中确定符合条件的家庭和年轻妇女进行现金转移干预（目标1）。年轻女性将在九年级结束时被招募，并随机分配到干预措施中（n=200/组），以出勤率为条件向家庭提供现金转移。现金转移将提供3年（直到预计完成高中学业，12年级）。为了检查有条件现金转移的效果，年轻妇女将在基线时接受访谈，然后每12个月接受一次访谈，直到干预结束（基线后3年）。在确定家庭进行现金转移干预后，将随机分配村庄接受社区动员干预（目标2）。我们将选择社区动员者（15名），他们将在干预村（12名）开展动员活动，包括一对一接触、研讨会和社区活动，以提高对负面性别规范和艾滋病毒风险作用的认识，并鼓励年轻男性和社区成员采取行动，降低年轻女性的艾滋病毒风险。为了评估社区动员干预对性别规范和性行为变化的影响，我们将从25个村庄中选择18-35岁的年轻人样本，我们将在基线和基线后3年对他们进行调查。我们还将评估现金转移干预和社区动员干预对年轻女性的综合影响（目标3）。

DESCRIPTION (provided by applicant): We propose to determine the effect of an innovative, multi-level HIV prevention intervention that will jointly address both structural and social factors that contribute to young women's increased vulnerability to HIV. We propose providing cash transfers to the families of young women conditional on the young women attending school with the goal of reducing the young women's HIV risk by keeping her in school by improving her family's economic resources (structural factors). The structural level intervention will be complemented by a community level mobilization intervention focused on engaging young men around the issues of gender norms and HIV risk and encouraging them to take action to protect young women and reduce HIV risk in their communities. This study will be situated in the Agincourt sub-district of Bushbuckridge of rural Mpumalanga Province in South Africa. Approximately 84,000 individuals live in Agincourt in 25 villages, and the area is a Households Demographic Surveillance Site (Agincourt HDSS). We will use the AHDSS as the platform from which we will identify eligible households and young women for the cash transfer intervention (Aim 1). Young women will be recruited at the end of grade 9 and randomly allocated to the intervention (n=200/arm), a cash transfer to the household conditional on school attendance. The cash transfer will be provided for 3 years (until the expected completion of high school, grade 12). To examine the effect of the conditional cash transfers, young women will be interviewed at baseline and then every 12 months until the end of the intervention (3 years post baseline). After households are identified for the cash transfer intervention, villages will be randomized to receive the community mobilization intervention (Aim 2). We will select community mobilizers (n=15) who will conduct mobilization activities in the intervention villages (n=12), including one-on-one contact, workshops and community events to promote awareness around the role of negative gender norms and HIV risk and to encourage young men and community members to take action to reduce young women's HIV risk. To assess the effect of the community mobilization intervention on changes in gender norms and sexual behavior, we will select a sample of young people (age 18-35) from the 25 villages in whom we will conduct a survey at baseline and 3 years post baseline. We will also assess the combined effect of the cash transfer intervention and community mobilization intervention in young women (Aim 3).